Drug & supplement interaction

Bismuth + Amoxicillin, Omeprazole Magnesium, Rifabutin

Amoxicillin, Omeprazole Magnesium, Rifabutin brand name: Talicia.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Bismuth has a moderate interaction with Amoxicillin, Omeprazole Magnesium, Rifabutin. Theoretically, concomitant use of bismuth and omeprazole may increase the effects and side effects of bismuth.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bismuth and Amoxicillin, Omeprazole Magnesium, Rifabutin

Here is the interaction we found between these two, with the evidence behind it.

Moderate

OMEPRAZOLE (Prilosec)

Theoretically, concomitant use of bismuth and omeprazole may increase the effects and side effects of bismuth.
In humans, omeprazole increases the absorption of bismuth from tripotassium dicitrato bismuthate. The area under the concentration-time curve (AUC) and urinary excretion (Ae) of bismuth have been shown to be higher when tripotassium dicitrato bismuthate is administered with omeprazole (172 ± 158 mcg/L/hour and 1.9 ± 2.0 mg per eight hours, respectively) compared with administration alone (46 ± 33 mcg/L/hour and 0.27 ± 0.28 mg per eight hours, respectively).
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's an interesting wrinkle with Talicia (which combines amoxicillin, omeprazole, and rifabutin). The omeprazole piece is what matters here. By lowering stomach acid, omeprazole can actually let your body absorb more bismuth if you take a separate bismuth product (like Pepto-Bismol) at the same time. Studies in people showed bismuth blood levels climbing noticeably when paired with omeprazole.

For most short-term use this isn't a big deal, but more bismuth in your system means a higher chance of bismuth-related effects, like darkened stools, a dark tongue, or, with heavier or longer use, the salicylate cautions that come with these products. Since bismuth is sometimes used in stomach-ulcer treatment anyway, the safest move is to check with your pharmacist or doctor before combining them regularly.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Treiber, G., Walker, S., and Klotz, U. Omeprazole-induced increase in the absorption of bismuth from tripotassium dicitrato bismuthate. Clin Pharmacol Ther 1994;55(5):486-491. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Bismuth Also Interacts With Other Medications

Bismuth has 124 moderate known drug interactions in our database — the Amoxicillin, Omeprazole Magnesium, Rifabutin one above is one of them. If you take anything else, check it against the full list below.

Moderate 124 No known interaction 2,706 (incl. Amoxicillin, Omeprazole Magnesium, Rifabutin)
Taking anything else?

Check Another of Your Medications Against Bismuth

Covers the 2,830 medications we’ve checked against Bismuth. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Amoxicillin, Omeprazole Magnesium, Rifabutin

This page covers Bismuth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Amoxicillin, Omeprazole Magnesium, Rifabutin page lists 250 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Grapefruit (major) and Khat (major).

By severity: 8 major · 193 moderate · 49 minor.

From our pharmacist’s overview on the Amoxicillin, Omeprazole Magnesium, Rifabutin page

“Talicia combines amoxicillin, omeprazole, and rifabutin in one capsule to clear H. pylori, and because success depends on all three staying at full strength, the supplements flagged here warrant genuine care rather than a quick skim.”

Reviewed by 2 · Jul 18, 2026

Open the Amoxicillin, Omeprazole Magnesium, Rifabutin interaction page

One more smart check

Taking Bismuth as Part of a Dietary Supplement Product? Check It for Interactions

We hold 65 real supplement products containing Bismuth, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bismuth. Your product may carry other ingredients that interact with Amoxicillin, Omeprazole Magnesium, Rifabutin too, on top of Bismuth — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Bismuth and Amoxicillin, Omeprazole Magnesium, Rifabutin Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Bismuth
Top half

#524 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Amoxicillin, Omeprazole Magnesium, Rifabutin
Top half

#766 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Bismuth

What is Bismuth?

  • Upset stomach and indigestion
  • Diarrhea
  • Heartburn and nausea
  • Helicobacter pylori treatment (with other drugs)
  • Traveler's diarrhea prevention

Bismuth is a metallic element used in medicine mostly as bismuth subsalicylate (the active ingredient in some well-known stomach remedies) to ease upset stomach, heartburn, nausea, and diarrhea. It is generally well tolerated for short-term use, but it can cause harmless black stools or a dark tongue, and because most products contain salicylate, it carries cautions similar to aspirin. Always follow the label and check with a pharmacist before regular use.

Read the full Bismuth monograph & all interactions
Keep checking

Other Drugs & Bismuth

Browse every other medication we’ve checked against Bismuth — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
124Moderate
0Minor
2,705No known interaction
124 Moderate 2,705 No interaction
Moderate

124 interactions

Showing 60 of 124 moderate interactions — see all 124 on the Bismuth page.

No interaction 2,705 drugs checked — show the list

We also checked Bismuth against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,705 medications checked with no known interaction — see the full Bismuth list.

See the full Bismuth interactions page
See every supplement checked against Amoxicillin, Omeprazole Magnesium, Rifabutin, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Bismuth monograph › Uses, safety, and every drug interaction in one place Amoxicillin, Omeprazole Magnesium, Rifabutin supplement interactions › Every supplement checked against Amoxicillin, Omeprazole Magnesium, Rifabutin, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Bismuth and Amoxicillin, Omeprazole Magnesium, Rifabutin Together: Common Questions

Can you take Bismuth with Amoxicillin, Omeprazole Magnesium, Rifabutin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Bismuth and Amoxicillin, Omeprazole Magnesium, Rifabutin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Amoxicillin, Omeprazole Magnesium, Rifabutin and Bismuth?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.