Drug & supplement interaction

Bismuth + Aspirin, Oxycodone

Aspirin, Oxycodone brand name: Percodan.

Moderate Interaction
The bottom line Moderate

Aspirin, Oxycodone falls into 2 drug categories that Bismuth can interact with; the most serious is rated moderate. Theoretically, use of bismuth subgallate or other bismuth salts might reduce the effects of anticoagulant/antiplatelet drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bismuth and Aspirin, Oxycodone

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Bismuth interacts with whole categories of medication. Aspirin, Oxycodone falls into 2 of those categories, so it can interact with Bismuth in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

1 of 2

Why this applies to Aspirin, Oxycodone

Aspirin, Oxycodone falls under ANTICOAGULANT/ANTIPLATELET DRUGS — the group Bismuth interacts with.

Theoretically, use of bismuth subgallate or other bismuth salts might reduce the effects of anticoagulant/antiplatelet drugs.
In humans, bismuth subgallate activates factor XII and accelerates the coagulation cascade.
Severity Moderate Likelihood Possible Evidence D

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

Percodan combines aspirin with oxycodone. The piece that matters here is the aspirin, which thins the blood a bit by making your platelets less sticky. That mild blood-thinning effect is part of why aspirin can help your heart but also why it can raise bleeding risk.

Here's the theoretical concern: certain bismuth salts may nudge the clotting system in the opposite direction, which could blunt some of aspirin's anti-platelet action. Honestly, this is based on how things work on paper, not on strong human studies, so I wouldn't lose sleep over an occasional dose of a stomach remedy. Both products also lean on salicylate, so doubling up can be a separate issue. Just run regular use of either past your pharmacist or doctor first.

References
  1. Callanan, V., Curran, A. J., Smyth, D. A., and Gormley, P. K. The influence of bismuth subgallate and adrenaline paste upon operating time and operative blood loss in tonsillectomy. J Laryngol Otol 1995;109(3):206-208. PubMed
Moderate

ASPIRIN

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Theoretically, bismuth subsalicylate might have an additive effect with other salicylate-containing drugs.
Dietary supplements often contain bismuth in the form of bismuth subsalicylate. In humans, oral bismuth subsalicylate is hydrolyzed in the stomach to form salicylate and bismuth oxychloride.
Severity Moderate Likelihood Possible Evidence D

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 the simple version. Products like Pepto-Bismol contain bismuth subsalicylate, and once it hits your stomach it breaks down into salicylate, which is basically the same family as the aspirin already in Percodan. So you'd be stacking salicylate on top of salicylate. The worry isn't the oxycodone half here, it's getting more total aspirin-like medicine than you planned.

In real life that could mean a bit more stomach irritation, heartburn, or even bleeding risk, and at higher amounts ringing in the ears. This is a theoretical concern based on how these drugs work, not strong proof, and an occasional dose is unlikely to cause trouble. Still, if you take Percodan regularly, please run it by your pharmacist or doctor before using bismuth often.

References
  1. Mishkin, S. Intriguing gastrointestinal properties of bismuth: a folk remedy brought into the realm of clinical and investigative medicine. Can J Gastroenterol 1998;12(8):569-570. 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 Aspirin, Oxycodone one above is among them. If you take anything else, check it against the full list below.

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 Aspirin, Oxycodone

This page covers Bismuth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Aspirin, Oxycodone page lists 328 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Danshen (major).

By severity: 12 major · 281 moderate · 35 minor.

Open the Aspirin, Oxycodone 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 Aspirin, Oxycodone 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 Aspirin, Oxycodone 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

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

29 days ago today
Medication Aspirin, Oxycodone
Steady interest

#1,835 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
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
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

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Pharmacist Counseling Corner

Taking Bismuth and Aspirin, Oxycodone Together: Common Questions

Can you take Bismuth with Aspirin, Oxycodone?
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.
Why are there 2 interactions listed for Bismuth and Aspirin, Oxycodone?
Aspirin, Oxycodone belongs to more than one drug category, and Bismuth interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Bismuth and Aspirin, Oxycodone 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

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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.