Drug & supplement interaction

Bismuth + Avatrombopag Maleate

Avatrombopag Maleate brand name: Doptelet.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Bismuth and Avatrombopag Maleate in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Avatrombopag Maleate states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Bismuth and Avatrombopag Maleate

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Avatrombopag Maleate and Bismuth in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Bismuth safety at a glance

Bismuth overall Use caution Generally safe for short-term use, but most products contain salicylate and should not be overused.
Pregnancy Avoid Bismuth subsalicylate is generally avoided in pregnancy, especially later, due to its salicylate content.
Breastfeeding Use caution Salicylate can pass into breast milk, so check with a doctor before use while nursing.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Avatrombopag Maleate and Bismuth? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Avatrombopag Maleate

Interactions in our licensed database are recorded against drug classes, not just single drug names. Avatrombopag Maleate is filed under 2 classifications — p-glycoprotein substrates, oral drugs. Bismuth has documented interactions with 4 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), aspirin (moderate) and omeprazole (prilosec) (moderate) — and none of Avatrombopag Maleate’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Bismuth Does Interact With Other Medications

Bismuth has 125 moderate known drug interactions in our database — Avatrombopag Maleate isn’t one of them. If you take anything else, check it against the full list below.

Moderate 125 No known interaction 2,705 (incl. Avatrombopag Maleate)
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.

What to actually watch for

No Interaction Found — But Data Suggests Bismuth and Avatrombopag Maleate May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 2 of them are worth acting on rather than waiting out — marked below.

  • Anemia Worth acting on Additional detail

    Bismuth

    “Orally, aplastic anemia has been reported as a potential side effect of bismuth salts. Lymphoid follicles are a reported side effect in a clinical trial investigating colloidal bismuth subcitrate in combination with tetracycline and furazolidone. However, the effect of bismuth alone is unclear. Excessive intake of bismuth subnitrate may cause methemoglobinemia.”

    Bismuth · Natural Medicines adverse-effect record, reported in anemia.

    4 sources cited
    1. 26338. Moeschlin, S. [Clinical-hematological demonstrations: aplastic anemia, acute leukemias, polyneuropathy in Waldenstrom's disease, acute porphyria]. Schweiz Med Wochenschr 1975;105(40):1289-1298.
    2. 26335. Araujo Castillo, R., Pinto Valdivia, J. L., Ramirez, D., Cok Garcia, J., and Bussalleu Rivera, A. [New ultrashort scheme for helicobacter pylori infection eradication using tetracyline, furazolidone and colloidal bismuth subcitrate in dyspeptic patients w
    3. 29947. James JA. Acute renal failure due to a bismuth preparation. Calif Med 1968;109(4):317-9.
    4. 29948. Jacobsen JB, Hüttel MS. [Methemhemoglobinemia after excessive intake of a subnitrate containing antacid]. Ugeskr Laeger 1982;144(32):2349-50.

    Avatrombopag Maleate

    Listed in the ADVERSE REACTIONS section of the FDA label for Avatrombopag Maleate. Read the label on DailyMed ›

  • A higher chance of infection Worth acting on Additional detail

    Bismuth

    “Orally, multiple cases of bismuth-related neurotoxicity have been reported. In general, the risk of neurotoxicity from bismuth salts appears to be greater for colloidal bismuth than other forms due to the greater bioavailability of colloidal bismuth. In most cases, the neurotoxicity results from excessive use of bismuth salts over prolonged time periods (up to 30 years).”

    Bismuth · Natural Medicines adverse-effect record, reported in anxiety.

    6 sources cited
    1. 25775. 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
    2. 29942. Supino-Viterbo V, Sicard C, Risvegliato M, Rancurel G, Buge A. Toxic encephalopathy due to ingestion of bismuth salts: clinical and EEG studies of 45 patients. J Neurol Neurosurg Psychiatry 1977;40(8):748-52. PubMed
    3. 25770. Cengiz, N., Uslu, Y., Gok, F., and Anarat, A. Acute renal failure after overdose of colloidal bismuth subcitrate. Pediatr Nephrol 2005;20(9):1355-1358. PubMed
    4. 29946. Masannat Y, Nazer E. Pepto bismuth associated neurotoxicity: A rare side effect of a commonly used medication. W V Med J 2013;109(3):32-4.
    5. 106807. Halani S, Wu PE. Salicylate toxicity from chronic bismuth subsalicylate use. BMJ Case Rep 2020;13(11):e236929. PubMed
    6. 97817. Tsay FW, Wu DC, Yu HC, et al. A randomized controlled trial shows that both 14-day hybrid and bismuth quadruple therapies cure most patients with Helicobacter pylori infection in populations with moderate antibiotic resistance. Antimicrob Agents Chemother

    “Orally, bismuth that is not absorbed is excreted in the feces as insoluble salts and may cause stools to appear grayish black. Also, bismuth may cause the tongue to turn black due to macular lingual pigmentation.”

    Bismuth · Natural Medicines adverse-effect record, reported in constipation.

    6 sources cited
    1. 25770. Cengiz, N., Uslu, Y., Gok, F., and Anarat, A. Acute renal failure after overdose of colloidal bismuth subcitrate. Pediatr Nephrol 2005;20(9):1355-1358. PubMed
    2. 26333. DuPont, H. L., Ericsson, C. D., Johnson, P. C., Bitsura, J. A., DuPont, M. W., and de la Cabada, F. J. Prevention of travelers' diarrhea by the tablet formulation of bismuth subsalicylate. JAMA 1987;257(10):1347-1350. DOI
    3. 29957. Ford AC, Malfertheiner P, Giguere M, et al. Adverse events with bismuth salts for Helicobacter pylori eradication: systematic review and meta-analysis. World J Gastroenterol 2008;14(48):7361-70. PubMed
    4. 101113. Zaveri H, Surve A, Cottam D, et al. Does bismuth subgallate affect smell and stool Character? A randomized double-blinded placebo-controlled trial of bismuth subgallate on loop duodenal switch patients with complaints of smelly stools and diarrhea. Obes S PubMed
    5. 29943. Cohen PR. Black tongue secondary to bismuth subsalicylate: case report and review of exogenous causes of macular lingual pigmentation. J Drugs Dermatol 2009;8(12):1132-5.
    6. 29944. Ioffreda MD, Gordon CA, Adams DR, Naides SJ, Miller JJ. Black tongue. Arch Dermatol 2001;137(7):968-9.

    Avatrombopag Maleate

    Listed in the ADVERSE REACTIONS section of the FDA label for Avatrombopag Maleate. Read the label on DailyMed ›

  • Stomach pain Additional detail

    Bismuth

    Recorded for Bismuth in the same Natural Medicines adverse-effect record shown under A higher chance of infection above.

    Avatrombopag Maleate

    Listed in the ADVERSE REACTIONS section of the FDA label for Avatrombopag Maleate. Read the label on DailyMed ›

  • Tiredness Additional detail

    Bismuth

    “Orally, cases of nephrotoxicity or acute kidney failure resulting from short-term exposure to high levels of bismuth salts, including colloidal bismuth subcitrate (De-Nol) and bismuth sodium triglycollamate (Bistrimate), have been reported.”

    Bismuth · Natural Medicines adverse-effect record, reported in myasthenia gravis.

    2 sources cited
    1. 25770. Cengiz, N., Uslu, Y., Gok, F., and Anarat, A. Acute renal failure after overdose of colloidal bismuth subcitrate. Pediatr Nephrol 2005;20(9):1355-1358. PubMed
    2. 29947. James JA. Acute renal failure due to a bismuth preparation. Calif Med 1968;109(4):317-9.

    Avatrombopag Maleate

    Listed in the ADVERSE REACTIONS section of the FDA label for Avatrombopag Maleate. Read the label on DailyMed ›

  • Headache Additional detail

    Bismuth

    “Orally, bismuth salts are generally well tolerated when taken alone or in combination with antibiotics.

    Most Common Adverse Effects:

    Orally: Change in taste perception, discolored stools or tongue, dizziness, gastrointestinal symptoms, such as nausea and diarrhea, and headache.

    Serious Adverse Effects (Rare):

    Orally: After large doses or chronic use, kidney failure and encephalopathy have been reported.”

    Bismuth · Natural Medicines adverse-effect record, reported in cluster headache.

    Avatrombopag Maleate

    Listed in the ADVERSE REACTIONS section of the FDA label for Avatrombopag Maleate. Read the label on DailyMed ›

  • Nausea Additional detail

    Bismuth

    Recorded for Bismuth in the same Natural Medicines adverse-effect record shown under Headache above.

    Avatrombopag Maleate

    Listed in the ADVERSE REACTIONS section of the FDA label for Avatrombopag Maleate. Read the label on DailyMed ›

Reported for Bismuth but not commonly for Avatrombopag Maleate: kidney problems, confusion, a change in taste and memory problems.

Effects for Avatrombopag Maleate come from the ADVERSE REACTIONS section of its FDA label; effects for Bismuth come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

How to take them

Some Avatrombopag Maleate Products Have a Food Rule — Bismuth Should Not Break It

At least one FDA label for a product containing Avatrombopag Maleate says to take it with food. If you take Bismuth on an empty stomach out of habit, keep them separate — and take Avatrombopag Maleate with a meal where the label says to.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Avatrombopag Maleate products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

Administer DOPTELET tablets and DOPTELET SPRINKLE with food.

From the Dosage and Administration section of the FDA label we read for Avatrombopag Maleate — where that label names a specific product, the instruction is that product's. Read the label on DailyMed ›

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

Everything else you take

See Every Supplement That Interacts With Avatrombopag Maleate

This page covers Bismuth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Avatrombopag Maleate page lists 54 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), St. John's Wort (major), Bitter Melon (moderate), Black Pepper (moderate) and Bulbine Natalensis (moderate).

By severity: 2 major · 35 moderate · 17 minor.

From our pharmacist’s overview on the Avatrombopag Maleate page

“Avatrombopag maleate (Doptelet) exists to raise a low platelet count, so anything that drags its blood level down invites the bleeding risk it was prescribed to prevent. I would handle this list of 54 supplements with real care, and the two rated major come first.”

Reviewed by 2 · Jul 18, 2026

Open the Avatrombopag Maleate 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. Even though Bismuth itself has no known interaction with Avatrombopag Maleate, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Bismuth and Avatrombopag Maleate 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

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

29 days ago today
Medication Avatrombopag Maleate
Top half

#748 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Bismuth reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Bismuth and Avatrombopag Maleate records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
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.

Mineral element (not a plant); used as bismuth salts · Chewable tablets, caplets, liquid suspensions (commonly as bismuth subsalicylate)

An interaction check asks whether these two react with each other — it does not ask whether Bismuth is a good idea for someone in your situation. Here is what our Bismuth record says about it on its own.

Bismuth: dosing

There is no single "supplement" dose of bismuth. The right amount depends on the specific product and the reason for use. Always follow the directions on the package label for the product you have, and do not exceed the maximum daily amount listed.For medical uses such as H. pylori treatment, dosing is set by a doctor as part of a multi-drug regimen. Do not use bismuth products for more than a couple of days for diarrhea without checking with a healthcare provider.

From our Bismuth monograph — the full record covers uses, side effects and every documented interaction.

Read the full Bismuth monograph & all interactions
Medication

About Avatrombopag

What Is Avatrombopag Used For?

Brand name: Doptelet

Avatrombopag treats thrombocytopenia (a low platelet count that raises bleeding risk) in three groups of patients. Doptelet tablets are used in adults with chronic liver disease who need their platelet count raised before a medical procedure, and in adults with chronic immune thrombocytopenia (ITP) whose platelet count has not responded well enough to earlier treatments. Doptelet tablets are also used in children aged 6 years and older with persistent or chronic ITP who have not responded to prior treatment.

Doptelet Sprinkle (oral granules) is specifically indicated for children aged 1 year to less than 6 years with persistent or chronic ITP who have not responded adequately to a previous treatment.

See full Avatrombopag drug information
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
125Moderate
0Minor
2,704No known interaction
125 Moderate 2,704 No interaction
Moderate

125 interactions

Showing 60 of 125 moderate interactions — see all 125 on the Bismuth page.

No interaction 2,704 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 2,704 medications checked with no known interaction — see the full Bismuth list.

See the full Bismuth interactions page
See every supplement checked against Avatrombopag Maleate, ranked by severity
Evidence & sources

Bismuth References

The 36 references that drive our Bismuth monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Cengiz, N., Uslu, Y., Gok, F., and Anarat, A. Acute renal failure after overdose of colloidal bismuth subcitrate. Pediatr Nephrol 2005;20(9):1355-1358. PubMed
  2. 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
  3. 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
  4. GOELTNER, E. [Versenate treatment of alopecia following bismuth therapy]. Z Haut Geschlechtskr 1961;31:164-169.
  5. Hoffman, J. S., Katz, L. M., and Cave, D. R. Efficacy of a 1-week regimen of ranitidine bismuth citrate in combination with metronidazole and clarithromycin for Helicobacter pylori eradication. Aliment Pharmacol Ther 1999;13(4):503-506.
  6. Scott, B. B. Bismuth-containing single-antibiotic 1-week triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 1998;12(3):277-279.
  7. Sontag, S. J., O'Connell, S., Schnell, T., Chejfec, G., Seidel, J., and Sonnenberg, A. Reduced symptoms and need for antisecretory therapy in veterans 3 years after Helicobacter pylori eradication with ranitidine bismuth citrate/amoxicillin/clarithromycin PubMed
  8. Chey, W. D., Fisher, L., Elta, G. H., Barnett, J. L., Nostrant, T., DelValle, J., Hasler, W. L., and Scheiman, J. M. Bismuth subsalicylate instead of metronidazole with lansoprazole and clarithromycin for Helicobacter pylori infection: a randomized trial.
  9. Kaviani, M. J., Malekzadeh, R., Vahedi, H., Sotoudeh, M., Kamalian, N., Amini, M., and Massarrat, S. Various durations of a standard regimen (amoxycillin, metronidazole, colloidal bismuth sub-citrate for 2 weeks or with additional ranitidine for 1 or 2 we
  10. Gisbert, J. P., Marcos, S., Gisbert, J. L., and Pajares, J. M. High efficacy of ranitidine bismuth citrate, amoxicillin, clarithromycin and metronidazole twice daily for only five days in Helicobacter pylori Eradication. Helicobacter 2001;6(2):157-162.
  11. Nijevitch, A. A., Farztdinov, K. M., Sataev, V. U., Khasanov, R. Sh., Katayev, V. A., Khusnutdinov, S. M., Akhunov, E. D., and Kazykhanov, N. S. Helicobacter pylori infection in childhood: results of management with ranitidine bismuth citrate plus amoxici
  12. Bujanda, L., Sanchez, A., Iriondo, C., Santos, A., Cosme, A., and Munoz, C. [Comparative study of the eradication of Helicobacter pylori: ranitidine bismuth citrate versus omeprazole plus two antibiotics for seven days]. An Med Interna 2001;18(7):361-363.
  13. Wilhelmsen, I., Weberg, R., Berstad, K., Hausken, T., Hundal, O., and Berstad, A. Helicobacter pylori eradication with bismuth subnitrate, oxytetracycline and metronidazole in patients with peptic ulcer disease. Hepatogastroenterology 1994;41(1):43-47.
  14. DuPont, H. L., Ericsson, C. D., Johnson, P. C., Bitsura, J. A., DuPont, M. W., and de la Cabada, F. J. Prevention of travelers' diarrhea by the tablet formulation of bismuth subsalicylate. JAMA 1987;257(10):1347-1350. DOI
  15. Pozzato, P., Zagari, M., Cardelli, A., Catalano, F. A., Giglio, A., Lami, F., Pilotto, A., Scarpulla, G., Spadaccini, A., Susi, D., Tosatto, R., Olivieri, A., Bazzoli, F., and Roda, E. Ranitidine bismuth citrate plus clarithromycin 7-day regimen is effect

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Bismuth and Avatrombopag Maleate Together: Common Questions

Is it safe to take Bismuth with Avatrombopag Maleate?
We do not list a known interaction between Bismuth and Avatrombopag Maleate. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Bismuth and Avatrombopag Maleate have any of the same side effects?
Yes — our sources link each of them separately to 6 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Bismuth and Avatrombopag Maleate at the same time of day?
At least one FDA label for a product containing Avatrombopag Maleate says to take it with food. If you take Bismuth on an empty stomach out of habit, keep them separate and take Avatrombopag Maleate with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Avatrombopag Maleate products can differ — so check the directions on your own box. This is about absorption, not an interaction.
How was the Bismuth and Avatrombopag Maleate combination checked?
Interactions in our licensed database are recorded against drug classes. Avatrombopag Maleate is filed under 2 classifications, and Bismuth has documented interactions with 4 drug classes — none of Avatrombopag Maleate's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Bismuth interact with any other medications?
Yes. Bismuth has 125 documented drug interactions in our database — Avatrombopag Maleate is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Avatrombopag Maleate interact with any supplements?
Yes. Avatrombopag Maleate has documented interactions with 54 supplements in our database — Bismuth is not one of them. The Avatrombopag Maleate interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Bismuth monograph Uses, safety profile, and every drug interaction in one place Avatrombopag drug information The full plain-English guide to this medication Avatrombopag Maleate supplement interactions Every supplement checked against Avatrombopag Maleate, 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 References The 36 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Avatrombopag Maleate 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.