Drug & supplement interaction

Bismuth + dabigatran

dabigatran brand names: Pradaxa, Pradax.

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

Bismuth has a moderate interaction with dabigatran. Theoretically, use of bismuth subgallate or other bismuth salts might reduce the effects of anticoagulant/antiplatelet drugs.

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

Bismuth and dabigatran

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to dabigatran

dabigatran 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

Here's the thinking on this one. Dabigatran (Pradaxa) is a blood thinner that works by directly blocking thrombin, a key step in clot formation. The concern with bismuth, like the kind found in some stomach remedies, is that certain bismuth salts may switch on a clotting protein called factor XII and nudge your blood toward clotting a bit more easily. In theory, that could push back against what dabigatran is trying to do, meaning slightly less protection against clots.

I want to be honest about the strength here: this is theoretical, based on how things work in the lab and the body, not on real-world reports of failures. Still, since dabigatran is preventing serious clots and strokes, it's worth a quick word with your pharmacist or doctor before using bismuth regularly.

Contact Dr. Brian directly if you have additional questions on this interaction
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

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 dabigatran 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. dabigatran)
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.

From our Q&A

Questions About Bismuth or dabigatran

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Bismuth or dabigatran, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With dabigatran

This page covers Bismuth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the dabigatran page lists 235 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Danshen (major), Piracetam (major), St. John's Wort (major) and Aconite (moderate).

By severity: 4 major · 201 moderate · 30 minor.

From our pharmacist’s overview on the dabigatran page

“Dabigatran (Pradaxa) is a blood thinner prescribed to prevent strokes and dangerous clots, which makes the stakes for mixing in supplements higher than for most medicines, and I would go through this list with real care. Of the 235 ingredients on file, 202 could add to dabigatran's blood-thinning effect and increase bruising or bleedin…”

Reviewed by 2 · Jul 18, 2026

Open the dabigatran 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 dabigatran 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 dabigatran 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 dabigatran
Top 10%

#167 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
Medication

About Dabigatran

What Is Dabigatran Used For?

Brand names: Pradaxa, Pradax

Dabigatran etexilate capsules are approved for adults to reduce the risk of stroke and systemic embolism (blood clots traveling through the body) in non-valvular atrial fibrillation (an irregular heart rhythm not caused by a heart valve problem). Capsules are also used to treat deep vein thrombosis (DVT — a blood clot in a deep vein, usually the leg) and pulmonary embolism (PE — a clot in the lungs), to prevent those clots from coming back, and to prevent DVT and PE in adults who have had hip replacement surgery.

For children, the capsule form is approved for treating VTE (venous thromboembolism — blood clots in veins) and reducing recurrence in patients aged 8 to under 18. Pradaxa Oral Pellets are approved specifically for children aged 3 months to under 12 years for the same treatment and recurrence-prevention purposes.

See full Dabigatran 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
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 dabigatran, 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 dabigatran supplement interactions › Every supplement checked against dabigatran, ranked by severity Dabigatran drug information › The full plain-English guide to this medication 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 dabigatran Together: Common Questions

Can you take Bismuth with dabigatran?
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 dabigatran 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 dabigatran 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.