Drug & supplement interaction

Bismuth + Diclofenac Sodium

Diclofenac Sodium brand names: Voltaren XR, Voltaren, Voltaren SR, Diclo, Difenac, and others.

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

Bismuth has a moderate interaction with Diclofenac Sodium. 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 Diclofenac Sodium

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

Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

Why this applies to Diclofenac Sodium

Diclofenac Sodium 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 idea behind this one. Diclofenac is an NSAID, and like aspirin it has a mild blood-thinning, anti-platelet effect on top of relieving pain and swelling. Bismuth (the metal in some stomach remedies) may nudge your blood toward clotting a little faster by activating part of the clotting cascade. So in theory, bismuth could slightly blunt that blood-thinning side of diclofenac.

I want to be honest about the strength of this: it's a theoretical concern based on how these substances behave, not something proven in real patients taking the two together. For most people using diclofenac for arthritis or pain, occasional bismuth for an upset stomach is unlikely to cause a noticeable problem. Still, if you take either one regularly, run it past your pharmacist or doctor first.

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 Diclofenac Sodium 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. Diclofenac Sodium)
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 Diclofenac Sodium

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 Diclofenac Sodium, 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 Diclofenac Sodium

This page covers Bismuth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Diclofenac Sodium page lists 308 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), Danshen (major) and Piracetam (major).

By severity: 7 major · 266 moderate · 35 minor.

From our pharmacist’s overview on the Diclofenac Sodium page

“Diclofenac (Voltaren), a daily mainstay for arthritis and joint pain, comes with a supplement list that calls for real vigilance. Of the 308 ingredients on file, 7 rate major, and roughly two hundred entries share a single theme: anything with blood-thinning activity adds to diclofenac's own bleeding risk, especially in the stomach.”

Reviewed by 2 · Jul 18, 2026

Open the Diclofenac Sodium 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 Diclofenac Sodium 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 Diclofenac Sodium 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

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

29 days ago today
Medication Diclofenac Sodium
Top 25%

#366 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 Diclofenac

What Is Diclofenac Used For?

Brand names: Voltaren XR, Voltaren, Voltaren SR, Diclo, Difenac, Diclo SR, Voltarol, Acoflam, Defenac, Dicloflex, Diclovol, Diclozip, Fenactol, Flamrase, Volraman, Diclomax SR, Diclomax Retard, Motifene 75 mg, Voltarol 75 mg SR, Acoflam 75 SR, Defenac SR, Dexomon 75 SR, Dicloflex 75 SR, Diclovol SR, Fenactol 75 mg SR, Flamatak 75 MR, Flamrase SR, Flexotard MR 75, Rheumatac Retard 75, Rhumalgan CR, Slofenac SR, Volsaid Retard 75, Voltarol Retard, Acoflam Retard, Defenac Retard, Dexomon Retard 100, Dicloflex Retard, Diclovol Retard, Fenactol Retard 100 mg, Flamatak 100 MR, Volsaid Retard 100, Voltarol Ophtha Multidose, Voltarol Ophtha, Pennsaid, Voltaren Emulgel, Dyloject

Diclofenac sodium topical gel is used to treat actinic keratoses (AK) — rough, scaly skin patches that form after years of sun exposure. These patches are considered precancerous, meaning they can develop into skin cancer if left untreated.

This is a topical gel, meaning it is applied directly to the skin over the affected area rather than taken by mouth. It belongs to the NSAID (nonsteroidal anti-inflammatory drug) family.

See full Diclofenac 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 Diclofenac Sodium, 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 Diclofenac Sodium supplement interactions › Every supplement checked against Diclofenac Sodium, ranked by severity Diclofenac 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 Diclofenac Sodium Together: Common Questions

Can you take Bismuth with Diclofenac Sodium?
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 Diclofenac Sodium 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 Diclofenac Sodium 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.