Bismuth + Ivermectin
Ivermectin brand names: Stromectol, Mectizan, Sklice, Soolantra.
We found no known interaction between Bismuth and Ivermectin 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 Ivermectin 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.
Bismuth and Ivermectin
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 Ivermectin 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
Safety guidance is general; always confirm with your pharmacist or doctor for your situation.
Why No Interaction Is Listed for Ivermectin
Interactions in our licensed database are recorded against drug classes, not just single drug names. Ivermectin is filed under 4 classifications — including topical drugs, 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 Ivermectin’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.
Bismuth Does Interact With Other Medications
Bismuth has 125 moderate known drug interactions in our database — Ivermectin isn’t one of them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Bismuth
We haven’t checked that one against Bismuth yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Bismuth. Pick one to open its full report.
Some Ivermectin Products Have a Food Rule — Bismuth Should Not Break It
At least one FDA label for a product containing Ivermectin says to take it on an empty stomach. Most supplements — Bismuth included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Ivermectin on its own and move Bismuth to a meal later in the day.
This may not be true of your version. Food instructions belong to the product, not the ingredient: two Ivermectin 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.
Patients should take tablets on an empty stomach with water.
From the Dosage and Administration section of the FDA label we read for Ivermectin — 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.
Questions About Bismuth or Ivermectin
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 Ivermectin, 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:
- Ivermectin and Fenbendazole With Losartan and Lercanidipine ›
- Ivermectin or Fenbendazole With Opioids and Blood Thinners? ›
Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.
See Every Supplement That Interacts With Ivermectin
This page covers Bismuth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Ivermectin page lists 58 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), Sweet Orange (major), Bitter Melon (moderate) and Black Pepper (moderate).
By severity: 3 major · 37 moderate · 18 minor.
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 Ivermectin, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:
Where Bismuth and Ivermectin 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.
#436 of 1,452 supplements looked up here in the last 7 days
#12 of 2,830 medications looked up here in the last 7 days
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 Ivermectin 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.
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.
About Ivermectin
What Is Ivermectin Used For?
Brand names: Stromectol, Mectizan, Sklice, Soolantra
Ivermectin tablets (including Stromectol) are used to treat two parasitic infections: strongyloidiasis (a roundworm infection of the intestinal tract) and onchocerciasis (river blindness, caused by a parasitic worm spread by blackfly bites). These are prescription uses for serious infections.
Topical ivermectin lotion — sold under several names including RID One and Done, Head Lice Treatment Ivermectin Lotion, Scalp Care Lotions, and others — is applied to the scalp to treat head lice. A separate topical ivermectin cream (1%), available as Soolantra and ivermectin cream 1%, is used to treat the inflammatory pimple-like bumps of rosacea.
Most-Reported Side Effects for Ivermectin
From FAERS, the FDA’s public side-effect reporting system (6,298 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.
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.
No drugs match “”.
125 interactions
- Diclofenac Sodium ›
- Ibuprofen ›
- Aspirin ›
- Naproxen ›
- Minocycline ›
- Diclofenac Potassium ›
- Dipyridamole ›
- Ketoprofen ›
- Bivalirudin ›
- Omeprazole ›
- Warfarin Sodium ›
- Bromfenac Sodium ›
- Dabigatran ›
- Diclofenac Epolamine ›
- Iloprost ›
- Piroxicam ›
- Streptokinase ›
- Ticlopidine ›
- Treprostinil (oral) ›
- Abciximab ›
- Abrocitinib ›
- Acenocoumarol ›
- Acetylsalicylic Acid ›
- Anacaulase-bcdb ›
- Anagrelide ›
- Anisindione ›
- Antithrombin Iii ›
- Apixaban ›
- Argatroban ›
- Betrixaban ›
- Cablivi ›
- Cangrelor ›
- Cilostazol ›
- Clopidogrel ›
- Dalteparin ›
- Danaparoid ›
- Defibrotide Sodium ›
- Diclofenac ›
- Dicumarol ›
- Edoxaban ›
- Effient ›
- Enoxaparin ›
- Eptifibatide ›
- Fish Oil Triglycerides ›
- Fondaparinux ›
- Heparin ›
- Ibrutinib ›
- Ibuprofen Lysine ›
- Icosapent Ethyl (prescription Drug) ›
- Inotersen ›
- Lepirudin ›
- Nadroparin ›
- Naproxen Sodium ›
- Nintedanib Esylate ›
- Nusinersen Sodium ›
- Omega-3 Fatty Acids (prescription Drug) ›
- Pazopanib ›
- Pentoxifylline ›
- Phenprocoumon ›
- Reteplase ›
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.
- Levothyroxine ›
- Amlodipine ›
- Methylphenidate ›
- Sertraline ›
- Testosterone ›
- Losartan Potassium ›
- Metoprolol ›
- Rosuvastatin ›
- Escitalopram ›
- Tadalafil ›
- Acetaminophen ›
- Atorvastatin ›
- Valacyclovir ›
- Docusate ›
- Hydroxyurea ›
- Abemaciclib ›
- Methamphetamine ›
- Semaglutide ›
- Sumatriptan ›
- Tirzepatide ›
- Prednisone ›
- Propranolol ›
- Lisdexamfetamine ›
- Bupropion ›
- Metformin ›
- Amoxicillin ›
- Acyclovir ›
- Lisinopril ›
- Bendamustine ›
- Amitriptyline ›
- Doxycycline ›
- Lamotrigine ›
- Fluoxetine ›
- Methotrexate ›
- Pregabalin ›
- Gabapentin ›
- Amphetamine ›
- Acetaminophen, Codeine ›
- Isotretinoin ›
- Azithromycin ›
- Dextroamphetamine ›
- Clonazepam ›
- Quetiapine ›
- Methylene Blue ›
- Amlodipine Besylate ›
- Duloxetine ›
- Letrozole ›
- Buspirone ›
- Citalopram ›
- Ciprofloxacin ›
- Bisoprolol ›
- Levothyroxine, Liothyronine ›
- Acetaminophen, Oxycodone ›
- Dapsone ›
- Diazepam ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Mannitol ›
- Cephalexin ›
- Roxithromycin ›
Showing the 60 most looked-up of 2,704 medications checked with no known interaction — see the full Bismuth list.
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.
- 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
- 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
- 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
- GOELTNER, E. [Versenate treatment of alopecia following bismuth therapy]. Z Haut Geschlechtskr 1961;31:164-169.
- 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.
- Scott, B. B. Bismuth-containing single-antibiotic 1-week triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 1998;12(3):277-279.
- 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
- 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.
- 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
- 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.
- 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
- 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.
- 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.
- 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
- 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
- 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
- Bianchi Porro, G., Lazzaroni, M., and Cortvriendt, W. R. Maintenance therapy with colloidal bismuth subcitrate in duodenal ulcer disease. Digestion 1987;37 Suppl 2:47-52. PubMed
- Johnson, P. C., Ericsson, C. D., DuPont, H. L., Morgan, D. R., Bitsura, J. A., and Wood, L. V. Comparison of loperamide with bismuth subsalicylate for the treatment of acute travelers' diarrhea. JAMA 1986;255(6):757-760. DOI
- Moeschlin, S. [Clinical-hematological demonstrations: aplastic anemia, acute leukemias, polyneuropathy in Waldenstrom's disease, acute porphyria]. Schweiz Med Wochenschr 1975;105(40):1289-1298.
- 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
- 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
- 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.
- Ioffreda MD, Gordon CA, Adams DR, Naides SJ, Miller JJ. Black tongue. Arch Dermatol 2001;137(7):968-9.
- Bingham AL, Brown RO, Dickerson RN. Inadvertent exaggerated anticoagulation following use of bismuth subsalicylate in an enterally fed patient receiving warfarin therapy. Nutr Clin Pract 2013;28(6):766-9. PubMed
- 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.
- James JA. Acute renal failure due to a bismuth preparation. Calif Med 1968;109(4):317-9.
- Jacobsen JB, Hüttel MS. [Methemhemoglobinemia after excessive intake of a subnitrate containing antacid]. Ugeskr Laeger 1982;144(32):2349-50.
- 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
- Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
- 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
- De Francesco V, Pontone S, Bellesia A, et al. Quadruple, sequential, and concomitant first-line therapies for H. pylori eradication: a prospective, randomized study. Dig Liver Dis 2018;50(2):139-41. PubMed
- Wu TS, Hsu PI, Kuo CH, et al. Comparison of 10-day levofloxacin bismuth-based quadruple therapy and levofloxacin-based triple therapy for Helicobacter pylori. J Dig Dis 2017;18(9):537-42.
- Liou JM, Fang YJ, Chen CC, Taiwan Gastrointestinal Disease and Helicobacter Consortium. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016; PubMed
- 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
- Halani S, Wu PE. Salicylate toxicity from chronic bismuth subsalicylate use. BMJ Case Rep 2020;13(11):e236929. PubMed
- Galleani C, Bautista-Villanueva S, Barranco R, et al. Fixed drug eruption due to bismuth during Helicobacter pylori eradication therapy. J Allergy Clin Immunol Pract 2021;9(6):2503-2504. PubMed
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.
Taking Bismuth and Ivermectin Together: Common Questions
Is it safe to take Bismuth with Ivermectin?
Do Bismuth and Ivermectin have any of the same side effects?
Should I take Bismuth and Ivermectin at the same time of day?
How was the Bismuth and Ivermectin combination checked?
Does Bismuth interact with any other medications?
Does Ivermectin interact with any supplements?
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.