Drug & supplement interaction

Bismuth + Omeprazole, Sodium Bicarbonate

Omeprazole, Sodium Bicarbonate brand name: Konvomep.

Moderate Interaction
The bottom line Moderate

Bismuth has a moderate interaction with Omeprazole, Sodium Bicarbonate. Theoretically, concomitant use of bismuth and omeprazole may increase the effects and side effects of bismuth.

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

Bismuth and Omeprazole, Sodium Bicarbonate

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

Moderate

OMEPRAZOLE (Prilosec)

Theoretically, concomitant use of bismuth and omeprazole may increase the effects and side effects of bismuth.
In humans, omeprazole increases the absorption of bismuth from tripotassium dicitrato bismuthate. The area under the concentration-time curve (AUC) and urinary excretion (Ae) of bismuth have been shown to be higher when tripotassium dicitrato bismuthate is administered with omeprazole (172 ± 158 mcg/L/hour and 1.9 ± 2.0 mg per eight hours, respectively) compared with administration alone (46 ± 33 mcg/L/hour and 0.27 ± 0.28 mg per eight hours, respectively).
Severity Moderate Likelihood Possible Evidence B

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 gist: your Konvomep is a combo of omeprazole (a stomach acid reducer) plus sodium bicarbonate. When you add a bismuth product like Pepto-Bismol, the omeprazole side of things can actually let your body absorb more bismuth than usual. So in this pairing it's the bismuth whose effects get nudged up, not the omeprazole.

In plain terms, you might notice a bit more of bismuth's usual quirks, like darker stools or a dark-coated tongue, and since most bismuth products contain a salicylate (aspirin cousin), more of it isn't ideal. This is a moderate, possible interaction backed by limited human data, so don't panic. A short dose of Pepto is usually fine, but if you're using bismuth regularly, check with your pharmacist or doctor first.

References
  1. 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

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 Omeprazole, Sodium Bicarbonate one above is one of 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 Omeprazole, Sodium Bicarbonate

This page covers Bismuth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Omeprazole, Sodium Bicarbonate page lists 174 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 121 moderate · 50 minor.

From our pharmacist’s overview on the Omeprazole, Sodium Bicarbonate page

“Omeprazole with sodium bicarbonate (Konvomep) is a heartburn and ulcer treatment, a proton pump inhibitor paired with an antacid, and its supplement list warrants real vigilance because three of the 174 ingredients on file rate major. St.”

Reviewed by 2 · Jul 18, 2026

Open the Omeprazole, Sodium Bicarbonate 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 Omeprazole, Sodium Bicarbonate 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 Omeprazole, Sodium Bicarbonate 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
Steady interest

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

29 days ago today
Medication Omeprazole, Sodium Bicarbonate
Steady interest

#1,822 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 Omeprazole, Sodium Bicarbonate Together: Common Questions

Can you take Bismuth with Omeprazole, Sodium Bicarbonate?
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 Omeprazole, Sodium Bicarbonate 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 Omeprazole, Sodium Bicarbonate 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.