Drug & supplement interaction

Bismuth + Vericiguat

Vericiguat brand name: Verquvo.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 20, 2026

The bottom line No known interaction

We found no known interaction between Bismuth and Vericiguat 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 Vericiguat 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 Vericiguat

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 Vericiguat 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 Vericiguat and Bismuth? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

How we checked

Why No Interaction Is Listed for Vericiguat

Interactions in our licensed database are recorded against drug classes, not just single drug names. Vericiguat 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 Vericiguat’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 — Vericiguat 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. Vericiguat)

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 Vericiguat May Share a Side Effect

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. One of them is 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

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.

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

29947. James JA. Acute renal failure due to a bismuth preparation. Calif Med 1968;109(4):317-9.

29948. Jacobsen JB, Hüttel MS. [Methemhemoglobinemia after excessive intake of a subnitrate containing antacid]. Ugeskr Laeger 1982;144(32):2349-50.
Vericiguat

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

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

Effects for Vericiguat 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 Vericiguat Products Have a Food Rule — Bismuth Should Not Break It

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

2 DOSAGE AND ADMINISTRATION The recommended starting dose of VERQUVO is 5 mg orally once daily with food.

From the Dosage and Administration section of the FDA label we read for Vericiguat — 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 Vericiguat

This page covers Bismuth only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Vericiguat 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 Vericiguat page

“No supplement on this page worries me more for vericiguat (Verquvo) users than St. John's wort.”

Reviewed by 2 · Jul 18, 2026

Open the Vericiguat 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 Vericiguat, 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 Vericiguat 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

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

29 days ago today

Medication Vericiguat

Steady interest

#2,656 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 20, 2026. The Bismuth and Vericiguat 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 Dr. Brian Staiger, PharmD, BCPS.

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 Vericiguat

What Is Vericiguat Used For?

Brand name: Verquvo

Verquvo (vericiguat) is used to reduce the risk of cardiovascular death and hospitalization due to heart failure. It is specifically for adults with symptomatic chronic heart failure whose heart pumps with reduced function (ejection fraction less than 45%), following a recent hospitalization for heart failure or a need for IV diuretics given outside the hospital.

Verquvo is taken on top of other standard heart failure treatments — it is not a replacement for them.

Most-Reported Side Effects for Vericiguat

From FAERS, the FDA’s public side-effect reporting system (966 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Hypotension 111 reports

Cardiac failure 72 reports

Dizziness 68 reports

Anemia 40 reports

Blood pressure decreased 40 reports

See full Vericiguat 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 Vericiguat, 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.

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.

Pharmacist Counseling Corner

Taking Bismuth and Vericiguat Together: Common Questions

Is it safe to take Bismuth with Vericiguat?

We do not list a known interaction between Bismuth and Vericiguat. 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 Vericiguat have any of the same side effects?

Yes — our sources link each of them separately to one 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 Vericiguat at the same time of day?

At least one FDA label for a product containing Vericiguat says to take it with food. If you take Bismuth on an empty stomach out of habit, keep them separate and take Vericiguat with a meal where the label says to. Food instructions belong to the product rather than the ingredient — two Vericiguat products can differ — so check the directions on your own box. This is about absorption, not an interaction.

How was the Bismuth and Vericiguat combination checked?

Interactions in our licensed database are recorded against drug classes. Vericiguat is filed under 2 classifications, and Bismuth has documented interactions with 4 drug classes — none of Vericiguat'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 — Vericiguat 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 Vericiguat interact with any supplements?

Yes. Vericiguat has documented interactions with 54 supplements in our database — Bismuth is not one of them. The Vericiguat 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 Vericiguat drug information The full plain-English guide to this medication Vericiguat supplement interactions Every supplement checked against Vericiguat, 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 Vericiguat 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.