Herb & supplement monograph

Bismuth Nitrate Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by ·Updated July 2026
What is this page for?

First and foremost: how Bismuth Nitrate interacts with medications. The heart of this page is the interaction list — every drug Bismuth Nitrate is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Bismuth Nitrate is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Interaction report

Drugs that interact with Bismuth Nitrate

0 medications have a known interaction with Bismuth Nitrate, graded by severity. Select any drug for the full evidence-based detail.

We don’t currently list any known drug interactions for Bismuth Nitrate. This doesn’t guarantee none exist — always confirm with your pharmacist before combining supplements with your medications.

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

  • Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
  • Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
  • Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
  • No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

  • Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
  • Probable. Interaction 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.
  • Possible. 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
  • Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

  • Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
  • Each drug listed above links to the full report for that exact Bismuth Nitrate combination — clinical detail, likelihood, evidence level, and citations.
  • Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.
Monograph

Bismuth Nitrate: Uses, Safety & Side Effects

Medically reviewed by · Reviewed July 2026 ·
The bottom line

Bismuth nitrate is a bismuth-based chemical compound that was historically used for stomach complaints and as a mild topical antiseptic, but it is not a common modern dietary supplement and is rarely used today. Better-studied bismuth products (like bismuth subsalicylate) have largely replaced it, and bismuth nitrate carries safety concerns, so talk with a pharmacist or doctor before using any bismuth product.

Part used
Not applicable (a chemical bismuth compound, not a plant)
Common forms
Compounded powders, topical preparations, and historically in some oral antacid or stomach formulas
People commonly use it for
  • Upset stomach and indigestion
  • Diarrhea
  • Wound and skin protection (topical)
  • Mild antiseptic

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance
OverallUse caution

Bismuth nitrate is not a standard supplement and can pose toxicity risks, so it should only be used under professional guidance.

PregnancyInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full pregnancy detail
BreastfeedingInsufficient reliable information

Insufficient reliable information available; avoid using.

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Bismuth nitrate is a chemical compound made from the metal bismuth combined with nitrate. It is not an herb or plant product. Historically, bismuth salts were used in medicine for stomach and digestive problems and as mild antiseptics applied to the skin.

Today, bismuth nitrate is uncommon in over-the-counter products. Other bismuth compounds, such as bismuth subsalicylate (found in some well-known stomach remedies) and bismuth subcitrate, are far more widely used and studied. Bismuth nitrate is more often seen in chemistry, manufacturing, and some compounded preparations than as a typical dietary supplement.

How it works

Bismuth compounds are thought to work by coating the lining of the stomach and gut, which may provide a protective barrier. Some bismuth salts also appear to have mild antibacterial effects, including activity against certain bacteria linked to stomach ulcers, based on laboratory and clinical studies of other bismuth products.

These proposed actions are mostly described for bismuth salts in general. Much of this understanding comes from lab research and studies of compounds other than bismuth nitrate, so the exact behavior of bismuth nitrate in the body is not well defined.

Effectiveness

Does Bismuth Nitrate work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by .

Evidence overview · 1 use evaluated
1 Insufficient evidence
How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.
2Likely EffectiveGood evidence, though not yet conclusive.
3Possibly EffectiveSome evidence suggests a benefit.
4Possibly IneffectiveSome evidence it may not help.
5Likely IneffectiveFairly strong evidence it doesn’t help.
6IneffectiveStrong evidence it doesn’t work.
7Insufficient Reliable Evidence to RateToo little research to say either way.

For Bismuth Nitrate, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 1 condition — evidence insufficient to rate
Insufficient Reliable Evidence To Rate Helicobacter pylori
Rating & evidence shown verbatim from Natural Medicines

Clinical research in patients with duodenal ulcers shows that bismuth nitrate 375 mg along with metronidazole 250 mg and tetracycline 500 mg, each taken orally four times daily for two weeks, followed by bismuth nitrate 375 mg orally four times daily for an additional 2 weeks, increases the rate of duodenal ulcer healing and the rate of Helicobacter pylori eradication when compared to treatment with omeprazole plus amoxicillin, with or without tinidazole. However, an intention to treat analysis showed no significant between-group difference in duodenal ulcer healing rate. Also, there was improvement in eradication rate only when compared to treatment with omeprazole plus amoxicillin alone, but not when compared to treatment with omeprazole, amoxicillin, and tinidazole. After one year, there was no significant between-group difference in the rate of symptomatic ulcer relapse.

Sources Ref 100548

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Bismuth nitrate is not a routine dietary supplement, and its safety as a swallowed product is not well established. Bismuth can build up in the body, and in some cases bismuth toxicity has been reported with overuse of bismuth-containing products, which may affect the nervous system and kidneys.

People with kidney problems, those who are older, and anyone taking many medications should be especially careful and seek professional advice. Pregnant and breastfeeding people should avoid bismuth nitrate because there is not enough safety information. Keep all bismuth products out of reach of children. Always talk with a pharmacist or doctor before using bismuth nitrate.

Side effects

Bismuth products can commonly cause a harmless darkening of the stool and tongue, as well as nausea or constipation. With topical use, skin irritation is possible.

More serious but rarer concerns include bismuth toxicity from too much or prolonged use, which can cause confusion, tremors, trouble with coordination, or kidney effects. Nitrate-containing compounds may also carry their own risks. Stop use and seek medical care if you notice unusual symptoms.

Bismuth Nitrate: Reported Adverse Effects

Documented safety reports on Bismuth Nitrate from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, bismuth nitrate may cause loss of appetite, headache, methemoglobinemia, or kidney damage. Chronic use of bismuth nitrate may cause black spots on the gums, bad breath, salivation, and a "bismuth line." In rare cases, chronic use of bismuth may cause bismuth encephalopathy. Orally or topically, bismuth nitrate may cause mild skin irritation. Occupational exposure to bismuth nitrate may cause eye irritation or respiratory tract irritation.

  1. - Jaeger A, Kopferschmitt J, Sauder Ph, Flesch F, Tournoud C. Diagnosis in clinical toxicology. In: Bolt HM, de Wolff FA, Henderson PT (eds) Medical Toxicology. Archives of Toxicology (Supplement). Berlin/Heidelberg, Germany: Springer-Verlag; 1992:29-39.
  2. Bismuth nitrate; MSDS No. B3396 [Online]; Mallenckrodt Baker: Phillipsburg, NJ, December 8, 1996. https://hazard.com/msds/mf/baker/baker/files/b3396.htm (accessed December 27, 2019).
  3. Von Bose MJ, Zaudig M. Encephalopathy resembling Creutzfeldt-Jakob disease following oral, prescribed doses of bismuth nitrate. Br J Psychiatry. 1991;158:278-80.
  4. Lewis RJ Sr. Hazardous Chemicals Desk Reference. 6th Edition. Hoboken, NJ: Wiley; 2008.
  5. Raafat BM, Samir WA, Khader MH. Met-Hemoglobin concentration reduction and methemoglobin reductase enhancement after applying of alpha-tocopherol and selenium combination as a radio protector against ionizing radiation exposure. Wulfenia J. 2012;19(10):37
Reports by condition
Cluster headache Neurologic/CNS

Orally, bismuth nitrate may cause headache. Long-term use of bismuth nitrate has been associated with bismuth encephalopathy. One report describes a patient who developed confusion, restlessness, convulsions, hypertonia, hypoventilation, and fever after taking 30-40 grams of bismuth nitrate daily for 10-20 years to treat stomach troubles. The patient was comatose upon admission to the hospital. Treatment with anticonvulsant therapy improved the convulsions, but the patient remained comatose for weeks thereafter. Bismuth encephalopathy was confirmed with laboratory analyses, which showed bismuth concentrations of 575 mcg/L in plasma, 918 mcg/L in urine, and 98 mcg/L in cerebrospinal fluid. Another report describes a patient who developed malaise, nausea, dizziness, night sweats, and dry mouth within two months of taking bismuth nitrate 8 grams orally daily for 3 weeks followed by 4 grams daily thereafter. Depressed mood, insomnia, lack of interest in activities, fatigue, loss of energy, and difficulty concentrating occurred over the next 6 months. Panic attacks, nervousness, and apprehension were also reported. Myoclonic encephalopathy resembling Creutzfeldt-Jakob disease became apparent after 15 months. The patient improved within 4 months of discontinuing bismuth and treatment with steroids by parenteral infusion.

  1. Bismuth nitrate; MSDS No. B3396 [Online]; Mallenckrodt Baker: Phillipsburg, NJ, December 8, 1996. https://hazard.com/msds/mf/baker/baker/files/b3396.htm (accessed December 27, 2019).
  2. - Jaeger A, Kopferschmitt J, Sauder Ph, Flesch F, Tournoud C. Diagnosis in clinical toxicology. In: Bolt HM, de Wolff FA, Henderson PT (eds) Medical Toxicology. Archives of Toxicology (Supplement). Berlin/Heidelberg, Germany: Springer-Verlag; 1992:29-39.
  3. Von Bose MJ, Zaudig M. Encephalopathy resembling Creutzfeldt-Jakob disease following oral, prescribed doses of bismuth nitrate. Br J Psychiatry. 1991;158:278-80.
Cluster headache Hematologic

Orally, bismuth nitrate may be converted to nitrites in the intestines, which may cause methemoglobinemia. Symptoms may include shortness of breath, cyanosis, headache, fatigue, changes in mental status, dizziness, and discoloration of the skin. In severe cases, dysrhythmias, convulsion, coma, or death may occur.

  1. Bismuth nitrate; MSDS No. B3396 [Online]; Mallenckrodt Baker: Phillipsburg, NJ, December 8, 1996. https://hazard.com/msds/mf/baker/baker/files/b3396.htm (accessed December 27, 2019).
  2. Raafat BM, Samir WA, Khader MH. Met-Hemoglobin concentration reduction and methemoglobin reductase enhancement after applying of alpha-tocopherol and selenium combination as a radio protector against ionizing radiation exposure. Wulfenia J. 2012;19(10):37
Cough Pulmonary/Respiratory

Inhalation of bismuth nitrate may cause respiratory tract irritation, with symptoms including cough and shortness of breath.

  1. Bismuth nitrate; MSDS No. B3396 [Online]; Mallenckrodt Baker: Phillipsburg, NJ, December 8, 1996. https://hazard.com/msds/mf/baker/baker/files/b3396.htm (accessed December 27, 2019).
Gingivitis Gastrointestinal

Orally, bismuth nitrate may cause loss of appetite. Chronic use of bismuth nitrate may cause black spots on the gums, bad breath, salivation, and a "bismuth line," which is a thin, blue-black discoloration along the gum margin. Serious ulcerative stomatitis may occur if bismuth nitrate use is not discontinued when gingivitis appears.

  1. Bismuth nitrate; MSDS No. B3396 [Online]; Mallenckrodt Baker: Phillipsburg, NJ, December 8, 1996. https://hazard.com/msds/mf/baker/baker/files/b3396.htm (accessed December 27, 2019).
  2. Lewis RJ Sr. Hazardous Chemicals Desk Reference. 6th Edition. Hoboken, NJ: Wiley; 2008.
Skin irritation Dermatologic

Orally or topically, bismuth nitrate may cause mild skin irritation.

  1. Bismuth nitrate; MSDS No. B3396 [Online]; Mallenckrodt Baker: Phillipsburg, NJ, December 8, 1996. https://hazard.com/msds/mf/baker/baker/files/b3396.htm (accessed December 27, 2019).
DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no established standard dose of bismuth nitrate as a supplement, and it is not a typical over-the-counter product. Because of this, no specific safe amount can be recommended here.

If a product containing bismuth nitrate is available to you, follow the directions on the label exactly and do not exceed them. Most importantly, check with a pharmacist or doctor first to make sure it is appropriate and to discuss safer, better-studied alternatives.

Pregnancy & Breastfeeding

Bismuth Nitrate & Pregnancy

Insufficient reliable information

Insufficient reliable information available; avoid using.

Bismuth Nitrate & Breastfeeding

Insufficient reliable information

Insufficient reliable information available; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

© 2026 Therapeutic Research Center

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 6 references that drive our Bismuth Nitrate 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.

  1. - Jaeger A, Kopferschmitt J, Sauder Ph, Flesch F, Tournoud C. Diagnosis in clinical toxicology. In: Bolt HM, de Wolff FA, Henderson PT (eds) Medical Toxicology. Archives of Toxicology (Supplement). Berlin/Heidelberg, Germany: Springer-Verlag; 1992:29-39. PubMed
  2. Bismuth nitrate; MSDS No. B3396 [Online]; Mallenckrodt Baker: Phillipsburg, NJ, December 8, 1996. https://hazard.com/msds/mf/baker/baker/files/b3396.htm (accessed December 27, 2019).
  3. Saberi-Firoozi M, Massarrat S, Zare S, et al. Effect of triple therapy or amoxycillin plus omeprazole or amoxycillin plus tinidazole plus omeprazole on duodenal ulcer healing, eradication of Helicobacter pylori, and prevention of ulcer relapse over a 1-ye
  4. Von Bose MJ, Zaudig M. Encephalopathy resembling Creutzfeldt-Jakob disease following oral, prescribed doses of bismuth nitrate. Br J Psychiatry. 1991;158:278-80. PubMed
  5. Lewis RJ Sr. Hazardous Chemicals Desk Reference. 6th Edition. Hoboken, NJ: Wiley; 2008.
  6. Raafat BM, Samir WA, Khader MH. Met-Hemoglobin concentration reduction and methemoglobin reductase enhancement after applying of alpha-tocopherol and selenium combination as a radio protector against ionizing radiation exposure. Wulfenia J. 2012;19(10):37
Keep reading

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.

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

Brand directory

Brands that make products with Bismuth Nitrate

1 brand in our database make a supplement containing Bismuth Nitrate.

Product directory

Supplement products with Bismuth Nitrate

1 product in our database contain Bismuth Nitrate. Open any to see its full ingredient list and every drug interaction we check.

Pharmacist Counseling Corner

Bismuth Nitrate: Common Questions

What is Bismuth Nitrate used for, and does it work?
People use Bismuth Nitrate for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.
Does Bismuth Nitrate interact with prescription medications?
We do not currently list any known drug interactions for Bismuth Nitrate. This does not guarantee that none exist, so always confirm with your pharmacist before combining it with your medications.
How are Bismuth Nitrate interactions rated?
Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.
Is it safe to take Bismuth Nitrate with my medications?
It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.
Where does this Bismuth Nitrate interaction information come from?
Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.
What is Bismuth Nitrate used for?
Historically it was used for upset stomach, indigestion, and diarrhea, and as a mild topical antiseptic. However, there is little modern evidence supporting Bismuth Nitrate specifically, and better-studied bismuth products exist.
Is Bismuth Nitrate safe to take?
It is not a standard supplement and carries risks such as bismuth buildup and possible toxicity, so it should only be used under the guidance of a pharmacist or doctor.
Can I take Bismuth Nitrate while pregnant or breastfeeding?
No. There is not enough safety information for Bismuth Nitrate, so it is best to avoid it during pregnancy and breastfeeding.
Why might my stool turn dark when using a bismuth product?
Bismuth can cause a harmless darkening of the stool and sometimes the tongue. This is usually temporary, but tell your doctor if you have other unusual symptoms.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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