Drug interactions
Acetylsalicylic acid + Bismuth subsalicylate
Severity: Moderate
Acetylsalicylic acid and Bismuth subsalicylate: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Bismuth subsalicylate is hydrolysed to release salicylate, so taking it with aspirin adds to the total salicylate load. This can raise the risk of salicylate toxicity such as tinnitus and gastrointestinal bleeding, especially with repeated or high dosing.
What this interaction means in plain words
Acetylsalicylic acid and Bismuth subsalicylate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Acetylsalicylic acid belongs to Musculoskeletal; Bismuth subsalicylate belongs to Gastrointestinal Tract.
Why it happens
Additive salicylate exposure and additive antiplatelet and gastrointestinal mucosal effects.
What to do
Avoid routine concurrent use of bismuth subsalicylate with analgesic-dose aspirin and limit duration. Monitor for tinnitus, GI bleeding and bruising, particularly in older adults and those on anticoagulants.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Acetylsalicylic acid
- Acetylsalicylic acid + Ketorolac Contraindicated
- Acetylsalicylic acid + Ketorolac intranasal Contraindicated
- Abciximab + Acetylsalicylic acid Major
- Acemetacin + Acetylsalicylic acid Major
- Acetazolamide + Acetylsalicylic acid Major
- Acetylsalicylic acid + Alteplase Major
Other interactions of Bismuth subsalicylate
Frequently asked questions
Can I take Acetylsalicylic acid with Bismuth subsalicylate?
MediHelp rates the interaction as moderate. Acetylsalicylic acid and Bismuth subsalicylate can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Bismuth subsalicylate is hydrolysed to release salicylate, so taking it with aspirin adds to the total salicylate load. This can raise the risk of salicylate toxicity such as tinnitus and gastrointestinal bleeding, especially with repeated or high dosing.
How serious is the interaction between Acetylsalicylic acid and Bismuth subsalicylate?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid routine concurrent use of bismuth subsalicylate with analgesic-dose aspirin and limit duration. Monitor for tinnitus, GI bleeding and bruising, particularly in older adults and those on anticoagulants.
What other medicines interact with Acetylsalicylic acid?
MediHelp also lists interactions of Acetylsalicylic acid with, for example, Ketorolac, Ketorolac intranasal, Abciximab. The full list is on the Acetylsalicylic acid page.
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