Can you take Bismuth subsalicylate with Imodium?
No drug interactions found, but 13 warnings to review for the following 2 drugs:
- bismuth subsalicylate
- Imodium (loperamide)
Drug interactions
There were no interactions found between bismuth subsalicylate and Imodium. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
loperamide Food/Lifestyle
Applies to: Imodium (loperamide)
Alcohol can increase the nervous system side effects of loperamide such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with loperamide. Do not use more than the recommended dose of loperamide, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.
Disease interactions
12 potential interactions Applies to: 12 conditions, including Inflammatory Bowel Disease, Influenza, Liver Disease, Vitamin K Deficiency, and Varicella-Zoster.
Bleeding Disorder
Moderate:
bismuth subsalicylate
Bismuth subsalicylate has a moderate potential interaction with Bleeding Disorder.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Coagulation Defects and Disorders
Moderate:
bismuth subsalicylate
Bismuth subsalicylate has a moderate potential interaction with Coagulation Defects and Disorders.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Dehydration
Moderate:
Imodium
The loperamide in Imodium has a moderate potential interaction with Dehydration.
Diarrhea can cause severe dehydration and electrolyte imbalance. Fluid accumulation within the GI track due to antiperistaltic-associated decrease in peristalsis can further aggravate dehydration and electrolyte imbalance. Antiperistaltic agents should be administered cautiously in patients with electrolyte imbalance and rehydration and electrolyte replacement should be initiated prior to initiation of therapy.
Infectious Gastroenteritis
Major:
Imodium
The loperamide in Imodium has a major potential interaction with Infectious Gastroenteritis.
The use of drugs with antiperistaltic activity (primarily antidiarrheal and antimuscarinic agents, but also antispasmodic agents such as dicyclomine or oxybutynin at high dosages) is contraindicated in patients with diarrhea due to pseudomembranous enterocolitis or enterotoxin-producing bacteria. These drugs may prolong and/or worsen diarrhea associated with organisms that invade the intestinal mucosa, such as toxigenic E. coli, Salmonella and Shigella, and pseudomembranous colitis due to broad-spectrum antibiotics. Other symptoms and complications such as fever, shedding of organisms and extraintestinal illness may also be increased or prolonged. In general, because antiperistaltic agents decrease gastrointestinal motility, they may delay the excretion of infective gastroenteric organisms or toxins and should be used cautiously in patients with any infectious diarrhea, particularly if accompanied by high fever or pus or blood in the stool. Some cough and cold and other combination products may occasionally include antimuscarinic agents for their drying effects and may, therefore, require careful selection when necessary.
Inflammatory Bowel Disease
Moderate:
Imodium
The loperamide in Imodium has a moderate potential interaction with Inflammatory Bowel Disease.
Decreased intestinal motility and prolonged transit time have resulted in toxic megacolon in patients with acute ulcerative colitis. Paralytic ileus has also occurred. Antiperistaltic agent GI motility and prolongs transit time and therapy should be administered cautiously in these patients.
Influenza
Major:
bismuth subsalicylate
Bismuth subsalicylate has a major potential interaction with Influenza.
The use of salicylates, primarily aspirin, in children with varicella infections or influenza-like illnesses has been associated with an increased risk of Reye's syndrome. Although a causal relationship has not been established, the majority of evidence to date seems to support the association. Most authorities, including the American Academy of Pediatrics Committee on Infectious Diseases, recommend avoiding the use of salicylates in children and teenagers with known or suspected varicella or influenza and during presumed outbreaks of influenza. If antipyretic or analgesic therapy is indicated under these circumstances, acetaminophen may be an appropriate alternative. The same precautions should also be observed with related agents such as salicylamide or diflunisal because of their structural and pharmacological similarities to salicylate.
Liver Disease
Moderate:
Imodium
The loperamide in Imodium has a moderate potential interaction with Liver Disease.
Therapy with antiperistaltic agents should be administered with extreme caution in patients with hepatorenal disease or abnormal liver enzymes. Antiperistaltic agents are metabolized by the liver (diphenoxylate to an active form) and primarily excreted in the feces. Hepatic coma can be precipitated.
Renal Dysfunction
Moderate:
Imodium
The loperamide in Imodium has a moderate potential interaction with Renal Dysfunction.
Therapy with antiperistaltic agents should be administered with extreme caution in patients with hepatorenal disease or abnormal liver enzymes. Antiperistaltic agents are metabolized by the liver (diphenoxylate to an active form) and primarily excreted in the feces. Hepatic coma can be precipitated.
Thrombocytopathy
Moderate:
bismuth subsalicylate
Bismuth subsalicylate has a moderate potential interaction with Thrombocytopathy.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Thrombocytopenia
Moderate:
bismuth subsalicylate
Bismuth subsalicylate has a moderate potential interaction with Thrombocytopenia.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
Varicella-Zoster
Major:
bismuth subsalicylate
Bismuth subsalicylate has a major potential interaction with Varicella-Zoster.
The use of salicylates, primarily aspirin, in children with varicella infections or influenza-like illnesses has been associated with an increased risk of Reye's syndrome. Although a causal relationship has not been established, the majority of evidence to date seems to support the association. Most authorities, including the American Academy of Pediatrics Committee on Infectious Diseases, recommend avoiding the use of salicylates in children and teenagers with known or suspected varicella or influenza and during presumed outbreaks of influenza. If antipyretic or analgesic therapy is indicated under these circumstances, acetaminophen may be an appropriate alternative. The same precautions should also be observed with related agents such as salicylamide or diflunisal because of their structural and pharmacological similarities to salicylate.
Vitamin K Deficiency
Moderate:
bismuth subsalicylate
Bismuth subsalicylate has a moderate potential interaction with Vitamin K Deficiency.
All salicylates can interfere with the action of vitamin K and induce a dose-dependent alteration in hepatic synthesis of coagulation factors VII, IX and X. At usual recommended dosages, a slight increase in prothrombin time (PT) may occur. Therapy with salicylates, especially if given in high dosages, should be administered cautiously in patients with significant active bleeding or a hemorrhagic diathesis, including hemostatic and/or coagulation defects associated with hemophilia, vitamin K deficiency, hypoprothombinemia, thrombocytopenia, thrombocytopathy, or severe hepatic impairment. The same precaution should also be observed with the use of related agents such as salicylamide because of their structural and pharmacological similarities to salicylate.
More resources
bismuth subsalicylate
A total of 145 drugs are known to interact with bismuth subsalicylate.
- Bismuth subsalicylate is in the drug class antidiarrheals.
- Bismuth subsalicylate is used to treat the following conditions:
Imodium
A total of 382 drugs are known to interact with Imodium.
- Imodium is in the drug class antidiarrheals.
- Imodium is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.