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Bismuth Subsalicylate

    Brands

    DEA Class; OTC

    Common Brand Names; Kaopectate, Pepto Bismol, Maalox Total Relief, Kaopectate Extra Strength, Pepto-Bismol Maximum Strength

    • Antidiarrheals; 
    • H pylori Agents

    Antimicrobial anti-inflammatory action (bismuth); antisecretory effect (salicylate)

    Indicated for Diarrhea, Gas, Upset Stomach, Indigestion, Heartburn, Nausea, Traveler’s Diarrhea, Helicobacter Pylori

    Hypersensitivity to bismuth, aspirin, other salicylates

    Infectious diarrhea, high fever, von Willebrand disease, hemorrhage, ulcer or GI bleeding with black or bloody stool, hemophilia

    In pediatric patients, chicken pox or influenza (risk of Reye syndrome)

    • Nausea (12%)
    • Diarrhea (7%)
    • Abdominal pain (7%)
    • Melena (3%)
    • Upper respiratory tract infection (2%)
    • Constipation (2%)
    • Anorexia (2%)
    • Vomiting (2%)
    • Asthenia (2%)
    • Discolored tongue (2%)
    • Headache (2%)
    • Dyspepsia (2%)
    • Dizziness (2%)
    • Stool abnormality (1%)
    • Duodenal ulcer (1%)
    • Sinusitis (1%)
    • Taste perversion (1%)
    • Flatulence (1%)
    • GI hemorrhage (1%)
    • Pain (1%)
    • Insomnia (1%)
    • Anal discomfort (1%)
    • Paresthesia (1%)

    Bismuth subcitrate potassium may cause temporary and harmless darkening of tongue and/or black stools, generally reversible within several days after treatment stopped; stool darkening should not be confused with melena

    Bismuth absorbs x-rays and may interfere with x-ray diagnostic procedures of gastrointestinal tract

    Cases of neurotoxicity associated with excessive doses of various bismuth-containing products reported; effects have been reversible with discontinuation of bismuth therapy

    Not to be administered to children or teenagers recovering from flu-like symptoms or chickenpox; increased incidence of Reye syndrome, associated with salicylate products

    Pregnancy category: C; D in 3rd trimester

    Lactation: Salicylates enter breast milk; use with caution

    Diarrhea, Gas, Upset Stomach, Indigestion, Heartburn, Nausea

    2 tablets (262 mg/tab) or 30 mL (regular strength) PO q½-1hr PRN; maximum daily dose: 8 regular-strength doses or 4 extra-strength doses

    Traveler’s Diarrhea

    Prophylaxis

    2 tablets (262 mg/tab) q6hr for up to 3 weeks

    Helicobacter Pylori

    525 mg (2 regular-strength tablets or 1 extra-strength tablet) + 250 mg metronidazole + 500 mg tetracycline PO q6hr for 14 days, plus an H2 antagonist (Helidac Therapy pack)

    Bismuth subsalicylate

    tablet, chewable

    • 262mg
    • 525mg

    caplet

    • 262mg

    oral suspension

    • 262mg/15mL
    • 525mg/15mL
    • 525 mg/30 mL
    • 1050 mg/30 mL