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Bismuth Subsalicylate

(biz muth) (sub sa lis' i late)

Brand Name(s): Bismusal®, Kaopectate®, Peptic Relief®, Pepto-Bismol®, Pink Bismuth®, Stomach Relief®; also available generically

WHY is this medicine prescribed?

Bismuth subsalicylate is used to treat diarrhea, heartburn, and upset stomach in adults and children 12 years of age and older. Bismuth subsalicylate is in a class of medications called antidiarrheal agents. It works by decreasing the flow of fluids and electrolytes into the bowel, reduces inflammation within the intestine, and may kill the organisms that can cause diarrhea.

HOW should this medicine be used?

Bismuth subsalicylate comes as a liquid, tablet, or chewable tablet to be taken by mouth, with or without food. Follow the directions on the package carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take bismuth subsalicylate exactly as directed. Do not take more or less of it or take it more often than recommended by the manufacturer or your doctor.

Swallow the tablets whole; do not chew them.

Shake the liquid well before each use to mix the medication evenly.

If your symptoms get worse or if your diarrhea lasts longer than 48 hours, stop taking this medication and call your doctor.

What SPECIAL PRECAUTIONS should I follow?

Before taking bismuth subsalicylate,

  • tell your doctor or pharmacist if you are allergic to salicylate pain relievers such as aspirin, choline magnesium trisalicylate, choline salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doan's, others), and salsalate (Argesic, Disalcid, Salgesic); or any other medication.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to talk to your doctor or pharmacist about taking bismuth subsalicylate if you take: anticoagulants ('blood thinners') such as warfarin (Coumadin); a daily aspirin; or medication for diabetes, arthritis or gout.
  • if you are taking tetracycline antibiotics such as demeclocycline (Declomycin), doxycycline (Doryx, Vibramycin), minocycline (Dynacin, Minocin), and tetracycline (Sumycin), take them at least 1 hour before or 3 hours after taking bismuth subsalicylate.
  • ask your doctor before taking this medication if you have ever had an ulcer, bleeding problem, stools that are bloody or blackened, or kidney disease. Also ask your doctor before taking bismuth subsalicylate if you have a fever or mucus in your stool. If you will be giving bismuth subsalicylate to a child or teenager, tell the child's doctor if the child has any of the following symptoms before he or she receives the medication: vomiting, listlessness, drowsiness, confusion, aggression, seizures, yellowing of the skin or eyes, weakness, or flu-like symptoms. Also tell the child's doctor if the child has not been drinking normally, has had excessive vomiting or diarrhea, or appears dehydrated.
  • ask your doctor about taking this medication if you are pregnant or are breast-feeding.

What SPECIAL DIETARY instructions should I follow?

Drink plenty of water or other beverages to replace fluids that you may have lost while having diarrhea.

Unless your doctor tells you otherwise, continue your normal diet.

What should I do IF I FORGET to take a dose?

This medication is usually taken as needed. If your doctor has told you to take bismuth subsalicylate regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Bismuth subsalicylate may cause side effects.

Some side effects can be serious. If you experience this symptom, stop taking this medication and call your doctor immediately:

  • ringing or buzzing in your ear(s)

Bismuth subsalicylate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Ask your pharmacist any questions you have about bismuth subsalicylate.

You may notice darkening of the stool and/or tongue while you are taking bismuth subsalicylate. This darkening is harmless and usually goes away in a few days after you stop taking this medication.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.


This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists® represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists® makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists® does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

Pronunciation Guide for Drug Names is used with permission. © 2009. The United States Pharmacopeial Convention. All Rights Reserved.

AHFS® Patient Medication Information™. © Copyright, 2020. The American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: August 15, 2016.