bismuth subsalicylate (Pepto Bismol, Kaopectate, Bismatrol Maximum Strength, and others)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is bismuth subsalicylate-oral, and how does it work (mechanism of action)?

Bismuth subsalicylate (BSS) is a commonly used over the counter medicine used to treat:

Bismuth subsalicylate is also used to prevent traveler's diarrhea and to treat Helicobacter pylori (H. pylori) infection as part of a quadruple-drug therapy that also includes two antibiotics, and either a histamine-2 receptor antagonist or proton pump inhibitor.

Bismuth subsalicylate has various therapeutic benefits in the body including anti-bacterial, weak antacid, anti-inflammatory, and anti-secretory actions. After oral administration, bismuth subsalicylate is degraded in the stomach to produce salicylic acid. Salicylic acid inhibits the synthesis of prostaglandin, a chemical made in the body that plays an important role in contraction of smooth muscle and relaxation, dilation & constriction of blood vessels, blood pressure control, and modulation of inflammation.

The antidiarrheal benefits of bismuth subsalicylate may be due to the reduction in prostaglandin synthesis. Bismuth subsalicylate also prevents the attachment of bacteria to the walls of the intestine, inactivates enterotoxins (toxic chemicals made by bacteria), and has a direct inhibiting effect on bacteria.

Bismuth subsalicylate was first approved by the FDA in 1939.

What brand names are available for bismuth subsalicylate-oral?

Bismatrol Maximum Strength, Pepto Bismol, Kaopectate, and many other brands

Is bismuth subsalicylate-oral available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for bismuth subsalicylate-oral?

No

What are the side effects of bismuth subsalicylate-oral?

Dark brown or black stools are common with use of bismuth subsalicylate. Tongue discoloration and constipation also may occur.

Other side effects associated with bismuth subsalicylate include:

Quick GuideDigestive Disorders: Common Misconceptions

Digestive Disorders: Common Misconceptions
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