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.

woman with abdominal pain

SIDE EFFECTS: 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:

PRESCRIPTION: No

GENERIC AVAILABLE: Yes

PREPARATIONS:

  • Chewable tablets: 262, 525 mg
  • Oral suspension: 262 mg/15 ml, maximum strength 525 mg/15 ml
  • Caplets: 262 mg

STORAGE: Bismuth subsalicylate products should be stored at room temperature, between 59 F to 86 F (15 C to 30 C).

DOSING:

Over-the-counter treatment of nonspecific diarrhea in adults and adolescents (= 12 years):

  • Chewable tablets, caplets, liquids containing 262 mg/15 ml: 524 mg by mouth every 30-60 minutes as needed. Not to exceed 8 doses in 24 hours.
  • Liquids containing 525 mg/15 ml: 1050 mg by mouth every hour as needed. Not to exceed 4 doses in 24 hours.
  • Over-the-counter treatment of upset stomach, heartburn, indigestion, nausea, and related symptoms in adults and adolescents (= 12 years):
  • Chewable tablets, caplets, liquids containing 262 mg/15 ml: 524 mg by mouth every 30-60 minutes as needed. Not to exceed 8 doses in 24 hours.
  • Liquids containing 525 mg/15 ml: 1050 mg by mouth every hour as needed. Not to exceed 4 doses in 24 hours.
  • For the prevention of traveler's diarrhea due to Escherichia coli (E. coli) and viral infections in adults and adolescents (≥ 12 years):
  • 524 mg by mouth four times daily, starting 1 day before departure and continuing for 2 days after returning. Generally, treatment duration should not exceed 3 weeks.
  • For the eradication of helicobacter pylori as part of quadruple-drug regimen in adults and adolescents (≥ 12 years):
  • 525 mg by mouth 4 times daily.
Medically Reviewed by a Doctor on 5/12/2015

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