Pepto Bismol is an over-the-counter (OTC) that can help control the intermittent symptoms of simple digestive problems such as indigestion, heartburn, and diarrhea.
Pepto Bismol is an antacid. It comes in various forms, including capsules and liquids, and has many advantages. Some people may experience side effects after taking Pepto Bismol, such as dark or black stools. However, these side effects are usually temporary and harmless.
This drug may also interact with other medications, such as anticoagulants or blood thinners. People should only use Pepto Bismol or similar products for a short period to treat intermittent symptoms. People suffering from chronic digestive symptoms should consult their doctor.
This article provides an overview, including uses, risks, and instructions for Pepto Bismol.
A study published in the journal Clinical and Experimental Gastroenterology (Clinical and Experimental Gastroenterology) found that bismuth has diarrheal, antibacterial, and anti-inflammatory properties in the body.
These combined efforts can help with digestive symptoms such as:
- Water brash
- Upset stomach
- Feeling so full
In some cases, you can always use Pepto Bismol and other drugs under the guidance of a doctor to treat an infection caused by the H. pylori bacterium and the symptoms it causes. Sometimes doctors may recommend it to treat symptoms of chronic digestive disorders.
Some people find the antibacterial effect of Pepto Bismol beneficial when traveling to unfamiliar areas where local bacteria can infect the digestive tract and cause traveler’s diarrhea.
No one should self-diagnose the underlying problem and treat it with Pepto Bismol. People whose symptoms worsen or persist for more than two days should contact their doctor for a complete diagnosis.
Types of Pepto Bismol
Pepto Bismol is available in a variety of forms, including:
- Oral liquid
- Oral liquid capsules
- Oral tablet
- Chewable Tablets
Each option includes different strengths and doses of Bismuth Subsalicylate designed for specific symptoms and how quickly relief is needed.
How to take it?
Anyone taking Pepto Bismol to treat intermittent digestive symptoms should follow the instructions on the label.
The original liquid Pepto Bismol contains a single 30ml (ml) cup that provides 525mg of bismuth subsalicylate. The Pepto Bismol website recommends taking the:
- Take 30ml every 30 minutes for gastrointestinal disorders, nausea, heartburn, and indigestion.
- Take 30 ml every 30 minutes for 1 hour or two times every hour for diarrhea or traveler’s diarrhea.
It also warns against taking more than eight doses in 24 hours.
When using the original chewable tablets, the single dose is two tablets. The recommended dosage is:
- For diarrhea, two tablets every 30 minutes or four tablets every hour
- Two tablets every 30 minutes for gastrointestinal upset, nausea, heartburn, and indigestion
- Likewise, do not take more than eight doses (16 tablets) in 24 hours.
Pepto Bismol Extra Strength is a more concentrated liquid but provides the same amount of active ingredient per recommended dose (525 mg of bismuth subsalicylate in 15 ml of liquid).
For children under 12, use a children’s version of a similar drug or consult a doctor before using Pepto Bismol.
Do not take more Pepto Bismol than directed, even if symptoms do not go away.
People who use Pepto Bismol or similar drugs to treat more severe problems, such as infections, should follow their doctor’s instructions.
How Pepto-Bismol Works
The scientific name for the active ingredient in Pepto-Bismol is bismuth subsalicylate. Bismuth is a mineral with antibacterial, antacid, and anti-diarrheal effects. Subsalicylate is a drug in the same class as aspirin.
The active ingredients in Pepto-Bismol are thought to:
- It hardens stool by increasing the amount of fluid absorbed in the intestine.
- Reduced inflammation
- Calming intestinal cramps
- Decreasing numbers of disease-causing bacteria and viruses
- Reduce excessive stomach acid levels
Pepto-Bismol is considered safe for short-term use by adults and children 12 years of age and older.
Common side effects
When appropriately used, Pepto-Bismol has several side effects.
Blackening of the tongue
Dark or black stool
These side effects are temporary and usually harmless.
Serious side effects
Serious side effects of Pepto-Bismol are rare but not unheard of.
Adults 65 and older: A side effect of constipation can lead to an intestinal blockage, a severe condition.
Children and adolescents: Pepto-Bismol belongs to the aspirin family. Aspirin use in children and teenagers is associated with a risk of Reye’s syndrome, a potentially life-threatening disease. This risk is exceptionally high for people who have chickenpox, influenza (flu), or other types of viral infections.
Peptokiz, a children’s formulation, is safe for children as it does not contain bismuth subsalicylate. Pepto Kids is designed to treat heartburn and upset stomachs in children.
Side effects from the use of bismuth subsalicylate are uncommon. The most common side effects are very dark or black stools and darkening of the tongue. This is a reaction to bismuth and is temporary. The discoloration should disappear when the person stops taking the product.
Most people do not experience severe side effects. However, people who are allergic to salicylic acid, a chemical found in aspirin, may experience more severe side effects. People who are allergic to any of these ingredients may want to talk to their doctor about alternatives to using Pepto Bismol.
In rare cases, you may experience ringing in your ears or hearing loss. If this happens, you should stop taking the product immediately and contact your doctor.
Extreme reactions may result in internal bleeding in the stomach or intestines. People who experience severe cramps, bloody or black, sticky stools, or vomiting, like coffee grounds, should stop taking the drug and see a doctor immediately.
Children or adolescents recovering from chickenpox or the flu should not take Pepto Bismol. Taking Pepto Bismol in these situations may cause Reye’s syndrome. Symptoms of Reye’s syndrome include behavioral changes, nausea, vomiting, and seizures.
Pepto-Bismol is recommended for use only for two days. This makes it a poor choice as a treatment for people experiencing chronic diarrhea, which is common in people with IBS. It is also a poor choice for people experiencing chronic heartburn or acid reflux due to gastroesophageal reflux disease (GERD).
Before taking Pepto-Bismol, it is essential to remove it with your healthcare provider as it may interact with other medications, particularly medications for diabetes or gout, blood thinners, and certain antibiotics.
Precautions and contraindications
- Under 12 years old
- Got the flu
- Fever and blood in stool
- People who have had chickenpox or have been vaccinated against chickenpox within the past six weeks
- During pregnancy
- While breastfeeding
If you are allergic to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
Pepto-Bismol is an oral drug that comes in liquid, tablet, or chewable form. Carefully follow the directions and recommended dosage on the product packaging.
Frequently Asked Questions
What are the side effects of Pepto-Bismol?
The most common side effect of Pepto-Bismol is a black tongue or black stool. Both are harmless. Pepto-Bismol contains a non-toxic metal called bismuth, which, when mixed with sulfur (a naturally occurring mineral in the body), forms a black substance called bismuth sulfide.4
Can Pepto-Bismol cause serious side effects?
In rare cases, Pepto-Bismol is known to cause potentially serious side effects. Call your healthcare provider if any of the following occur after taking Pepto-Bismol:
- Severe vomiting
- Blood in the stool (usually mild)
- Coffee grounds-like vomiting (a sign of stomach bleeding)
- Tinnitus (ringing or buzzing in the ears)
Who should not take Pepto-Bismol?
Pepto-Bismol is contraindicated in people with the following conditions:
- Aspirin allergy
- stomach ulcer
- Bloody stool (bloody stool)
- Flu-like symptoms (because only children and adolescents are at risk for Reye syndrome)
Also, children under the age of 12 should not take generic Pepto-Bismol. Pepto Kids should not be given to children under two years of age.
What drugs interact with Pepto-Bismol?
Pepto-Bismol can potentially interact with a wide range of drugs. Before starting Pepto-Bismol, tell your healthcare provider if you are taking any of the following:
- Arthritis or gout medications
- blood thinners such as warfarin
- Daily aspirin
- Diabetes Treatment
- Tetracycline antibiotics
What are the alternatives to Pepto-Bismol?
Depending on the condition being treated, Pepto-Bismol has several over-the-counter alternatives.
- Indigestion may be relieved with Alka-Seltzer (sodium bicarbonate) or Mylanta (simethicone).
- Constipation can be treated with stool softeners, osmosis, stimulants, or bulky laxatives.
- Diarrhea can be treated with Imodium (loperamide).
- Nausea can be treated with Dramamine (dimenhydrinate) or Bonine (meclizine).
How long does Pepto-Bismol take to work?
Pepto-Bismol usually starts working within 30 minutes to an hour. You can take a second dose if you do not feel relieved after an hour.
What happens if I overdose?
Overdose symptoms may include weakness, depression, anxiety, irritability, balance or coordination problems, confusion, tremors, or rapid muscle movements.
What other drugs will affect bismuth subsalicylate?
Ask your doctor or pharmacist before using bismuth subsalicylate, especially with other medications, such as:
- arthritis medicine;
- gout medicine;
- insulin or oral antidiabetic drugs;
- anticoagulants – warfarin, coumadin, xanthoven;
This list is not exhaustive. Other drugs, including prescription and over-the-counter medicines, vitamins, and herbal products, can affect bismuth subsalicylic acid. Not all possible interactions are listed here.
Where can I get more information?
Your pharmacist can provide more information about bismuth subsalicylate.
Remember. Keep this and all other medicines out of the reach of children, do not share the treatment with others and use this medicine only for the conditions prescribed.
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