Bismuth Subsalicylate

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Oct 09, 2023

Warnings


Bismuth Subsalicylate Risks, Warnings, and Complications


Bismuth subsalicylate can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatments for diarrhea and indigestion if you are at an increased risk of serious adverse events from this medication. Some of the risks of treatment with bismuth subsalicylate include:

  • REYE’S SYNDROME: Children and teenagers who currently or recently had chicken pox or flu-like symptoms should not take bismuth subsalicylate. If you give Pepto Bismol to a child or teenager and notice nausea, vomiting, or altered mental status (changes in behavior), contact your doctor immediately. These can be early signs of a rare but serious condition called Reye's syndrome.

  • ALLERGIC REACTIONS: Bismuth subsalicylate contains salicylate. You should not take this medication if you have an allergy to aspirin or other salicylates (pain relievers) such as choline salicylate (Arthropan), magnesium salicylate (Doan's, others), choline magnesium trisalicylate, diflunisal (Dolobid), and salsalate (Disalcid, Argesic, others).

  • OVERDOSE: Do not exceed the recommended maximum dose of bismuth subsalicylate in a 24-hour period, as indicated on the package. In case of bismuth toxicity, contact your doctor without delay or call a poison control center immediately.


Precautions Before Starting Bismuth Subsalicylate

Tell your doctor if you had an allergic reaction to bismuth subsalicylate in the past, any of the active or inactive ingredients in bismuth subsalicylate formulations, aspirin equivalent drugs, other salicylates, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions between your medications.

Tell your health care professional if you have any pre-existing health problems. Bismuth subsalicylate may not be right for people with certain medical conditions such as peptic ulcer disease, bleeding disorders, or kidney disease. Ask your healthcare provider before starting bismuth therapy if you have a fever or mucus in your stool.

Tell your health care professional if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.

Precautions During Use of Bismuth Subsalicylate

Call your health care professional if your symptoms are getting worse or if diarrhea is still present after 48 hours (2 days). You may have gastrointestinal diseases that cannot be treated with bismuth subsalicylate. 

Drink plenty of water to prevent dehydration due to fluid loss from diarrhea.

If you are taking antibiotics such as doxycycline (Vibramycin, Doryx), demeclocycline (Declomycin), minocycline (Minocin, Dynacin), or tetracycline (Sumycin), make sure you take them 1 or more hours before or 3 or more hours after taking Pepto Bismol (bismuth subsalicylate).

Bismuth Subsalicylate Drug Interactions

Other drugs may affect how bismuth subsalicylate works. Possible interactions with some other medication can increase the risk of severe adverse effects. 

Check with your doctor or pharmacist before starting bismuth therapy if you are taking anticoagulants (blood thinners) such as warfarin (Coumadin) or medications used to treat diabetes, gout, or arthritis. 

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription and non-prescription medications.