Adult Dosing

Antidiarrheal

• 2 tablets or 30 mL (262 mg/15 mL) susp PO q30-60 mins PRN until diarrhea stops but not more than 2 day (Max: 8 doses/day)

Pediatric Dosing

Antidiarrheal

• Child >12 yrs: 2 tablets or 30 mL (262 mg/15 mL) suspension PO q30-60 mins PRN until diarrhea stops but not more than 2 day (Max: 8 doses/day)
• Child 9-12 yrs: 1 tablet (262 mg) or 15 mL (262 mg/15 mL) susp PO q30-60 mins PRN (Max: 8 doses/day)
• Child 6-9 yrs: 2/3 tablet (175 mg) or 10 mL (262 mg/15 mL) susp PO q30-60 mins PRN (Max: 8 doses/day)
• Child 3-6 yrs: 1/3 tablet (87 mg) or 5 mL (262 mg/15 mL) susp PO q30-60 mins PRN (Max: 8 doses/day )

[Outline]

• Adult Dosing
• Pediatric Dosing

• Treatment of diarrhea
• Nausea, abdominal cramping, heartburn, and indigestion that may accompany diarrheal illnesses
• Stomach upset
• Prevention of traveler’s diarrhea

• Hypersensitivity to any of the ingredients of the product
• Hypersensitivity to salicylates
• Bleeding disorder
• Bloody or black stool
• Febrile viral infection
• Peptic ulcer diseases
• Children or teenagers with or recovering from influenza or varicella

• N/A

Renal Dose Adjustment (Based on CrCl)

• <80 mL/min: Avoid use

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Discontinue therapy if symptoms get worse or last for more than 2 days
• Bismuth subsalicylate therapy can cause ringing in the ear or hearing loss, discontinue the drug immediately on onset of these symptoms
• Darkening of stool and or tongue can occur with bismuth subsalicylate
• During bismuth subsalicylate therapy if changes in behavior with nausea and vomiting occur, evaluate for Reye’s syndrome as these are the early signs of Reye’s syndrome
• Colitis or other GI mucosa abnormalities may enhance bismuth absorption
• Concomitant administration of anticoagulants or other medications by alter absorption

Cautions: Use cautiously in

• Diabetes mellitus
• Gout
• Arthritis
• Anticoagulant use
• Hemophilia
• Ulcers

Bismuth interacts with :

	Adoxa
	Declomycin
	Demeclocycline
	Doryx
	Doxy 100
	Doxy 200
	Doxycycline
	Dynacin
	Minocin
	Minocon
	Minocycline
	Monodox
	Oracea
	Oxytetracycline
	Periostat
	Solodyn
	Tetracycline
	Vibra-Tabs
	Vibramycin
	Ximino

Pregnancy Category:C

Breastfeeding: Because of the possibility of absorption of salicylate from the breastmilk by the infant, alternatives drug is preferred based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 1 Feb 2011).

• GI: Constipation, blackened stool, blackened tongue
• EENT: Tinnitus
• MISC: Reye syndrome

• Antidiarrheal; exact mechanism unknown, however stimulates absorption of fluid and electrolytes across the intestinal wall (antisecretory action) and also hydrolyzed to salicylic acid, by inhibiting synthesis of a prostaglandin responsible for intestinal inflammation and hypermotility
• Metabolized by chemical dissociation in the GI tract
• Excretion: Unchanged in feces (Bismuth); >90% in urine(Salicylate)
• Half life
• Bismuth: 21-72 days
• Salicylic acid: 2-5 hrs

US Trade Name(s)

• Kaopectate
• Kaopectate Extra strength
• Pepto-Bismol
• Pepto-Bismol Maximum strength
• Maalox Total Relief

US Availability

bismuth subsalicylate (generic)

• CHEW TABS: 262 mg
• LIQ: 262 mg/15 mL
• LIQ: 575 mg/15 mL

Kaopectate

• LIQ: 262 mg/15 mL

Kaopectate extra strength

• LIQ: 525 mg/15 mL

Pepto-Bismol

• TABS: 262 mg
• CHEW TABS: 262 mg
• LIQ: 262 mg/15 mL

Pepto-Bismol Maximum strength

• LIQ: 525 mg/15 mL

Maalox Total Relief

• LIQ: 525 mg/15 mL

Canadian Trade Name(s)

• Bismuth
• Bismuth Extra strength
• Pepto-Bismol
• Pepto-Bismol Extra strength
• Pepto-Bismol with Instacool
• Stomak-Care Multi Action

Canadian Availability

bismuth subsalicylate (generic)

• LIQ: 17.5 mg/mL
• CAPLET: 262 mg

bismuth subsalicylate extra strength (generic)

• LIQ: 35 mg/mL

Bismuth

• LIQ: 17.6 mg/mL
• LIQ: 17.5 mg/mL
• TABS: 262 mg
• CAPLET: 262 mg
• CHEW TABS: 262 mg

Bismuth Extra strength

• LIQ: 35 mg/mL

Pepto-Bismol

• CAPLET: 262 mg
• LIQ: 17.6 mg/mL
• CTABS: 262 mg

Pepto-Bismol Extra strength

• LIQ: 35.2 mg/mL

Pepto-Bismol with Instacool

• CHEW TABS: 262 mg

Stomak-Care Multi Action

• LIQ: 35 mg/mL

UK Trade Name(s)

• Pepto-Bismol

UK Availability

Pepto-Bismol

• CHEW TABS: 262.5 mg
• LIQ: 17.5 mg/ mL

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Gastrointestinal

Antidiarrheals

Drug Name: Pepto-Bismol (Bismuth Subsalicylate 262 mg)

Ingredient(s): N/A

Imprint: N/A

Color(s): Pink

Shape: Round

Size (mm): 16.00

Score: 1

Inactive Ingredient(s): N/A

Drug Label Author:
The Procter & Gamble Manufacturing Company

DEA Schedule:
Non-Scheduled