Pepto- Bismol side effects and drug information

Pepto- Bismol or also more commonly known as “the pink stuff” is quite popular over- the- counter medicine that is formulated to treat digestive problems. 

Formula C7H5BiO4
ChemSpider ID 17615374
ChemSpider 17215772
DrugBank DB01294
Molar mass 362.093 g/mol

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If you feel like you are feeling a bit queasy, then read on about this product to learn more about it and know how to use it properly.

What is Pepto- Bismol?

This medication called “the pink stuff” is used for the treatment of diarrhea as well as to provide relief for the symptoms of the upset stomach, which can be identified as the following: heartburn, nausea, indigestion, gas, belching, and feeling of fullness.

Pepto- Bismol contains an active ingredient called bismuth subsalicylate and belongs to the Flexeril drug class known as salicylates. This medicine comes in regular strength and is available in 3 different forms, which are caplet, chewable tablet, and liquid.

In its liquid form, maximum strength is available as well. All this product’s forms are ingested by mouth.

How it works

How does Pepto- Bismol work? As a treatment for diarrhea, this is how this drug functions:

  • It increases the amount of fluid that the intestines absorb
  • It decreases the inflammation and the overactivity of the intestines, so it gives a calming effect to the intestines
  • It prevents the body from releasing a chemical called prostaglandin which is the one causing the inflammation
  • It blocks toxins that are produced by certain bacteria such as E. coli
  • It eliminates other bacteria that cause diarrhea
  • Its active component called bismuth salicylate contains antacid properties that aid in decreasing heartburn, upset stomach indigestion, and diarrhea

Side Effects

This medicine for digestive problems is generally safe to use, but as in any other drug, it may still possibly cause some side effects, which may range from the common ones to some severe reactions. Though the users have experienced mostly mild side effects that go away shortly after they stop taking medicine, there are still some few and rare cases where the side effects turned severe. If this kind of reaction happens, see your doctor right away.

Common Side Effects

  • Black stool
  • Black, hairy tongue

These types of common side effects are not harmful and are only temporary. These usually go away within a couple of days after stopping the use of medicine. If these conditions persist, talk to your doctor.

Serious Side Effect

The only reported serious side effect from Pepto- Bismol is if you experience ringing in your ears. This condition is rare and uncommon, so if you encounter this symptom, stop taking medicine and consult your doctor right away.

Indication and Dosage

Pepto- Bismol may be used by both adults and children from 12 years old and up. They may take any of the forms of this medicine (liquid, caplet, or chewable tablet) but for only up to 2 days.

In case the condition did not get better after two days of taking this drug, or if you experience ringing in your ears, immediately stop the use of Pepto- Bismol and see your doctor.

The dosage that will be mentioned here applies to all digestive problems.

Liquid Suspension

Its liquid version comes in 2 strengths, which are regular and maximum.

The recommended dosage for the regular strength is:

  • Take 30ml or 525mg every 30 to 60 minutes as needed
  • You are not allowed to take more than eight doses or 240ml in 24 hours

The appropriate dosage for the maximum strength is:

  • Take 30ml of 1,050mg every 60 minutes as needed
  • You should not consume more than four doses or 120ml within the 24 hours

Chewable Tablets

The recommended dosage and instructions for its chewable tablet version is:

  • Take two tablets of 262mg each for the interval of 30 to 60 minutes as needed
  • Dissolve in your mouth or chew
  • Do not consume more than eight doses or 16 pills or 4,192mg in 24 hours


The instructions for usage and appropriate dosage for the caplet version is:

  • Take two caplets of 262mg each every 30 to 60 minutes as needed
  • Swallow the caplets with water. Caplets are not intended to be chewed.
  • Do not take more than eight doses that would be equivalent to 16 caplets or 4,192mg in 24 hours

Drug Interaction

Though Pepto- Bismol is a generally safe medicine to use, it may still have interactions with some other medications. So before taking this product, it would be best if you consult with your doctor and inform him or her about all your other medications like thorazine and if you have other medical conditions aside from the digestive problem.

This product may interact with the following medicines:

  • Angiotensin-converting enzymes (ACE) inhibitors such as benazepril, captopril, enalapril, fosinopril, Lisinopril and trandolapril
  • Blood thinners or anticoagulants that include warfarin
  • Treatments used for diabetes such as insulin, metformin, sulfonylureas, dipeptidyl- peptidase- IV (DPP- IV) inhibitors and sodium-glucose transporter (SGLT) 2 inhibitors
  • Medicines for gout like probenecid
  • Methotrexate
  • Other salicylates including aspirin
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen, ibuprofen, meloxicam, indomethacin, diclofenac
  • Phenytoin
  • Tetracycline antibiotics that include demeclocycline, doxycycline, minocycline and tetracycline
  • Medicines used to treat seizures such as valproic acid and Divalproex

Warnings and Precautions

This medication is considered to be typically safe to use, and with generally mild side effects that go away after a short while. But since it is still a drug, it does not come without some warnings and precautions that users should know about to protect themselves from further harm or complications.

If you have the following conditions, it is advised that you avoid the use of Pepto- Bismol:

  • If you are allergic to salicylates such as aspirin or NSAIDs that include ibuprofen, naproxen, and celecoxib
  • If you have an active or bleeding ulcer
  • If you are passing bloody stools or black stools which is not caused by this medicine
  • If you are a teenager who has or is just recovering from chickenpox or flu-like symptoms

Pepto- Bismol’s active ingredient, bismuth salicylate may potentially interact with some other medical conditions, so if you have these, consult with your doctor first before starting with this treatment:

  • Stomach ulcers
  • Bleeding problems that include hemophilia and von Willebrand disease
  • Kidney problems
  • Gout
  • Diabetes

If in case you start to experience vomiting and extreme diarrhea along with behavior changes such as loss of energy, aggressive behavior, or confusion, immediately stop taking Pepto- Bismol and see your healthcare provider as these symptoms can be early signs of Reye’s syndrome.

Reye’s syndrome is a rare but serious disease that affects the brain and the liver. Using this product to self- treat for diarrhea is not recommended if you have a fever or stools with blood or mucus as they may be symptoms of a more serious condition or infection.

Overdose and Contraindication

Always know the appropriate dosage for your medicines to avoid drug overdose. However, if you think that you have consumed too much of the medications like triamcinolone, call your doctor or the local poison control center.

Watch out for these symptoms of overdose:

  • Ringing in your ears
  • Loss of hearing
  • Extreme drowsiness
  • Nervousness
  • Fast breathing
  • Confusion
  • Seizures

Clinical Pharmacology

Pepto- Bismol is a treatment for occasional upset stomach, heartburn, and nausea. It is also being used to treat other conditions such as diarrhea and aids in preventing traveler’s diarrhea. This medication functions by slowing down the growth of bacteria that causes diarrhea.

This product though, is not intended to be used for self- treatment of diarrhea if you are experiencing other conditions such as fever or if you have blood or mucus in your stools as they may be symptoms of a more serious health condition.

Pepto-Bismol is not meant for the self- treatment of ulcers as well. If the patient has an ulcer, this product must be used under the doctor’s instructions as it will be combined with other medications to treat the stomach ulcer that is caused by bacteria such as helicobacter pylori.

If you have concerns with the use of salicylates, you must also be careful about using this product as it contains an active ingredient called bismuth salicylate, and it may lead to serious bleeding problems when used alone in persons with ulcers.

It is strongly recommended that individuals should always check the product label’s ingredients even if they have used the medicine before because, in some cases, ingredients may have changed. They may contain some components that may not be compatible with you.

Medicines with similar names may have different components. They may be intended for various purposes. If you are not sure of before taking them, ask your doctor first to avoid causing you any harm.

Medication Guide

Pepto- Bismol is always taken by mouth whatever form you choose to consume. Use it only as needed, or as instructed by the doctor or how the package directs it. The recommended dosage is based on factors such as age, medical condition, and body’s pain response to the first treatment.

Do not take more than as directed or increase dosage without the doctor’s advice.

There are several types of bismuth salicylate, so read the instructions and labels carefully before consuming the medicine as dosages may be different.

If you are using the chewable tablets, chew the tablet, then swallow it.

If you are using the liquid form, shake the bottle well first before every use, and measure the dose by always using the special measuring device and not a household spoon.