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Bismuth subsalicylate

PEPTO-BISMOL

Pronunciation: BIZ-muth sub-sa-LIS-i-layt

Bismuth subsalicylate ballicule: receptor binding, kinetics and half-life diagram
Mechanism of action: Bismuth subsalicylate ballicule

What it isBismuth–salicylate mucosal protectant with antisecretory and antibacterial effects; dyspepsia and acute diarrhea.

Why this oneUnlike simple antidiarrheals, it also belongs in bismuth quadruple therapy for Helicobacter pylori.

What limits itAvoid in children with viral illness and with other salicylates or anticoagulants; black tongue and stool are harmless.

Bismuth subsalicylate molecular structure (skeletal formula)
Molecular structure: Bismuth subsalicylate

FDA label

FDA dosingPopulationStartTargetMax
Diarrhea (OTC; per Directions)Adults & children ≥12 y2 chewable tablets q30–60 min PRN2 tablets q30–60 min PRN8 doses (16 tablets)/24 h

Renal Undefined

Hepatic Undefined

Do not exceed 8 doses (16 tablets) in 24 h; max 2 days of use

Instructions

Available strengths

Pregnancy Undefined

Lactation Undefined

Cost

Bismuth subsalicylate (PEPTO-BISMOL)
What pharmacies pay · NADAC 9/30/26 · OTC
Strength#/mogeneric $/unitCostPlus
262 mgchew tabper unit$0.08/eanot offered
525 mgchew tabper unitnot offered

NO BOXED WARNINGS

Principal riskNo FDA boxed warning.

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4
Sedation liability0 / 4
Direct muscarinic antagonism0 / 4
Embryofetal risk2 / 4

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