Two medicines, side by side
Bismuth subsalicylate vs loperamide
Bismuth subsalicylate and loperamide are both labeled for diarrhea. Pharmacies paid $0.0817 per tablet (Bismuth 262 mg tablet chewable) and $0.0549 per loperamide 2 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Only the loperamide label carries a boxed warning.
Check it at the source: the bismuth subsalicylate FDA label on DailyMed (effective October 3, 2023); the loperamide FDA label on DailyMed (effective June 3, 2026).
Highlights of the bismuth subsalicylate record
Bismuth subsalicylate · label of October 3, 2023
Used for
From the label: indicationsrelieves travelers' diarrhea diarrhea upset stomach due to overindulgence in food and drink, including: heartburn indigestion nausea gas belching fullness
On the market
- Earliest approval on file
- n/a
- Generic labelers
- none listed
- Pharmacy cost
- $0.0817 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Highlights of the loperamide record
Loperamide (Imodium) · label of June 3, 2026
Used for
From the label: indicationscontrols symptoms of diarrhea, including Travelers' Diarrhea
On the market
- Earliest approval on file
- December 28, 1976
- Generic labelers
- 95 labelers
- Pharmacy cost
- $0.0549 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 2
Source: FDA drug labels via openFDA (Bismuth subsalicylate label of October 3, 2023, Loperamide label of June 3, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do bismuth subsalicylate and loperamide differ on the record?
Only the loperamide label carries a boxed warning.
Generics: bismuth subsalicylate none approved; loperamide since 1991 (Drugs@FDA).
| Bismuth subsalicylate | Loperamide | |
|---|---|---|
| Labeled for | Diarrhea, Acid reflux and ulcers, Nausea and vomiting | Diarrhea |
| Pharmacologic class | n/a | Opioid Agonist |
| How it works (label) | n/a | n/a |
| Half-life (label) | n/a | n/a |
| Earliest approval on file (Drugs@FDA) | n/a | December 28, 1976 |
| First generic approved | none | August 30, 1991 |
| Generic labelers (NDC) | none listed | 95 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0817 per tablet (Bismuth 262 mg tablet chewable) | $0.0549 per capsule (Loperamide 2 mg capsule) |
| 12-month price change | -2% | -31% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 1 | 2 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 5,773 | 50,250 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to bismuth subsalicylate
- every medicine labeled for the same conditions