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bismuth subsalicylate Side Effects

Also known as: Pepto-Bismol

Analysis of 5,567 adverse event reports submitted to the FDA from 2004 to 2025.

Total Reports

5,567

Death-Related

516

9.3% of reports

Hospitalizations

1,477

26.5% of reports

Top Indication

Gastrooesophageal Reflux Disease

Most Reported Adverse Reactions

CHRONIC KIDNEY DISEASE
1,418
ACUTE KIDNEY INJURY
822
RENAL FAILURE
724
DIARRHOEA
711
NAUSEA
615
END STAGE RENAL DISEASE
462
VOMITING
399
FATIGUE
368
RENAL INJURY
327
GASTROOESOPHAGEAL REFLUX DISEASE
311
DRUG INEFFECTIVE
286
DEPRESSION
281
CONSTIPATION
259
PAIN
255
OFF LABEL USE
243
ABDOMINAL PAIN
241
ABDOMINAL PAIN UPPER
239
DYSPNOEA
239
OSTEOPOROSIS
239
HEADACHE
224

Who Reports Side Effects

Gender Distribution

Female 3,059 (62%)
Male 1,845 (38%)
Unknown 12

Age Distribution

0-17 58 (2%)
18-44 642 (20%)
45-64 1,288 (40%)
65-74 639 (20%)
75+ 590 (18%)

Reporting Trend by Year

2004 2025

Reactions in Death Reports

Top reactions reported in 516 reports where death was an outcome. These are voluntarily reported and do not establish causation.

Reaction Reports
DEATH 182
CHRONIC KIDNEY DISEASE 150
END STAGE RENAL DISEASE 130
ACUTE KIDNEY INJURY 120
RENAL FAILURE 98
NAUSEA 91
VOMITING 87
ABDOMINAL DISTENSION 77
ABDOMINAL PAIN 75
OFF LABEL USE 73
SEPSIS 73
CONSTIPATION 72
ASCITES 70
VENTRICULAR FIBRILLATION 70
MULTIPLE ORGAN DYSFUNCTION SYNDROME 68
GENERAL PHYSICAL HEALTH DETERIORATION 67
APPENDICITIS 65
CONDITION AGGRAVATED 65
HYPONATRAEMIA 65
SOMNOLENCE 65

Reactions in Hospitalization Reports

Top reactions in 1,477 reports where hospitalization was an outcome.

Reaction Reports
NAUSEA 227
DIARRHOEA 202
VOMITING 198
CHRONIC KIDNEY DISEASE 197
ACUTE KIDNEY INJURY 196
RENAL FAILURE 167
OSTEOPOROSIS 140
ABDOMINAL PAIN 136
DYSPNOEA 132
FALL 121
DEPRESSION 120
END STAGE RENAL DISEASE 116
PAIN 111
FATIGUE 109
CONSTIPATION 107
ARTHRITIS 105
ASTHENIA 99
ANXIETY 90
OFF LABEL USE 89
ABDOMINAL DISTENSION 86

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What the FAERS Data Reveals About bismuth subsalicylate Side Effects

The FDA Adverse Event Reporting System (FAERS) contains 5,567 voluntary reports linked to bismuth subsalicylate and its brand equivalents (Pepto-Bismol), spanning 2004 through 2025. Of those, 516 (9.3%) listed death as an outcome and 1,477 (26.5%) involved hospitalization. The most common indication reported alongside adverse events was Gastrooesophageal Reflux Disease.

Demographic breakdowns help contextualize who is being exposed to the drug. Of reports with known sex, 62% were female and 38% male; age distribution skews toward 45-64, with 1,288 reports in that bracket. The single most reported reaction is chronic kidney disease with 1,418 submissions, followed by acute kidney injury and renal failure.

FAERS is a signal-detection tool, not a scorecard. Reports are voluntary, and a single case may list multiple suspect drugs, so numbers above should not be read as incidence rates or per-patient risk. Widely prescribed drugs naturally accumulate more reports than niche therapies even when individual risk is low. These aggregates are useful for spotting patterns that merit further pharmacovigilance, not for choosing between medications. This page is for educational reference only and is not medical advice — speak with a licensed clinician about any side-effect concerns.