bismuth subsalicylate
Brand names: Pepto-Bismol
Bismuth subsalicylate (Pepto-Bismol) is a medicine that can treat diarrhea and upset stomach. It works as both an antidiarrheal and an antacid.
Drug Pricing (NADAC)
Generic Price
$0.08/unit
Generic Available
Yes (2 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
This medicine can help with traveler's diarrhea.
Common side effects
Diarrhea, Nausea, Vomiting
Key warnings
Ask a doctor before giving this medicine to children under 12 years old.
How It Works
Bismuth subsalicylate works by coating your stomach and intestines. This helps to reduce inflammation and kill certain bacteria that can cause diarrhea. It also helps to reduce the amount of fluid that is secreted into your digestive tract.
How to Take It
Chew the tablets or let them dissolve in your mouth. Adults and children over 12 years can take 2 tablets every 30 minutes or 4 tablets every hour as needed for diarrhea. For upset stomach, heartburn, indigestion, or nausea, take 2 tablets every 30 minutes as needed. Do not take more than 16 tablets in 24 hours. Drink plenty of clear fluids to avoid dehydration.
Pregnancy & Breastfeeding
Ask a doctor if it is safe for you to take this medicine while pregnant or breastfeeding. It is not known if this medicine will harm your unborn baby or pass into your breast milk.
Missed Dose
Take the missed dose as soon as you remember. Do not take more than the maximum daily dose.
Storage
Store at room temperature away from moisture and heat.
Side Effects (from patient reports)
Based on 6,157 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 5,567 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
5,567
Death-Related Reports
516
Hospitalization Reports
1,477
Top Indication
Gastrooesophageal Reflux Disease
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | CHRONIC KIDNEY DISEASE | 1,418 |
| 2 | ACUTE KIDNEY INJURY | 822 |
| 3 | RENAL FAILURE | 724 |
| 4 | DIARRHOEA | 711 |
| 5 | NAUSEA | 615 |
| 6 | END STAGE RENAL DISEASE | 462 |
| 7 | VOMITING | 399 |
| 8 | FATIGUE | 368 |
| 9 | RENAL INJURY | 327 |
| 10 | GASTROOESOPHAGEAL REFLUX DISEASE | 311 |
| 11 | DRUG INEFFECTIVE | 286 |
| 12 | DEPRESSION | 281 |
| 13 | CONSTIPATION | 259 |
| 14 | PAIN | 255 |
| 15 | OFF LABEL USE | 243 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Ask a doctor before giving this medicine to children under 12 years old.
Known Drug Interactions
Absorption of tetracyclines is impaired by bismuth subsalicylate.
Mechanism: Bismuth subsalicylate prevents your body from properly absorbing the antibiotic into your bloodstream.
What to do: Talk to your doctor about how to time these medications so the antibiotic can be absorbed correctly.
Absorption of tetracyclines is impaired by bismuth subsalicylate.
Mechanism: Bismuth subsalicylate stops your body from absorbing doxycycline into your blood. This can prevent the antibiotic from working to kill bacteria.
What to do: Do not take these two medicines at the exact same time. Ask your doctor or pharmacist how to space them out during the day.
( 7.1 ) Absorption of tetracyclines, including NUZYRA, is impaired by antacids containing aluminum, calcium, or magnesium, bismuth subsalicylate and iron containing preparations. 7.2 Antacids and Iron Preparations Absorption of oral tetracyclines, including NUZYRA, is impaired by antacids containing aluminum, calcium, or magnesium, bismuth subsalicylate, and iron containing preparations [see Dosage and Administration (2.1) ].
Mechanism: Bismuth subsalicylate interferes with how your body takes in the antibiotic, making the medicine less effective at fighting infection.
What to do: Avoid taking these two medicines at the same time so the antibiotic can work correctly.
Common Questions
How often can I take this medicine?
Can children take this medicine?
How long should I take this medicine?
What should I drink while taking this medicine?
What do I do if I overdose?
Can I take this with other medicines?
What if my symptoms don't improve?
Can this medicine cause side effects?
How should I store this medicine?
What does this medicine treat?
What are the common side effects of bismuth subsalicylate?
Does bismuth subsalicylate interact with other medications?
What drug class is bismuth subsalicylate?
Is bismuth subsalicylate safe during pregnancy?
Related Medications in Antidiarrheal / Antacid
Other drugs grouped near bismuth subsalicylate — same-class peers and common alternatives.
alosetron
Lotronex
Alosetron (Lotronex) is a medicine for women with severe diarrhea-predominant irritable bowel syndrome (IBS).
Compare with bismuth subsalicylate →
aprepitant
Emend
Aprepitant (Emend) is a medicine that helps prevent nausea and vomiting.
Compare with bismuth subsalicylate →
bisacodyl
Dulcolax
Bisacodyl is a medicine that helps you have a bowel movement.
Compare with bismuth subsalicylate →
cimetidine
Tagamet
Cimetidine (Tagamet) reduces stomach acid.
Compare with bismuth subsalicylate →
dexlansoprazole
Dexilant
Dexlansoprazole (Dexilant) is a medicine that lowers stomach acid.
Compare with bismuth subsalicylate →
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What the FDA Data Shows for bismuth subsalicylate
The FDA label for bismuth subsalicylate (sold under brand names such as Pepto-Bismol) classifies it as an over-the-counter product in the Antidiarrheal / Antacid class. This medicine can help with traveler's diarrhea. Official labeling lists 5 commonly reported side effects, including Diarrhea, Nausea, Vomiting.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 6,157 voluntary reports. The database also lists 3 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $0.08.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: November 7, 2018
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages