Bismuth Subsalicylate (Oral)

Brand Names : Bismatrol, Bismatrol Extra Strength, Pepto-Bismol, Pepto-Bismol Easy-to-Swallow Caplets, Pepto-Bismol Maximum Strength, Bismed, PMS-Bismuth Subsalicylate

Before Using This Medicine

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For bismuth subsalicylate, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to bismuth subsalicylate or to other salicylates, such as aspirin, including methyl salicylate (oil of wintergreen), or to any of the following medicines:

• Carprofen (e.g., Rimadyl)
• Diclofenac (e.g., Voltaren)
• Diflunisal (e.g., Dolobid)
• Fenoprofen (e.g., Nalfon)
• Floctafenine (e.g., Idarac)
• Flurbiprofen taken by mouth (e.g., Ansaid)
• Ibuprofen (e.g., Motrin)
• Indomethacin (e.g., Indocin)
• Ketoprofen (e.g., Orudis)
• Ketorolac (e.g., Toradol)
• Meclofenamate (e.g., Meclomen)
• Mefenamic acid (e.g., Ponstel)
• Naproxen (e.g., Naprosyn)
• Oxyphenbutazone (e.g., Tandearil)
• Phenylbutazone (e.g., Butazolidin)
• Piroxicam (e.g., Feldene)
• Sulindac (e.g., Clinoril)
• Suprofen (e.g., Suprol)
• Tiaprofenic acid (e.g., Surgam)
• Tolmetin (e.g., Tolectin)
• Zomepirac (e.g., Zomax)

Also tell your health care professional if you are allergic to any other substances, such as certain foods, sulfites or other preservatives, or dyes.

Diet - Make certain your health care professional knows if you are on any special diet, such as a low-sodium or low-sugar diet.

Pregnancy - The occasional use of bismuth subsalicylate is not likely to cause problems in the fetus or in the newborn baby. However, based on what is known about the use of other salicylates, especially at high doses and for long periods of time, the following information may also apply for bismuth subsalicylate.

Salicylates have not been shown to cause birth defects in humans. However, studies in animals have shown that salicylates may cause birth defects.

There is a chance that regular use of salicylates late in pregnancy may cause unwanted effects on the heart or blood flow in the fetus or in the newborn infant.

Use of salicylates during the last 2 weeks of pregnancy may cause bleeding problems in the fetus before or during delivery or in the newborn infant. Also, too much use of salicylates during the last 3 months of pregnancy may increase the length of pregnancy, prolong labor, cause other problems during delivery, or cause severe bleeding in the mother before, during, or after delivery.

Breast-feeding - Salicylates pass into the breast milk. Although they have not been shown to cause problems in nursing babies, it is possible that problems may occur if large amounts of salicylates are taken regularly.

Children - The fluid loss caused by diarrhea may result in a severe condition. For this reason, medicine for diarrhea must not be given to young children (under 3 years of age) without first checking with their doctor. In older children with diarrhea, medicine for diarrhea may be used, but it is also very important that a sufficient amount of liquids be given to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

Also, children are usually more sensitive to the effects of salicylates, especially if they have a fever or have lost large amounts of body fluid because of vomiting, diarrhea, or sweating.

The bismuth in this medicine may cause severe constipation in children.

In addition, do not use this medicine to treat nausea or vomiting in children or teenagers who have or are recovering from the flu or chickenpox. If nausea or vomiting is present, check with the child's doctor because this could be an early sign of Reye's syndrome.

Older adults - The fluid loss caused by diarrhea may result in a severe condition. For this reason, elderly persons with diarrhea should not take this medicine without first checking with their doctor. It is also very important that a sufficient amount of liquids be taken to replace the fluid lost by the body. If you have any questions about this, check with your health care professional.

Also, the elderly may be more sensitive to the effects of salicylates. This may increase the chance of side effects during treatment. In addition, the bismuth in this medicine may cause severe constipation in the elderly.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When taking bismuth subsalicylate it is especially important that your health care professional know if you are taking any of the following:

• Anticoagulants (blood thinners) or
• Heparin - The salicylate in this medicine may increase the chance of bleeding

• Antidiabetics, oral (diabetes medicine you take by mouth) - This medicine may make the levels of sugar in the blood become too low

• Medicine for pain and/or inflammation (except narcotics) - If these medicines contain salicylates, use of bismuth subsalicylate (which also contains salicylate) may lead to increased side effects and overdose

• Probenecid (e.g., Benemid) or
• Sulfinpyrazone (e.g., Anturane) - Bismuth subsalicylate may make these medicines less effective for treating gout

• Tetracyclines by mouth (medicine for infection) - The tablet form of bismuth subsalicylate should be taken at least 1 to 3 hours before or after tetracyclines; otherwise it may decrease the effectiveness of the tetracycline

Other medical problems - The presence of other medical problems may affect the use of bismuth subsalicylate. Make sure you tell your doctor if you have any other medical problems, especially:

• Dysentery - This condition may get worse; a different kind of treatment may be needed

• Gout - The salicylate in this medicine may worsen the gout and make the medicines taken for gout less effective

• Hemophilia or other bleeding problems - The salicylate in this medicine may increase the chance of bleeding

• Kidney disease - There is a greater chance of side effects because the body may be unable to get rid of the bismuth subsalicylate

• Stomach ulcer - Use of this medicine may make the ulcer worse