BISMUTH SUBSALICYLATE

Brand & Generic Names

Pepto-Bismol

Basic Information

• Habit forming? No
• Prescription needed? No
• Available as generic? No
• Drug class: Antidiarrheal, antacid

Uses

• Treats symptoms of diarrhea, heartburn, nausea, acid indigestion.
• Helps prevent traveler's diarrhea.

Dosage & Usage Information

How to take:
Chewable tablets--Chew well before swallowing.
Liquid--Take as directed on label.

When to take:
As directed on label or by your doctor.

If you forget a dose:
Take as soon as you remember. Don't double this dose.

What drug does:
Binds toxin of some bacteria.
Stimulates absorption of fluid and electrolytes across the intestinal wall.
Decreases inflammation and increased motility of the intestinal muscles and lining.

Time lapse before drug works:
30 minutes to 1 hour.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Anxiety, confusion, speech difficulty, severe headache, muscle spasms, depression, trembling.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

In case of overdose, see Overdose section.

Common:

Black stools, dark tongue. (These symptoms are normal and medically insignificant.)

Infrequent:

• Hearing loss, confusion, dizziness, fast breathing, headache, increased thirst, ringing or buzzing in ears, vision problems.
• Constipation.

Rare:

Flapping movements of hands, abdominal pain, increased sweating, muscle weakness, drowsiness, anxiety, trembling.

Warnings & Precautions

Don't take if:

• You are allergic to aspirin, salicylates or other non- steroidal anti-inflammatory drugs.
• You have stomach ulcers that have ever bled.
• The patient is a child with fever.

Before you start, consult your doctor:

• If you are on a low-sodium, low-sugar or other special diet.
• If you have had diarrhea for more than 24 hours. This is especially applicable to infants, children and those over 60.
• If you have had kidney disease.

Over age 60:

• Consult doctor before using.
• May cause severe constipation.

Pregnancy:

• Don't use during last 3 months of pregnancy.
• Studies inconclusive on harm to unborn child. Decide with your doctor whether drug benefits justify risk to unborn child.

Breast-feeding:

• Drug passes into milk. Avoid or discontinue nursing until you finish medicine.
• May harm baby if mother takes large amounts.

Infants & children:
Not recommended for children 3 and younger. May cause constipation.

Prolonged use:
May cause constipation.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft if you take high or prolonged dose until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind- altering drugs.

Discontinuing:
No problems expected.

Others:

• Pepto-Bismol contains salicylates. When given to children with flu or chicken pox, salicylates may cause a serious illness called Reye's syndrome. An overdose in children can cause the same problems as aspirin poisoning.
• May cause false urine sugar tests.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticoagulants*	Increased risk of bleeding.
Insulin or oral	Increased insulin
antidiabetic drugs*	effect. May require dosage
	adjustment.
Probenecid	Decreased effect of probenecid.
Salicylates,	Increased risk of
other*	salicylate toxicity.
Sulfinpyrazone	Decreased effect of sulfinpyrazone.
Tetracylines*	Decreased absorption of
	tetracycline.
Thrombolytic agents*	Increased risk of bleeding.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	None expected.
Beverages:	None expected.
Cocaine:	Decreased Pepto-bismol effect.
	Avoid.
Foods:	None expected.
Marijuana:	None expected.
Tobacco:	None expected.