Bismuth subsalicylate

Indications

Bismuth subsalicylate is used for: Diarrhea, nausea, heartburn, indigestion, and upset stomach.

Adult Dose

Adult: 30 ml 3-4 times daily 30 mintues before meal.

Child Dose

Child: 3-12 years: 5-15 ml <3 years: Safety and efficacy not established

Renal Dose

Administration

Drink plenty of clear fluids to prevent dehydration caused by diarrhea Do not use for >2 days

Contra Indications

Hypersensitivity to bismuth, aspirin, other salicylates. Infectious diarrhea, high fever, von Willebrand disease, hemorrhage, ulcer or GI bleeding with black or bloody stool, hemophilia. In pediatric patients, chicken pox or influenza (risk of Reye syndrome); changes in behavior with nausea and vomiting may be early sign of Reye syndrome.

Precautions

May cause black tongue and/or black stool.

Pregnancy-Lactation

Pregnancy category: C; D in 3rd trimester

Interactions

Adverse Effects

Side effects of Bismuth subsalicylate : >10% Nausea (12%) 1-10% Diarrhea (7%),Abdominal pain (7%),Melena (3%),Upper respiratory tract infection (2%),Constipation (2%),Anorexia (2%),Vomiting (2%),Asthenia (2%),Discolored tongue (2%),Headache (2%),Dyspepsia (2%),Dizziness (2%),Stool abnormality (1%),Duodenal ulcer (1%),Sinusitis (1%),Taste perversion (1%),Flatulence (1%),GI hemorrhage (1%),Pain (1%),Insomnia (1%),Anal discomfort (1%),Paresthesia (1%) Frequency Not Defined Anxiety,Confusion,Depression,Tinnitus,Weakness,Gray-black stool,Impaction,Muscle spasm,Neurotoxicity (rare)

Mechanism of Action

Antimicrobial anti-inflammatory action (bismuth); antisecretory effect (salicylate).