Bismuth Subsalicylate (patient information)

# Why this medication is prescribed
Bismuth subsalicylate is used to treat diarrhea, heartburn, and upset stomach in adults and children 12 years of age and older. Bismuth subsalicylate is in a class of medications called antidiarrhea agents. It works by decreasing the flow of fluids and electrolytes into the bowel, reduces inflammation within the intestine, and may kill the organisms that can cause diarrhea.

# How this medication should be used
Bismuth subsalicylate comes as a liquid, tablet, or chewable tablet to be taken by mouth, with or without food. Follow the directions on the package carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take bismuth subsalicylate exactly as directed. Do not take more or less of it or take it more often than recommended by the manufacturer or your doctor.
Swallow the tablets whole; do not chew them.
Shake the liquid well before each use to mix the medication evenly.
If your symptoms get worse or if your diarrhea lasts longer than 48 hours, stop taking this medication and call your doctor.

# Special Precautions
Before taking bismuth subsalicylate:
- Ask your doctor or pharmacist if you are allergic to salicylate pain relievers such as aspirin, choline magnesium trisalicylate, choline salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doans, others), and salsalate (Argesic, Disalcid, Salgesic); or any other medication.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to talk to your doctor or pharmacist about taking bismuth subsalicylate if you take: anticoagulants (blood thinners) such as warfarin (Coumadin); a daily aspirin; or medication for diabetes, arthritis or gout.
- If you are taking tetracycline antibiotics such as demeclocyline (Declomycin), doxycycline (Doryx, Vibramycin), minocycline (Dynacin, Minocin), and tetracycline (Sumycin), take them at least 1 hour before or 3 hours after taking bismuth subsalcylate.
- ask your doctor before taking this medication if you have ever had an ulcer, bleeding problem, stools that are bloody or blackened, or kidney disease. Also ask your doctor before taking bismuth subsalcylate if you have a fever or mucus in your stool. If you will be giving bismuth subsalcylate to a child or teenager, tell the child's doctor if the child has any of the following symptoms before he or she receives the medication: vomiting, listlessness, drowsiness, confusion, aggression, seizures, yellowing of the skin or eyes, weakness, or flu-like symptoms. Also tell the child's doctor if the child has not been drinking normally, has had excessive vomiting or diarrhea, or appears dehydrated.
- ask your doctor about taking this medication if you are pregnant or are breast-feeding.

# Special dietary instructions
Drink plenty of water or other beverages to replace fluids that you may have lost while having diarrhea.
Unless your doctor tells you otherwise, continue your normal diet.

# What to do if you forget a dose
This medication is usually taken as needed. If your doctor has told you to take bismuth subsalicylate regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side Effects
Bismuth subsalicylate may cause side effects.
Some side effects can be serious. If you experience this symptom, stop taking this medication and call your doctor immediately:
- ringing or buzzing in your ear(s)
Bismuth subsalcylate may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

# Storage conditions needed for this medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

# Other information
Ask your pharmacist any questions you have about bismuth salicylate.
You may notice darkening of the stool and/or tongue while you are taking bismuth salicylate. This darkening is harmless and usually goes away in a few days after you stop taking this medication.

# Brand names
- Kaopectate
- Pepto-Bismol