Bismuth subsalicylate an antacid medication used to treat temporary discomforts of the stomach and gastrointestinal tract, such as diarrhea, indigestion, heartburn and nausea.

As a derivative of salicylic acid, bismuth subsalicylate displays anti-inflammatory, antibactericidal action, and also acts as an antacid.

Sold as generic and under the brand name Pepto-Bismol.

Commonly known as pink bismuth.


Adverse effects: black tongue and black stools when it combines with trace amounts of sulfur in saliva and the colon to form bismuth sulfide, nausea, constipation, and ringing in the ears.

Bismuth sulfide is a highly insoluble black salt.

The discoloration seen is temporary and harmless.

Its long-term use may lead to accumulation and toxicity.

Children should not take medication with bismuth subsalicylate while recovering from viral infections because the use of salicylate-containing medications and the onset of Reye syndrome.

Nursing mothers should not use medication containing bismuth subsalicylate because small amounts of the medication are excreted in human breast milk, and these pose a theoretical risk of Reye’s syndrome to nursing children.

Bismuth-containing antacids (unless can be neurotoxic, causing encephalopathy, and that such antacids tend to be constipating.

It has an antisecretory action and stimulates absorption of fluids and electrolytes by the intestinal wall.

As a salicylate, it reduces inflammation/irritation of stomach and intestinal lining through inhibition of prostaglandin.

It Reduces hypermotility of the stomach.

Binds toxins produced by Escherichia coli.

Bactericidal action of a number of its subcomponents.

Should not be taken by patients with aspirin allergy, kidney disease, or gout, nor concurrently with certain antibiotics such as the quinolones, and should not be taken continuously for more than three weeks.

Bismuth subsalicylate hydrolyzes in the gut to bismuth oxychloride and salicylic acid and less commonly bismuth hydroxide.

In the stomach, the salicylic acid is absorbed and therapeuti concentrations of salicylic acid can be found in blood after bismuth subsalicylate administration.

Bismuth oxychloride and bismuth hydroxide have bactericidal effects, as is salicylic acid for enterotoxigenic E. coli.

An over-the-counter drug in chewable tablets and swallowable caplets, but it is best known for its original formula, which is a thick liquid.

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