Generic name: bismuth subsalicylate [ BIZ-muth-sub-sa-LISS-i-late ]
Brand names: Bismarex, Bismatrol, Bismatrol Maximum Strength, Kaopectate, Kola-Pectin DS,  … show all 25 brands
Dosage forms: oral suspension (1050 mg/10 mL; 262 mg/15 mL; 525 mg/15 mL; 525 mg/30 mL; 527 mg/30 mL); oral tablet (262 mg); oral tablet, chewable (262 mg)
Drug class:  Antidiarrheals

What is bismuth subsalicylate?

Bismuth subsalicylate is used to treat  diarrhea ,  nausea ,  heartburn ,  indigestion , gas, or  upset stomach .

Bismuth subsalicylate may also be used for purposes not listed in this medication guide.


You should not use bismuth subsalicylate if you have bleeding problems, a  stomach ulcer , blood in your stools, or if you are allergic to  aspirin  or other  salicylates .

Do not give this medicine to a child or teenager with a fever, flu symptoms, or chickenpox.

Before taking this medicine

You should not use bismuth subsalicylate if you are allergic to it, or if you have:

  • black or bloody stools;
  • a stomach ulcer;
  • bleeding problems; or
  • if you are allergic to  salicylates  such as aspirin, Doan’s Extra Strength, Salflex, Tricosal, and others.

Do not give this medicine to a child or teenager with a fever, flu symptoms, or chickenpox. Salicylates can cause Reye’s syndrome, a serious and sometimes fatal condition in children.

Ask a doctor or pharmacist if this medicine is safe to use if you have:

  • mucus in your stools; or
  • if you currently have a fever.

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Do not give this medicine to a child younger than 12 years old without medical advice.

How should I take bismuth subsalicylate?

Use exactly as directed on the label, or as prescribed by your doctor.

Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

You must chew the chewable tablet before you swallow it.

Drink plenty of liquids while you are taking bismuth subsalicylate.

Do not take more than 8 doses in one day (24 hours).

Call your doctor if you still have diarrhea after 2 days of using bismuth subsalicylate.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using bismuth subsalicylate.

Store at room temperature away from moisture and heat. Do not freeze.

Detailed Bismuth subsalicylate dosage information

What happens if I miss a dose?

Since bismuth subsalicylate is used when needed, you may not be on a dosing schedule. Skip any missed dose if it’s almost time for your next dose. Do not use two doses at one time.

Do not take more than 8 doses per day.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include weakness,  depression ,  anxiety , feeling irritable, problems with balance or coordination, confusion, tremors, or jerky muscle movements.

What should I avoid while taking bismuth subsalicylate?

Ask a doctor or pharmacist before taking other  antacids  or diarrhea medicine, or taking medicine that may contain a salicylate (such as aspirin,  salsalate ,  magnesium salicylate , choline salicylate,  diflunisal ,  Ecotrin , Tricosal, Trilisate, and others).

Bismuth subsalicylate side effects

Get emergency medical help if you have signs of an allergic reaction:  hives ; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking bismuth subsalicylate and call your doctor at once if you have:

  • changes in behavior with  nausea and vomiting ;
  • hearing loss  or ringing in your ears;
  • diarrhea lasting longer than 2 days; or
  • worsened stomach symptoms.

Bismuth subsalicylate can cause you to have a black or darkened tongue. This is a harmless side effect.

Common side effects include:

  • constipation ; or
  • dark colored stools.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Bismuth subsalicylate side effects  (more detail)

What other drugs will affect bismuth subsalicylate?

Ask a doctor or pharmacist before using bismuth subsalicylate with any other medications, especially:

  • arthritis medicine;
  • gout medicine;
  • insulin  or oral diabetes medications; or
  • a blood thinner– warfarin ,  Coumadin ,  Jantoven .

This list is not complete. Other drugs may affect bismuth subsalicylate, including prescription and over-the-counter medicines,  vitamins , and  herbal products . Not all possible drug interactions are listed here.

Bismuth subsalicylate drug interactions  (more detail)

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