In this piece, we will talk about bismuth. This medication is intended to relieve minor stomach pain, heartburn, and nausea. It is also used to treat and avoid traveler's diarrhea.
The article has sections on uses, dosages, contraindications, and indications.
What Is Bismol Suspension?
Bismuth subsalicylate is an antidiarrheal and anti-inflammatory drug that treats nausea, indigestion, upset stomach, diarrhea, and other mild stomach and gastrointestinal issues.
It works by inhibiting the growth of germs that may be causing the diarrhea. Bismuth subsalicylate is a salicylate. When taken alone, salicylates can cause significant bleeding in ulcer patients.
Bismuth subsalicylate is an antacid and diarrhea reducer. Bismuth subsalicylate, an insoluble salicylic acid salt combined with a trivalent bismuth cation, exhibits antibacterial and gastroprotective properties. Each molecule of bismuth subsalicylate has 58% bismuth and 42% salicylate by weight. Bismuth subsalicylate has been around for almost a century, having been invented in 1901 for sanitary purposes and cholera infection prevention.
Bismuth subsalicylate was first licensed by the FDA in 1939 and is now most commonly used to treat nausea, diarrhea, and gastrointestinal discomfort. It is an active ingredient in Pepto-Bismol, a common over-the-counter medication intended to alleviate stomach and gastrointestinal discomfort. Bismuth subsalicylate is a component of HELIDAC Therapy (bismuth subsalicylate, metronidazole, and tetracycline), which is a therapy regimen approved for the eradication of H. pylori for individuals with H. pylori infection and duodenal ulcer disease.
Mechanism Of Action
The mechanism of bismuth subsalicylate has not been fully explored. Bismuth subsalicylate is an insoluble chemical composed of salicylic acid and trivalent bismuth.
Bismuth subsalicylate hydrolyzes in the stomach producing bismuth oxychloride, which is poorly absorbed into the bloodstream, and salicylic acid, which is almost entirely absorbed. Bismuth reacts with various anions and chemicals in the gastrointestinal tract to generate bismuth salts such as bismuth oxychloride, bismuth subcarbonate, bismuth phosphate, and bismuth sulfide. Bismuth salts have bactericidal and antibacterial properties, primarily by inhibiting bacterial binding and growth on stomach mucosal cells. It has no effect on the normal gut bacteria. Bismuth subsalicylate prevents bacteria from adhering to mucosal cells, which minimizes intestinal secretion and fluid loss, increases fluid and electrolyte reabsorption, reduces gastrointestinal inflammation, and enhances healing of pre-existing stomach ulcers.
Salicylic acid from dissociated bismuth subsalicylate enhances the anti-inflammatory properties of bismuth salts by blocking the cyclooxygenase enzyme and restricting the production of prostaglandin, a pro-inflammatory mediator. Bismuth subsalicylate has cytoprotective and demulcent properties that make it an excellent treatment for peptic ulcer disease. It prevents H. pylori from adhering to stomach epithelial cells and inhibits enzyme activity such as phospholipase, protease, and urease.
Ingredients Of Risek Sachet
Ingredients: Active is Bismuth Subsalicylate (88mg mg per 5ml).
Others:
- Aluminium Magnesium Silicate
- Methylcellulose
- Methyl Salicylate
- Salicylic Acid
- Sorbic Acid
- Benzoic Acid
- Saccharin Sodium Salicylate
- Amaranth and Water.
Bismol Suspension Indications or Uses.
Bismuth subsalicylate is an over-the-counter medication used for treatment of
- Diarrhea
- Gas
- Upset stomach
- Indigestion
- Heartburn
- Nausea
- As a prophylaxis for traveler's diarrhea.
- Bismuth subsalicylate used in conjunction with other medications to treat H. pylori.
Bismuth subsalicylate is available under the following different brand names: Kaopectate, Pepto Bismol, Maalox Total Relief, Kaopectate Extra Strength, and Pepto-Bismol Maximum Strength.
Contraindications Of Bismol Suspension
Hypersensitivity to bismuth, aspirin, other salicylates.
- Infectious diarrhea
- High fever
- Von Willebrand disease
- Hemorrhage
- Ulcer or gastrointestinal bleeding with black or bloody stool
- Hemophilia
- In pediatric patients, chickenpox or influenza (risk of Reye's syndrome); changes in behavior with nausea and vomiting may be an early sign of Reye's syndrome.
Dosage and Administration
Administration
Bismuth subsalicylate is administered orally, Patients (adults and children) should be advised to shake the suspension well before use and to utilize the enclosed dosage cup.
Dosage
Tablet, chewable
262 mg
525 mg
Suspension available strength
88mg/5 ml (Regular Strength)
176mg/5 ml (Extra Strength)
Adult Dosing:
30 ml (regular strength) orally every ½-1 hour as needed; maximum daily dose: 8 regular-strength doses or 4 extra-strength doses
Pediatric Dosing:
Children under 3: safety and efficacy not established
Children 3-6 years: 5 ml (regular strength) or 2.5 ml (extra strength) orally every ½-1 hour as needed
Children 6-9 years: 10 ml (regular strength) or 5 ml (extra strength) orally every ½-1 hour as needed
Children 9-12 years: 15 ml (regular strength) or 7.5 ml (extra strength) orally every ½-1 hour as needed
Children over 12 years: 30 ml (regular strength) or 15 ml (extra strength) orally every ½-1 hour as needed; maximum daily dose: 8 regular-strength doses or 4 extra-strength doses
Traveler's Diarrhea
Prophylaxis
Bismol 88mg/5ml Suspension 15 ml every 6 hours for up to 3 weeks
Helicobacter Pylori
Bismol Suspension 88mg/5ml strength 30ml plus 250 mg metronidazole plus 500 mg tetracycline orally every 6 hours for 14 days, plus an H2 antagonist (Helidac Therapy pack)
Chronic Infantile Diarrhea
Children under 2 years: 2.5 ml (regular strength) every 4 hours
Children 2-4 years: 5 ml (regular strength) every 4 hours
Children 4-6 years: 10 ml (regular strength) every 4 hours
Indications During Pregnancy And Breastfeeding.
Safety has not been established during pregnancy; use is not recommended.
Pregnancy
Animal studies are inadequate. There are no controlled data in human pregnancy. Bismuth subsalicylate lacks reports of adverse fetal outcomes; however salicylates may cause congenital defects, increased perinatal mortality from ductus arteriosus in utero, intrauterine growth restriction, and salicylate intoxication.
Pregnancy Category
Category C
Lactation
Use is not recommended. Bismuth is not expected to appear in high concentrations in breast milk due to poor systemic absorption. Use is not recommended in lactating mothers.
Risek Sachet Alternatives That Are Safe
- Gaviscon Advance Suspension
- Pantoprazole
- Sucralfate
- Risek Sachet
Side Effects Of Risek Sachet
Side effects of bismuth subsalicylate include:
- Abdominal pain
- Anal discomfort
- Anxiety
- Black or 'hairy' tongue
- Clay-colored or gray-black stools
- Cold symptoms (stuffy nose, sneezing, sore throat)
- Confusion
- Constipation (may be chronic)
- Dark urine
- Depression
- Diarrhea (may be severe, watery, or bloody)
- Dizziness
- Sores in the stomach lining
- Indigestion
- Gas (flatulence)
- Gastrointestinal bleeding
- Headache (may be severe)
- Difficulty falling asleep (insomnia)
- Itching
- Loss of appetite
- Lightheadedness
- Metallic taste in your mouth
- Muscle spasm
- Nausea
- Pain behind your eyes
- Pale skin
- Numbness and tingling
- Rapid heart rate
- Ringing in your ears (tinnitus)
- Seizure (convulsions)
- Severe allergic reaction
- Shortness of breath
- Sinusitis
- Trouble concentrating
- Trouble swallowing
- Upper respiratory tract infection
- Vaginal itching or discharge
- Vision problems
- Vomiting
- Weakness
- Yellowing of the skin or eyes (jaundice)
Interactions
Taking Bismol Suspension along with these medications is not recommended, as it can lead to drug toxicity or reduce the efficacy of other drugs.
To avoid drug interactions, always consult your doctor if you are already on another medications.
- Valproic Acid
- Carbonic anhydrase inhibitors (such as Acetazolamide)
- Corticosteroids (such as Prednisone)
- Dichlorphenamide
- Methotrexate.
- Anti-platelet drugs Clopidogrel
- Dabigatran
- Enoxaparin
- Warfarin
Pro Advice 💡
- For best results, always take the medication before meals or at bed time.
- In case of itching,rash,hives or swallowing of the face or hellucinations stop taking the drug immediately and consult your Physician.
- Try healthy natural alternatives in case of heart burn such as moderate exercise, low spice diet and skimmed Milk.
- Encourage childerns to eat a healthy balanced diet and avoid junk fast food.
- For infant less than 3 months with gastro Esophageal reflux disease you can try smaller frequent feeds, burping after every feeding and thikened the formula feed with rice helps with digestion and prevent reflux.
Price
Price Reference: emeds.pk
Other Alternative Medicines
FAQs
Q1. What is the Pepto-Bismol used for?
Ans. Bismuth subsalicylate is an over-the-counter medication used for treatment of
- Diarrhea
- Gas
- Upset stomach
- Indigestion
- Heartburn
- Nausea
- As a prophylaxis for traveler's diarrhea.
- Bismuth subsalicylate used in conjunction with other medications to treat H. pylori.
Q2. Is Pepto-Bismol good for gas?
Ans. Yes, Pepto-Bismol can be used to treat nausea, heartburn, and other digestive symptoms like: Gas & Indigestion.
Q3. Can I drink water after Pepto-Bismol?
Ans. Yes, You can eat and drink normally while taking Pepto-Bismol. However, it's best to avoid foods that causes indigestion like spicy and fatty foods also try to restrict caffeinated drinks, such as tea, coffee, cola and energy drinks.
Q4. Is Pepto-Bismol good for constipation?
Ans. No, Pepto-Bismol is not for constipation because It contains the heavy metal bismuth (its compound name is bismuth subsalicylate). It coats tissue in the digestive system to slow down the movement so don't use it for constipation.
Q5. Is Pepto-Bismol best for upset stomach?
Ans. Yes, Pepto-Bismol is used to treat releive the symptoms of an upset stomach. These symptoms can include: heartburn, nausea and indigestion.
Q6. Is Gaviscon same as Pepto-Bismol?
Ans. No pepto bismol contains a completely different active ingredient, bismuth subsalicylate while Gaviscon contains antacids which neutralizes the stomach acids
Q7. How does bismuth subsalicylate stop diarrhea?
Ans. The antidiarrheal effect of Bismuth subsalicylate is most likely due to: The reduction in prostaglandin formation, as Bismuth subsalicylate inhibits cyclooxygenase enzyme system.
References
Pink Bismol Suspension - Uses, Side Effects, and More | Webmd [Internet]: webmd.com [Last accessed: February 22, 2024].
Bismol Suspension 120ml Uses, Side effects & Price in Pakistan | emeds.pk [Internet] www.emeds.pk [Last accessed: February 22, 2024].
Bismuth Subsalicylate Suspension: Uses & Side Effects | Cleveland Clinic [Internet]: https://my.clevelandclinic.org [Last accessed: February 06, 2024].
Disclaimer
All information on the product's uses, dosage, side effects, formula, ingredients, indications, contraindications, drug interactions, warnings and precautions, and whether it is safe to use during pregnancy and breastfeeding is based solely on material found on the internet.And it is only provided here for general education and information purposes only.
We can not guarantee the accuracy of any of the information we published on this website. All of the information material we published is based only on FDA-approved literature and is not intended to replace expert medical advice.Always seek an expert medical advice from a health care provider before start using this medicine.
