bismuth subsalicylate (Pepto-Bismol, BSS, Kaopectate)
Jump to navigation
Jump to search
Introduction
Tradenames: Pepto-Bismol, Kaopectate*.
* Kaopectate has been reformulated to contain bismuth subsalicylate
Indications
Contraindications
- children recovering from viral infection
- allergy to salicylates
Dosage
Tabs: 262 mg.
Suspension: 262 mg/5 mL & 524 mg/15 mL.
Adverse effects
- common (> 10%)
- discoloration of tongue (black tongue)
- grayish black stools
- uncommon (< 1%)
- anxiety, confusion*, slurred speech, headache, mental depression, impactation (especially in infants & debilitated patients, muscle spasms, weakness, loss of hearing, tinnitus
- allergic reactions in aspirin-sensitive patients
- other[4]
- seizures, hallucinations, psychosis, myoclonic jerks#
* confusion & memory impairment may be progressive over a period of weaks & precede gait & balance impairment[5] EEG shows bilateral frontotemporal slowing.
* Neuroimaging & CSF are normal
# myoclonus generally not a feature of other heavy metal toxicity
Toxicity resolves over a period of weeks after the drug is discontinued
Drug interactions
- rarely may increase activity of warfarin
- may decrease absorption of tetracycline & quinolones, separate concurrent dosing by at least 2 hours
- increased toxicity of aspirin
Test interactions
Laboratory
- serum or blood bismuth levels (if toxicity suspected)
Mechanism of action
- antisecretory, antimicrobial & anti-inflammatory effects
- subsalicylate decreases inflammation
- bismuth has antimicrobial effects
More general terms
Additional terms
Component of
- bismuth subsalicylate/kaolin
- bismuth subsalicylate/metronidazole/tetracycline
- Helidac kit (triple therapy)
- metronidazole/subsalicylate/tetracycline (Pylera)
- attapulgite/bismuth subsalicylate/kaolin/pectin (Kaopectate)
- Maalox Total Relief
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 4.0 4.1 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
- ↑ 5.0 5.1 Prescriber's Letter 10(4):24 2003