bismuth subsalicylate (Pepto-Bismol, BSS, Kaopectate)

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Introduction

Tradenames: Pepto-Bismol, Kaopectate*.

* Kaopectate has been reformulated to contain bismuth subsalicylate

Indications

Contraindications

pregnancy category = d

safety in lactation = ?

Dosage

  • adults: 2 tabs or 30 mL PO every 1 hour up to 8 doses/day
  • pediatrics:
    • 10 mL/dose if 6-9 yo
    • 5 mL/dose if 3-5 yo

Tabs: 262 mg.

Suspension: 262 mg/5 mL & 524 mg/15 mL.

Adverse effects

* 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

Test interactions

Laboratory

Mechanism of action

More general terms

Additional terms

Component of

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  3. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  4. 4.0 4.1 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  5. 5.0 5.1 Prescriber's Letter 10(4):24 2003

Database