You’ve probably never heard of bismuth subsalicylate, but you have probably used it or bought it more than once in your life time.   This intimidating compound is what we know as the pink stuff, Pepto-Bismol.  Pepto-Bismol is very common over-the-counter medication, which comes in tablet or liquid form, used to cope with heartburn, nausea, indigestion and any other upset stomach problems. This medication is an antidiarrheal medication that decreases intestinal inflammation, fluid movement and electrolyte movement in the bowels and digestive system. It used to combat diarrhea, but the mechanism of how exactly it does do, is still a bit unclear.  It is thought that the chemical bismuth that is in Pepto-Bismol has a type of antibiotic affect, while the salicylate in the medication is thought to havean antacid effect.

What are the side effects of Pepto-Bismol?

The common side effects listed below are usually temporary reactions to the Pepto-Bismol medication.  Once you stop taking Pepto-Bismol these should clear up, and the negative reaction shouldn’t last more than a few days.   Each day that passes, means a lessening in the severity of the symptoms until they are completely gone.

Common Side Effects

Pepto-Bismol can commonly lead to:

·         Constipation

·         Black tongue

·         Black or dark-colored stools

·         Ringing in the ears

Serious Side Effects

·         Tinnitus

·         Severe stomach pains

·         Persistent diarrhea, lasting more than 2 days

·         Hearing loss

·         Anxiety

·         Rapid breathing

·         Confusion

·         Slurred speech

·         Increased thirst

·         Depression

·         Severe nausea

·         Vomiting

·         Severe headache

·         Muscle weakness

·         Trembling

·         Sweating

·         Trouble with vision

·         Involuntary body movements

If you are experiencing any of the serious side effects mentioned above, you should consult with your doctor immediately, and discontinue use of the bismuth medication. Continuing the use of Pepto-Bismol can cause Reye’s syndrome which causes vomiting, tiredness and confusion.  Reye’s syndrome is a potentially life threatening condition.

Some ways to avoid the possible negative side effects of Pepto-Bismol:

Knowing what drugs interact with Pepto-Bismol can help you avoid the negative effects of the medication.  Obviously, if you are aware that you are allergic to the bismuth medication, it is wise to avoid it.  Similarly, if you start to develop any uncharacteristic symptoms or negative side effects of Pepto-Bismol, you should stop taking it. If you are allergic to salicylates, or any products related to Pepto-bismol, you shouldn’t take it either, as you are at a higher risk for negative reaction.  If you are on other medications and are unsure if it interacts with Pepto-Bismol, then go over this with your doctor or pharmacist to make sure it is safe to take them together.

Other Pepto-Bismol interactions include:

·         Botox

·         ACE inhibitors, like blood pressure medications: common drugs include like benazepril, capropril, ramipril, and enalapril

·         Angiotensin II receptor blockers that treat blood pressure like Benicar and Avapro

·         Medications with salicylates such as aspirin, salsalate, Nuprin, Willow bark, or Bengay

·         Carbonic anhydrase inhibitors like acetazolamide and methazolamide

·         Probenecid (gout medication)

·         Medications for gout, like Alloprim or Zyloprim (allopurinol)

·         Coumadin or warfarin