How Safe Is Pepto-Bismol? (2024)

It takes 30 minutes to an hour for Pepto-Bismol (bismuth subsalicylate) to start working and help relieve diarrhea, upset stomach, and nausea.

How Safe Is Pepto-Bismol? (1)

Sometimes referred to as "the pink stuff," Pepto-Bismol is an over-the-counter (OTC) medication that is safe and effective for short-term use. Side effects are generally mild and can include a black tongue, black stool, and constipation. More serious side effects can occur but are rare.

This article discusses Pepto-Bismol, how it works, and its potential side effects.

Uses for Pepto-Bismol

Pepto-Bismol is primarily used for the short-term treatment of the following digestive symptoms in adults and children age 12 and older:

  • Diarrhea
  • Nausea
  • Stomach upset
  • Indigestion
  • Heartburn
  • Excessive intestinal gas
  • Excessive burping
  • A feeling of fullness caused by eating too much
  • Discomfort from drinking too much alcohol

Interestingly, researchers have found that when Pepto-Bismol is combined with antibiotics, it can be quite effective in treatingHelicobacter pylori—an infection that has been linked to peptic ulcers and gastritis.

How Pepto-Bismol Works

The scientific name for the active ingredient in Pepto-Bismol is bismuth subsalicylate.

Bismuth is a mineral that has antibacterial, antacid, and antidiarrheal effects.

Subsalicylate is a medication in the same class as aspirin.

The active ingredients of Pepto-Bismol are thought to have the following actions within the body:

  • Increasing the amount of fluid that is absorbed in the intestines, therefore firming up stool
  • Reducing inflammation
  • Calming intestinal spasms
  • Reducing the population of disease-causing bacteria and/or viruses
  • Reducing excess levels of stomach acid

It can take half an hour for an hour for Pepto to "kick in." If it doesn't offer relief in that time, do not take another dose right away. Follow dosing instructions provided on the product packaging.

Pepto-Bismol Side Effects

Pepto-Bismol is considered quite safe for short-term use by adults and children age 12 or over. However, there are some side effects that you should be aware of, including:

  • Blackening of the tongue
  • Dark or black stool
  • Constipation

These side effects are temporary and generally harmless.

Serious Side Effects

Serious side effects of Pepto-Bismol can occur, though they are rare:

  • Bowel blockage: This can occur due to Pepto-Bismol-related constipation and is a particular concern in adults 65 and older.
  • Reye's syndrome: The subsalicylate in Pepto-Bismol is in the aspirin family. Aspirin use in children and teenagers is associated with a risk of this potentially life-threatening illness. This risk is particularly high for those who have chickenpox, influenza (the flu), or any other type of viral infection.​

Pepto Kids

Pepto Kids (calcium carbonate) is designed to treat heartburn and upset stomach in children. It does not contain bismuth subsalicylate, so it poses no risk of Reye's syndrome.

When to Call Your Healthcare Provider

Contact your healthcare provider immediately and stop taking Pepto-Bismol if you experience:

  • Ringing in the ears
  • Diarrhea that lasts for more than two days
  • Severe vomiting
  • High fever
  • Any signs of an allergic reaction

If you think you have taken an overdose or are experiencing any severe symptoms, seek immediate attention by calling an ambulance.

Why Pepto Can Turn Stool Black

Before Taking Pepto-Bismol

Pepto-Bismol should be used for no more than two days . That makes it a poor choice for people who experience diarrhea, heartburn, or acid reflux that is chronic in nature.

Ask your healthcare provider about taking Pepto-Bismol before using it, as it may interact with other medications you are taking.

Drug Interactions

Pepto-Bismol can potentially interact with a wide range of medications. Let your healthcare provider know if you take any of the following before starting Pepto-Bismol:

  • Arthritis or gout medications
  • Blood thinners like warfarin
  • Daily aspirin
  • Diabetes medications
  • Tetracycline antibiotics

Precautions and Contraindications

Pepto-Bismol should not be taken by anyone who:

  • Is younger than 12 years of age (Pepto Kids is OK, however)
  • Has the flu
  • Has a fever and signs of blood in the stool
  • Has chickenpox or has received the chickenpox vaccine within the past six weeks
  • Is pregnant
  • Is breastfeeding
  • Is allergic to aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), like Advil (ibuprofen) or Aleve (naproxen sodium)

Dosage

Pepto-Bismol is an oral medication that comes in liquid, tablet, or chewable form. Follow the directions and dosing recommendations on the product packaging carefully.

Do not take this medication for more than two days.

How Safe Is Pepto-Bismol? (2)

Liquid

Use the provided dosing cup to take liquid Pepto-Bismol. (One dose equals one dosing cup filled to the top.)

If you've lost the dosing cup, look at the label to determine the strength of the formula, which dictates how much you should take:

  • Original Strength: 30 milliliters (ml)
  • Ultra-Strength: 15 ml
  • Pepto Diarrhea Liquid: 10 ml

Dispense the dose using a medication syringe or cup that allows you to measure out a precise dose. Never use a kitchen spoon.

Do not exceed eight doses in a 24-hour period.

Chewable Tablets

Take two Pepto-Bismol chewables at a time. Do not exceed a total of 16 tablets in 24 hours.

Pepto Kids also comes in chewable tablet form. Dosing depends on a child's weight and age:

  • Under 24 pounds/under age 2: Speak with a healthcare provider
  • 24-47 pounds/ages 2 to 5: 1 tablet (maximum 3 tablets in 24 hours)
  • 48-95 pounds/ages 6 to 11: 2 tablets (maximum 6 tablets in 24 hours)

If your child's weight and age do not correspond with one of the above, defer to the dosage that is appropriate for their weight.

Caplets

Pepto-Bismol caplets come in several different formulations. Take only the amount indicated on the label:

  • Pepto-Bismol LiquiCaps: 2 caplets
  • Pepto Diarrhea LiquiCaps: 2 caplets
  • Pepto-Bismol Caplets: 2 caplets
  • Pepto-Bismol Ultra Caplets: 1 caplet

Do not exceed eight doses in a 24-hour period.

Do You Need to Take Pepto-Bismol With Food?

You do not need to take Pepto-Bismol with food. However, be sure to drink plenty of water to replace fluid lost from diarrhea episodes.

Summary

Pepto-Bismol is an over-the-counter medication used to relieve digestive symptoms such as diarrhea and nausea. It works in a few different ways, including increasing the amount of fluid absorbed by your intestines and reducing inflammation.

Pepto-Bismol may cause side effects like a black tongue or constipation. These side effects are usually mild. Sometimes, however, it can cause more serious side effects like ringing in the ears or Reye's syndrome in children.

Don't take Pepto-Bismol for more than two days and avoid taking if you have health conditions like an aspirin allergy, if you're taking certain medications, or you are pregnant.

Frequently Asked Questions

  • How long does it take Pepto-Bismol to work?

    Pepto-Bismol generally starts to work within 30 minutes to an hour. If you aren't feeling relief after an hour, you can take a second dose.

  • What are the side effects of Pepto-Bismol?

    The most common side effect of Pepto-Bismol is a black tongue or black stools. Both are harmless. Pepto-Bismol contains a non-toxic metal called bismuth that, when mixed with sulfur (a naturally occurring mineral in the body), forms a black substance called bismuth sulfide.

  • Can Pepto-Bismol cause severe side effects?

    On rare occasions, Pepto-Bismol has been known to cause potentially serious side effects. Call your healthcare provider if you experience severe vomiting, blood in the stool, vomit that resembles coffee grounds-like vomit, or ringing in the ears after taking Pepto-Bismol.

    Learn MoreWhen to See a Healthcare Provider About Vomiting

  • Who should not take Pepto-Bismol?

    Pepto-Bismol is contraindicated for use in people with aspirin allergy, gastric ulcer, hematochezia (bloody stools), hemophilia, flu-like symptoms (for children and teens only due to the risk of Reye syndrome).

    Children under age 12 should not take regular Pepto-Bismol and children under 2 shouldn't be given Pepto Kids.

  • Is Pepto-Bismol safe during pregnancy?

    Pepto-Bismol contains bismuth subsalicylate, a drug that is generally avoided during the third trimester as it increases the risk of uterine bleeding. There remains considerable debate about the actual risk, but it may be best to avoid Pepto-Bismol just to be safe.

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. U.S. National Library of Medicine. Label:Pepto-Bismol—bismuth subsalicylate kit.

  2. Graham DY, Lee SY. How to effectively use bismuth quadruple therapy: The good, the bad, and the ugly. Gastroenterol Clin North Am. 2015;44(3):537-63. doi:10.1016/j.gtc.2015.05.003

  3. MedlinePlus. Bismuth subsalicylate.

  4. Procter & Gamble. Pepto Bismol Original Liquid [package labeling].

  5. Pepto Bismol. When & how to take Pepto Bismol?

  6. Pepto Kids. The Procter & Gamble Manufacturing Company.

  7. Pepto Bismol. FAQ.

  8. KidsHealth. Reye Syndrome.

  9. Servery J, Chang J. Over-the-counter medications in pregnancy. Am Fam Physician. 2014;90(8):548-55.

How Safe Is Pepto-Bismol? (3)

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.

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How Safe Is Pepto-Bismol? (2024)

FAQs

How Safe Is Pepto-Bismol? ›

As long as the diarrhea is not bloody and you don't have a fever, Pepto Bismol is likely a safe initial treatment option. Follow the label dosing instructions carefully, and do not give the medication to children.

How safe is it to take Pepto-Bismol? ›

Pepto-Bismol is typically safe for most people, but avoid it if you have certain health conditions. Pepto-Bismol may make them worse. Don't take Pepto-Bismol if you: are allergic to salicylates (including aspirin or NSAIDs such as ibuprofen, naproxen, and celecoxib)

Do doctors recommend Pepto-Bismol? ›

Sometimes, a doctor may recommend it to treat symptoms of chronic digestive disorders. Some people also find the antibacterial effects of Pepto Bismol useful when traveling to unfamiliar areas where the local bacteria may infect their digestive system and cause traveler's diarrhea.

What are the warnings about Pepto-Bismol? ›

Do not take this medicine if you are pregnant or breastfeeding. Pepto-Bismol is not suitable for some people. To make sure this medicine is safe for you, tell your doctor or pharmacist if you have: ever had an allergic reaction to bismuth subsalicylate or any of the other ingredients in Pepto-Bismol or Pepti Calm.

Why avoid Pepto-Bismol? ›

Pepto-Bismol side effects are typically mild. Nausea, a bitter taste, and a blackened tongue are possible. Rarely, Pepto-Bismol can cause serious side effects, such as Reye's syndrome in children and allergic reactions in those with aspirin allergies. It should be avoided if you're pregnant.

What is the best medicine for an upset stomach? ›

Antacids (such as Tums and Rolaids) are a good choice for heartburn and sour stomach. And medicines that contain bismuth subsalicylate (like Pepto-Bismol) can help treat diarrhea and nausea. If you're not sure which medicine to take for your upset stomach, talk with your healthcare professional.

Can you drink water after Pepto? ›

You can eat and drink normally while taking Pepto-Bismol. However, it's best to avoid foods that seem to make your indigestion worse, like rich, spicy and fatty foods. Try to cut down on caffeinated drinks, such as tea, coffee, cola and energy drinks.

Is there anything better than Pepto-Bismol? ›

Proton pump inhibitors are considered the most effective in providing long-lasting heartburn relief when compared to antacids and acid blockers. Prilosec, or omeprazole, is a proton pump inhibitor and works by decreasing the amount of acid that the stomach produces.

Does Pepto actually help your stomach? ›

This medicine is used for heartburn and acid reflux, indigestion, diarrhoea and feeling sick (nausea). It works by protecting your stomach and the lower part of your food pipe from stomach acid. It is also a mild antacid, which helps reduce too much stomach acid and eases any discomfort.

Is Pepto-Bismol or Tums better? ›

Pepto-Bismol has an average rating of 7.6 out of 10 from a total of 30 ratings on Drugs.com. 71% of reviewers reported a positive effect, while 18% reported a negative effect. Tums Regular Strength has an average rating of 7.0 out of 10 from a total of 4 ratings on Drugs.com.

Why is Pepto-Bismol illegal in France? ›

Over-the-counter medicine for traveler's diarrhea is regulated, too. Pepto-Bismol is not sold in France due to a health scare in the 1970s.

How long does Pepto stay in your system? ›

As it slowly makes its way out of your body you may see black poo. This side effect usually goes away when you stop taking the medicine but it may take several days. If your tongue or your poo is still black after you've stopped taking Pepto-Bismol for several days, speak to your doctor or a pharmacist.

Why is Pepto-Bismol not available in the UK? ›

Conversation. Unfortunately, we're still experiencing a challenge in getting Pepto Bismol to shelves in the UK, due to shortages. We know many people rely on our product and apologize for any inconvenience. We'll continue to do our best to bring Pepto back, hopefully by Summer/Autumn of 2024.

What should you not take with Pepto? ›

Cautions with other medicines
  • an anticoagulant – medicines that help to prevent blood clots.
  • tablets or other oral medicines for diabetes.
  • medicine for gout.
  • doxycycline or minocycline, or any other tetracycline antibiotics.

Can I take Pepto as a preventative? ›

Taking 2 tablets of Pepto-Bismol 4 times a day before you travel and while you are traveling can help prevent diarrhea. Do not take Pepto-Bismol for more than 3 weeks.

Will Pepto-Bismol prolong a stomach virus? ›

However, in some cases, Pepto-Bismol may prolong a stomach virus. This is because diarrhea is the body's way of getting rid of the virus, and treating diarrhea may slow this process down. Most of the time, a stomach virus will resolve on its own with at-home care.

How often is it OK to take Pepto? ›

No matter which tummy trouble you're experiencing, you should take 1 dose of Pepto Bismol every half hour to hour until you feel better, but do not take more than 8 doses in a 24-hour period.

Is Pepto-Bismol good for your stomach? ›

This medication is used to treat occasional upset stomach, heartburn, and nausea. It is also used to treat diarrhea and help prevent travelers' diarrhea. It works by helping to slow the growth of bacteria that might be causing the diarrhea.

What medications should not be taken with Pepto-Bismol? ›

To make sure Pepto-Bismol is safe for you, tell your doctor or a pharmacist if you are taking:
  • an anticoagulant – medicines that help to prevent blood clots.
  • tablets or other oral medicines for diabetes.
  • medicine for gout.
  • doxycycline or minocycline, or any other tetracycline antibiotics.

Does Pepto help food poisoning? ›

Pepto-Bismol® and Imodium® can help greatly with food poisoning and with the symptoms that come with it. Pepto-Bismol is great for helping with vomiting and nausea, while Imodium is an antidiarrheal that will help slow down the digestive process to help with diarrhea.

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