How Safe Is Using Pepto-Bismol?

Review the Side Effects You Should Know About

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Many people turn to Pepto Bismol (or Kaopectate) when they have an upset stomach or diarrhea. These problems may occur more frequently if you have irritable bowel syndrome (IBS) and you might use Pepto Bismol to alleviate IBS symptoms. It is good to learn about its safety and potential side effects.

Safety Tips for Taking Pepto-Bismol
Verywell / Brianna Gilmartin


Pepto Bismol is primarily used for the short-term treatment of the following digestive symptoms in adults and children aged 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 treating Helicobacter 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 from 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

Before Taking

Pepto Bismol is only recommended for use for a two-day period. That, therefore, makes it a poor choice as a treatment for people who experience chronic diarrhea, common in those with IBS. It also makes it a poor choice for people who experience chronic heartburn or acid reflux from gastroesophageal reflux disease (GERD).

Before taking Pepto Bismol it is essential that you clear it with your healthcare provider, as the medication may interact with other medications that you are taking, particularly some medications for diabetes or gout, blood thinners, and certain antibiotics.

Precautions and Contraindications

Pepto Bismol should not be taken by anyone who:

  • Is younger than 12 years of age
  • Has the flu
  • Has a fever and signs of blood in the stool
  • Has chickenpox or has received the chickenpox vaccination within the past six weeks
  • Is pregnant
  • Is breastfeeding
  • Is allergic to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)

How to Take Pepto Bismol

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.

You do not need to take the medication with food. Do not take Pepto Bismol for more than two days. Be sure to drink plenty of water while taking Pepto Bismol to replace fluid lost from diarrhea episodes.

Side Effects

Pepto Bismol is considered to be quite safe for short-term use by adults and children who are age 12 or over. When used properly, the only side effect may be a temporary and harmless blackening of the tongue or of the stool. In some cases, the medication may work too well, with constipation as a result.

Serious side effects of Pepto Bismol are rare, but not unheard of. For the elderly, any resulting constipation may lead to a bowel blockage.

For children and teenagers, as Pepto Bismol is in the aspirin family, the biggest risk associated with the medicine is the development of Reye's syndrome, a potentially life-threatening illness. This risk is particularly high for those who have chickenpox, influenza (the flu), or any other type of viral infection.​

However, there is a product for children called Pepto Kids. It does not contain bismuth subsalicylate and thus does not carry the same risk as Pepto Bismol. Pepto Kids is designed to treat heartburn and upset stomach in children.

When to Call a Healthcare Provider

You should 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.

A Word From Verywell

Although it may be tempting to take Pepto Bismol to address IBS symptoms, remember that it is only recommended for a maximum of two days. Thus, it is best only for short-term symptoms, and long-term use may enhance side effects. When you're experiencing chronic symptoms, work with your healthcare provider to find a better solution.

Frequently Asked Questions

  • 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 any of the following after taking Pepto-Bismol:

  • Who should not take Pepto-Bismol?

    Pepto-Bismol is contraindicated for use in people with the following conditions:

    Also, children under age 12 should not take regular Pepto-Bismol; children under 2 shouldn't take Pepto-Bismol 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 as to the actual risk, but it may be best to avoid Pepto-Bismol just to be safe.

  • What drugs interact Pepto-Bismol?

    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:

  • What are the alternatives to Pepto-Bismol?

    There are several over-the-counter alternatives to Pepto-Bismol based on the symptom being treated:

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6 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.
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