Bismuth Subsalicylate

Salicylate allergy
Concurrent use with other Salicylates OR Warfarin (relative contraindication)
Children and teens (relative contraindication)
1. Due to Reye's Syndrome risk
2. Avoid especially with febrile illness, Varicella Zoster Virus or Influenza
Do not exceed 3 weeks of use (or 2 days of use for Acute Diarrhea)

Bismuth Subsalicylate (Original Pepto-Bismol)
1. Chewable Tablets 262 mg
2. Suspension 262 mg/15 ml
3. Caplets 262 mg
Calcium Carbonate
1. Children's Pepto-Bismol

Tablet: Two tabs orally four times daily up to maximum of every 4 hours
Adult
1. Take 2 tablets or 30 ml every 30 to 60 minutes as needed
2. Maximum of 8 doses/day (240 ml/day) and up to 2 days
Child
1. Give 100 mg/kg/day divided in 5 doses for up to 2 days
2. Age 3 to 6 years old
  1. Give 1/3 of a 262 mg chewable tablet every 30 to 60 min up to 8 doses/day OR
  2. Give 5 ml of 262 mg/15 ml suspension every 30 to 60 min up to 8 doses/day
3. Age 7 to 9 years old
  1. Give 2/3 of a 262 mg chewable tablet every 30 to 60 min up to 8 doses/day OR
  2. Give10 ml of 262 mg/15 ml suspension every 30 to 60 min up to 8 doses/day
4. Age 10 to 12 years old
  1. Give 1 of a 262 mg chewable tablet every 30 to 60 min up to 8 doses/day OR
  2. Give 15 ml of 262 mg/15 ml suspension every 30 to 60 min up to 8 doses/day

Age 2 to 24 months (up to age 2): Give 2.5 ml of 262 mg/15 ml suspension orally every 4 hours as needed
Age 25 to 48 months (up to age 4): Give 5 ml of 262 mg/15 ml suspension orally every 4 hours as needed
Age 49 to 70 months (>age 4 years): Give 10 ml of 262 mg/15 ml suspension orally every 4 hours as needed

Adult
1. Take 2 tabs four times daily before meals and at bedtime (2.1 grams/day)

May potentiate other medications
1. Oral Anticoagulants
2. Hypoglycemic agents
Decreases effect of other drugs
1. Uricosurics (Probenecid, Sulfinpryazone)
2. Tetracyclines
  1. May decrease Bioavailability of Doxycycline, Tetracycline
  2. Doxycycline is used for Malaria Prophylaxis