Sometimes you suddenly feel a stomach ache, a burning sensation in your stomach, or you have diarrhea that makes you have to go to the toilet all the time, right? At times like these, there is a medicine that many of us buy from the pharmacy, usually a pink pill. So today we are talking about this medicine that many people know, namely Bismuth Subsalicylate. There are a few important things that we need to be careful about when using it.
Simply put, what is Bismuth Subsalicylate?
This is a medicine that is used to stop occasional diarrhea . It is also used to relieve symptoms such as stomach upset, heartburn, indigestion, and gas. It belongs to a group of drugs called antidiarrheals. It can be found in the market under names such as Pepto-Bismol and Bismatrol.
But even though this is a medicine to take for a common stomach ache, there are a few things we should be aware of before taking it.
Things you should tell your doctor before taking this medicine:
Before you use this medicine, you should definitely inform your doctor if you have any of the conditions below.
| Situation to be concerned about | A simple explanation |
|---|---|
| Bleeding problems | If you have a bleeding disorder, this medication may increase your risk. |
| Fever | If you have diarrhea along with a fever, it could be a sign of a serious infection, so seek medical advice. |
| Kidney or Liver disease | If the function of these organs is impaired, the medication will not be properly eliminated from the body. |
| If you have recently had a viral illness such as chickenpox or influenza (flu) | (Very important) Giving this medicine to children and young people at a time like this can cause a dangerous condition called Reye's syndrome. |
| Allergy to aspirin or other salicylates | This medicine also contains a chemical called salicylate, so it may be a problem for someone who is allergic to aspirin. |
| If you are pregnant or trying to get pregnant | This medicine is not recommended during pregnancy, especially in the last three months. |
| If you are a breastfeeding mother | Parts of the medicine may pass to the baby through breast milk, so ask your doctor. |
How exactly do I use this medicine?
This usually comes as a chewable tablet. Read the instructions on the box carefully and use it as directed. Chew the tablet well, or let it dissolve in your mouth. Do not swallow it directly with water. Do not take more than the prescribed dose.
Be especially careful if you give this medicine to children!
This is very important. This medicine is generally not recommended for children under the age of 12. In particular, if your child has a viral illness like the flu, chickenpox, or influenza, or is recovering from one, do not give this medicine for any reason.
Why is that? Because the ingredient in this medicine, called salicylate, can cause a very dangerous, life-threatening condition called Reye's syndrome , which damages the brain and liver in children with a viral illness.
What to do if you take too much medicine?
If you think you have taken more medicine than you think, do not panic and act immediately. Go to the nearest hospital Emergency Department (ETU) as soon as possible. Alternatively, call the National Poisons Information Centre at the Colombo National Hospital for advice.
What other medications may interact with this medicine?
If you are taking medication for another condition, you should also be aware of this. Bismuth subsalicylate is a medication that can interact with some other medications.
| Type of medicine | Why is it risky? |
|---|---|
| Don't take these together. | |
| Methotrexate | This medicine, which is used to treat cancer and arthritis, can increase its toxicity. |
| Seek medical advice when taking these together. | |
| Aspirin and similar medications | Both contain salicylate. Taking both together can increase salicylate levels in the body and cause side effects. |
| Medications for diabetes | Blood sugar levels can be lowered unnecessarily. |
| Medicines for Gout | It can reduce the effectiveness of gout medications. |
| Medicines that prevent blood clotting (e.g. Warfarin) | The risk of bleeding is significantly increased. |
Tell your doctor about all the medications you use (including vitamins and herbal products).
Possible side effects while taking the medicine
Some side effects may occur when taking this medicine. Some of them are serious, some are common.
| Side effects that require immediate medical attention | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the lips, tongue, face. |
| Symptoms of bleeding | Vomiting like coffee grounds, black and sticky tarry stools, red/dark brown urine, and red/purple spots on the skin. |
| Hearing loss | Ringing in the ears or hearing loss. |
| Side effects that you shouldn't be afraid of, but should be reported to your doctor if they persist | |
| Black tongue and stool | (Don't be afraid!) This is because of the bismuth component of the medicine. This is not bleeding. This will go away once you stop taking the medicine. |
| Constipation | Some people may experience constipation after the diarrhea stops. |
The most important thing is, if you have diarrhea for more than two days or if your symptoms do not improve, stop using this medicine and see your doctor. Also, drink plenty of fluids like soup, porridge, and water to prevent dehydration, as diarrhea causes your body to lose water and salts.
Take-Home Message
- Bismuth Subsalicylate is a medicine used to relieve temporary symptoms such as occasional diarrhea and indigestion.
- Very important: Never give this medicine to children or young people who have a viral illness such as the flu, chickenpox, or influenza. It can cause a dangerous condition called Reye's syndrome.
- If you are taking aspirin, diabetes medication, or blood thinners like Warfarin, be sure to ask your doctor before taking this medication.
- It is normal to have a black tongue or stool after taking the medicine, so don't worry. However, if your stool turns black like tar or you vomit coffee grounds, it could be a sign of bleeding, so go to the hospital immediately.
- If symptoms do not improve after two days of taking the medication, or if other symptoms such as fever and vomiting appear, discontinue use and seek medical advice.
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