Bismuth Subsalicylate is indicated for diarrhea, nausea, heartburn, indigestion, and upset stomach.
Anti-dyspeptic/Carminatives
Antacid action: Bismuth Subsalicylate coats ulcer surface, protecting it from acid and pepsin. It stimulates mucus and bicarbonate secretion and also reacts with HCl, produces bismuth oxychloride and salicylic acid thus reduces HCl.
Anti-diarrheal action: It stimulates absorption of water and electrolytes across the intestinal wall. In infectious diarrhea it binds with toxin produced by E.coli, disrupts cell, causing lysis of H.pylori and prevents adhesion of H.pylori in the cell wall of intestine.
Anti-inflammatory action: When hydrolyzed to salicylic acid, it inhibits prostaglandin G/H synthase ½. Thus reduces inflammation and Coats the irritated tissue to retard the expulsion of fluid.
Adult: 30 ml 3-4 times daily 30 minutes before meal. Child: 3-12 years: 5-15 ml.
Bismuth Subsalicylate Contains salicylates therefore care should be exercised if receiving drugs to thin the blood (anticoagulant therapy) or oral therapy for diabetes or treatment for gout or arthritis.
Hypersensitivity to bismuth, aspirin, other salicylates, Infectious diarrhea, high fever, von Willebrand disease, hemorrhage, ulcer or Gl bleeding with black or bloody stool, hemophilia, chicken pox or influenza (risk of Reye syndrome); changes in behavior with nausea and vomiting may be early sign of Reye syndrome.
Anxiety, any loss of hearing, confusion, constipation (severe), diarrhea (severe or continuing), difficulty in speaking or slurred speech, dizziness or lightheadedness drowsiness (severe), fast or deep breathing, headache (severe or continuing), increased sweating, increased thirst mental depression, muscle spasms (especially of face, neck, and back), muscle weakness, nausea or vomiting (severe or continuing), ringing or buzzing in ears (continuing) stomach pain (severe or continuing), trembling, uncontrollable flapping movements of the hands (especially in elderly, patients) or other uncontrolled body movements vision problems
Pregnancy Category-C. Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Bismuth intoxication may present as an acute encephalopathy with confusion, myoclonic movements, tremor, dysarthria and walking and standing disorders. Bismuth intoxication may also cause gastrointestinal disturbances, skin reactions, discoloration of mucous membranes, and renal dysfunction as a result of acute tubular necrosis. Treatment includes gastric lavage, purgation and hydration. Chelating agents may be effective in the early stages following ingestion and haemodialysis may be necessary. Overdose of Bismuth Subsalicylate may also give symptoms of salicylate intoxification e.g. dizziness, tinnitus, sweating, nausea, headache. If symptoms occur, use of Bismuth Subsalicylate should be discontinued. Management of overdose is the same as that for salicylate overdose.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
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