Pepto-Bismol guide: Original vs Ultra vs caplets, doses and warnings
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- Pepto-Bismol Original liquid. Best for: Upset stomach and diarrhea. See options on Amazon
- Pepto-Bismol Ultra liquid. Best for: A smaller dose volume. See options on Amazon
- Pepto-Bismol caplets. Best for: Travel and on-the-go. See options on Amazon
Three Pepto-Bismol forms compared
| Form | Bismuth subsalicylate per dose | Adult dose and daily limit |
|---|---|---|
| Original liquid | 525 mg in 30 mL | 30 mL every half hour as needed; max 8 doses (240 mL) in 24 hours |
| Ultra liquid | 525 mg in 15 mL | 15 mL every half hour as needed; max 8 doses (120 mL) in 24 hours |
| Caplets | 262 mg per caplet; 2 caplets per dose | 2 caplets every half hour as needed; max 8 doses (16 caplets) in 24 hours |
Details are from each product's DailyMed label, for adults and children 12 and over. For diarrhea, the labels also allow 2 doses every hour. Caplets should be swallowed with water, not chewed.
What Pepto-Bismol treats
The labels list the purpose as upset stomach reliever and antidiarrheal. Uses include travelers' diarrhea, diarrhea, and upset stomach due to overindulgence in food and drink, including heartburn, indigestion, nausea, gas, belching and fullness.
For diarrhea, use it until diarrhea stops but not more than 2 days, and drink plenty of clear fluids to help prevent dehydration. For a loperamide comparison, see our anti-diarrheal guide; for heartburn-only relief, our antacid chewables guide.
Salicylate and Reye's syndrome warnings
- Reye's syndrome. Children and teenagers who have or are recovering from chicken pox or flu-like symptoms should not use it. If changes in behavior with nausea and vomiting occur, consult a doctor, because these could be early signs of Reye's syndrome, a rare but serious illness.
- Contains salicylate. Do not take it if you are allergic to salicylates, including aspirin, or are taking other salicylate products. The Original liquid label lists salicylate 261 mg per 30 mL dose; each caplet contains salicylate 99 mg.
- Do not use if you have an ulcer, a bleeding problem, or bloody or black stool.
Medicines and conditions to ask about
Ask a doctor before use if you have a fever or mucus in the stool. Ask a doctor or pharmacist before use if you take any drug for anticoagulation (thinning the blood), diabetes, gout or arthritis. If pregnant or breastfeeding, ask a health professional before use.
Stop use and ask a doctor if symptoms get worse or last more than 2 days, ringing in the ears or loss of hearing occurs, or diarrhea lasts more than 2 days.
The black tongue and stool
The labels say a temporary, but harmless, darkening of the stool and/or tongue may occur when using this product. This is expected and different from the black, tarry stool of bleeding; if you have black stool before taking it, or other signs of bleeding such as vomiting blood, do not use it and get medical care.
For gas alone, see our simethicone gas relief guide, and for nausea, our ginger chews guide.
Sodium, minerals and dyes
If you watch sodium or other minerals, the labels list small amounts per dose. Each 30 mL dose of Original liquid contains magnesium 3 mg and sodium 4 mg and is labeled low sodium. Each 15 mL dose of Ultra contains magnesium 3 mg and sodium 2 mg. Each caplet contains calcium 27 mg and is also labeled low sodium. The pink color comes from dyes listed among the inactive ingredients, such as D&C Red No. 22 and D&C Red No. 28 in the Original liquid, so check the list if you avoid certain dyes. The Original liquid is also sweetened with sucralose.
Using it safely
- Shake liquids well and use only the dose cup provided.
- Do not exceed 8 doses in 24 hours.
- Do not combine with other salicylate products, including aspirin.
- Children under 12: ask a doctor.
- Protect liquids from freezing and avoid excessive heat over 104 F (40 C), as the label directs.
- In case of overdose, get medical help or contact a Poison Control Center right away.
What to look for when you buy
Pepto-Bismol Original liquid
Best for: Upset stomach and diarrhea
Its label lists bismuth subsalicylate 525 mg per 30 mL dose.
Watch out: Not for children or teens recovering from chickenpox or flu-like symptoms.
See options on AmazonPepto-Bismol Ultra liquid
Best for: A smaller dose volume
Its label lists the same 525 mg in a 15 mL dose.
Watch out: Max 8 doses (120 mL) in 24 hours.
See options on AmazonPepto-Bismol caplets
Best for: Travel and on-the-go
Its label lists bismuth subsalicylate 262 mg per caplet, 2 caplets per dose.
Watch out: Swallow with water; do not chew.
See options on AmazonQuestions people ask
- What is the active ingredient in Pepto-Bismol?
- Bismuth subsalicylate, an upset stomach reliever and antidiarrheal.
- Why does Pepto-Bismol turn my tongue black?
- The label says a temporary, harmless darkening of the stool and/or tongue may occur.
- Can kids take Pepto-Bismol?
- Under 12, ask a doctor; children and teens recovering from chickenpox or flu-like symptoms should not use it.
- Can I take Pepto-Bismol with aspirin?
- No. It contains salicylate; do not take it with other salicylate products or if allergic to aspirin.
- How much Pepto-Bismol can I take in a day?
- No more than 8 doses in 24 hours, per the labels.
- How long can I take Pepto-Bismol for diarrhea?
- Use it until diarrhea stops but not more than 2 days, and see a doctor if it lasts longer.
Sources
- Pepto-Bismol (bismuth subsalicylate) suspension label (dailymed.nlm.nih.gov), DailyMed, U.S. National Library of Medicine
- Pepto-Bismol Ultra (bismuth subsalicylate) suspension label (dailymed.nlm.nih.gov), DailyMed, U.S. National Library of Medicine
- Pepto-Bismol (bismuth subsalicylate) caplet label (dailymed.nlm.nih.gov), DailyMed, U.S. National Library of Medicine