The Unexpected Side Effects of Pepto-Bismol - GoodRx (2024)

Nausea, diarrhea, heartburn: most people experience these tummy troubles from time to time. And although they’ll likely pass on their own without needing medication, many people look to their local pharmacy shelves for quick relief. Thankfully, there’s a variety of products available to help with mild stomach upset and indigestion.

Pepto-Bismol (bismuth subsalicylate) is a potential option for these situations. It’s relatively inexpensive and readily available over-the-counter (OTC). Pepto-Bismol can be a great help for people when diarrhea and indigestion occur. However, it’s not free of risks and side effects.

Here, we’ll discuss common and serious Pepto-Bismol side effects you should be aware of.

What is Pepto-Bismol?

Pepto-Bismol is a common OTC medication that’s used for many mild digestive problems, including nausea, indigestion (upset stomach), and diarrhea. It’s best known in its pink liquid form, but it’s also available as capsules and chewable tablets.

Pepto-Bismol’s OTC label states it should only be taken by people ages 12 and older. Children under 12 shouldn’t take this medication without a healthcare provider’s OK. There is a chewable tablet called Pepto Kids that’s made by the same manufacturer. But this contains a different ingredient from other Pepto-Bismol products and can be safely given to children ages 2 and up.

How does it work for diarrhea?

Pepto-Bismol is most often used to relieve diarrhea, but it can also relieve general indigestion. Pepto-Bismol breaks down in the body into two separate substances: bismuth and salicylic acid. The individual ingredients work in different ways to help ease these symptoms.

Bismuth is thought to relieve diarrhea by working as an antiseptic (disinfectant). This allows it to get rid of bad bacteria that may be causing your stomach issues. It also helps your body to absorb more water from your gut, making your stools less watery. Very little bismuth is absorbed into your bloodstream, so its effects stay in the stomach and intestines.

Salicylic acid is similar to aspirin. Unlike bismuth, this ingredient is absorbed by the body. Salicylic acid helps lessen diarrhea and gut irritation by blocking an enzyme (protein) called cyclooxygenase (COX). This enzyme plays a role in creating inflammation and causes things to move through your intestines faster than usual.

By blocking COX, salicylic acid can lessen gut inflammation and slow down the movement of food through your GI tract. Slowing down your gut helps you to retain nutrients that can be lost when you have diarrhea.

Common Pepto-Bismol side effects

Common Pepto-Bismol side effects include:

• Nausea

• A bitter taste in the mouth

• Diarrhea

• Dark colored or black stools

Pepto-Bismol side effects are typically mild for most people. And they should go away once you stop the medication. If you continue to experience them more than a few days after stopping it, contact your healthcare provider.

Less commonly, Pepto-Bismol can also cause tiredness, mood changes, or a blackening of your tongue or teeth. People have also experienced a ringing in the ear (tinnitus) from this medication. These less common side effects typically happen when you take large amounts of Pepto-Bismol or take it for a long time.

Serious Pepto-Bismol side effects

Although available OTC, Pepto-Bismol does have a risk of some more serious side effects too. It’s important to keep in mind that these are rare. But they can be life-threatening if they happen.

Reye’s syndrome

Reye’s syndrome is a dangerous condition that can cause severe and permanent brain damage in children. It’s potentially life-threatening and requires immediate medical attention. Reye’s syndrome can happen when a child takes a form of aspirin, particularly when they have a fever or are getting over a viral illness, like the flu. Remember, Pepto-Bismol contains an ingredient similar to aspirin.

Possible symptoms of Reye’s syndrome include:

• Intense vomiting

• Severe tiredness

• Confusion

• Seizures

• Becoming unresponsive

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Reye’s syndrome is most common in children between the ages of 4 and 12. This is why Pepto-Bismol shouldn’t be given to kids under 12 without a healthcare provider’s OK. But this serious side effect can also happen to adolescents and even young adults between ages 18 and 20. So if your child has a fever, or recently got over being sick, it’s best to avoid Pepto-Bismol — even if they’re over the age of 12.

Allergic reactions

Because Pepto-Bismol contains an ingredient similar to aspirin, it could cause a reaction if you’re allergic to aspirin. Allergic reactions can range from mild to life-threatening. So if you are allergic to aspirin, then you shouldn’t take Pepto-Bismol. You should also avoid this mediation if you have an allergy to other nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin). Aspirin is a type of NSAID, and many people that are allergic to aspirin are also allergic to other NSAIDs.

Salicylate toxicity (Pepto-Bismol overdose)

Salicylate toxicity can happen if you take too much aspirin. It’s rare with Pepto-Bismol, though, because you’d have to consume a large amount of the medication. But if salicylate toxicity does happen, it requires immediate medical attention. This complication can be life-threatening if not treated quick enough.

If you or someone you know has consumed too much Pepto-Bismol, it’s crucial to tell medical personnel how much and when it was ingested. This will help them properly treat you and manage possible complications.

Mild symptoms of salicylate toxicity can include:

• Nausea

• Vomiting

• Stomach pain

• Fast breathing

• Headache

• Dizziness

• Tinnitus

In severe cases, symptoms can become life-threatening and may include:

• Fluid in the lungs

• Swelling around the brain

• Seizures

• Cardiac arrest

Call 911 if you believe you’re experiencing salicylate toxicity. Be sure to follow the directions when taking Pepto-Bismol. Although salicylate toxicity is rare with this medication, it’s advisable to be aware of it.

What can I do to manage common Pepto-Bismol side effects?

There’s not much you need to do if this medication causes mild side effects. As mentioned above, common Pepto-Bismol side effects should go away when you stop taking it. So, if you experience any side effects at all, you should stop using Pepto-Bismol.

If you experience diarrhea after starting the medication, it’s best to stay well hydrated. The darkening of the tongue or stool is harmless and will resolve on its own within a few days of stopping Pepto-Bismol.

When should I contact my healthcare provider about Pepto-Bismol side effects?

In addition to experiencing the serious side effects listed above, there are a few other times where you should contact your healthcare provider.

A healthcare provider should be contacted if:

• Your symptoms worsen or don’t improve within 2 days of starting Pepto-Bismol

• Ringing in the ears occurs

• Hearing loss occurs

• You have diarrhea that lasts for more than 2 days

You should also contact your healthcare provider before taking Pepto-Bismol if you’re pregnant. NSAIDs, including Pepto-Bismol, aren’t recommended after the 20th week of pregnancy. Risks associated with taking NSAIDs in pregnancy could include birth defects, miscarriage, and kidney problems for the unborn baby. It’s unknown if NSAIDs are safe in the first half of pregnancy, prior to 20 weeks.