Bismuth Subsalicylate 262 mg Dosing Regimen
For adults and children 12 years and over, take 2 tablets (524 mg) every 30 minutes or 4 tablets (1048 mg) every hour as needed for diarrhea, upset stomach, heartburn, indigestion, or nausea, not exceeding 8 doses (16 tablets) in 24 hours. 1
Dosing Guidelines by Condition
For Diarrhea:
- Initial dose: 2 tablets (524 mg) every 30 minutes as needed
- Alternative regimen: 4 tablets (1048 mg) every hour as needed
- Continue until diarrhea stops, but not more than 2 days
- Maximum: 16 tablets (4192 mg) in 24 hours 1
For Upset Stomach, Heartburn, Indigestion, or Nausea:
- 2 tablets (524 mg) every 30-60 minutes as needed
- Maximum: 16 tablets (4192 mg) in 24 hours 1
Important Administration Instructions
- Tablets should be fully chewed before swallowing
- Drink plenty of clear fluids to prevent dehydration, especially when treating diarrhea
- For children under 12 years: consult a doctor 1
Efficacy and Mechanisms
Bismuth subsalicylate is effective for multiple gastrointestinal symptoms through several mechanisms:
- For indigestion symptoms: Provides faster relief than placebo for nausea, sense of fullness, heartburn, abdominal distention, and flatulence 2
- For diarrhea: The salicylate component decreases enhanced fluid secretion in the colon 3
- For gastric protection: Offers strong and rapid protective effects on gastric mucosa 3
Treatment Duration and Response
- Use until symptoms resolve but not more than 2 days for self-treatment 1
- For diarrhea, response typically occurs within 2 weeks when used for specific conditions like microscopic colitis 4
Common Side Effects and Precautions
- Most common side effects: darkening of tongue and stools 5
- Tinnitus may occur but is typically clinically insignificant at recommended doses 5
- Not recommended for long-term use without medical supervision
When to Consider Alternative Treatments
- If diarrhea persists for more than 48 hours, consider other treatments such as loperamide 6
- For severe or persistent symptoms, seek medical attention
- For infectious diarrhea with fever or bloody stools, avoid antimotility agents 6
Special Populations
- Children under 12 years: Consult a healthcare provider before use 1
- For patients with true penicillin allergy requiring H. pylori treatment, bismuth-containing quadruple therapy is recommended 6
Bismuth subsalicylate is a versatile medication that effectively treats multiple gastrointestinal symptoms when used according to the recommended dosing regimen. The medication should be discontinued if symptoms persist beyond 2 days, as this may indicate a more serious condition requiring medical evaluation.