Pepto-Bismol is a widely recognized over-the-counter medication used to alleviate various digestive discomforts, including upset stomach, heartburn, indigestion, nausea, and diarrhea. Many individuals turn to this pink liquid or chewable form for temporary gastrointestinal issues. Understanding the appropriate dosage and safety considerations is important for effective and responsible use.
Adult Dosage Guidelines
For adults and children 12 years and older, the standard liquid Pepto-Bismol dosage is 30 milliliters (mL), which is equivalent to two tablespoons. This dose can be repeated every 30 to 60 minutes as needed for relief. For diarrhea, some formulations suggest a dose of 30 mL every 30 minutes or 60 mL every hour. The maximum dosage should not exceed eight doses, or 240 mL, within a 24-hour period. Always use the provided dosing cup for accurate measurement.
When using chewable tablets, a single adult dose is two tablets (262 mg each). Chew or dissolve these tablets in the mouth. This dose can be taken every 30 minutes for upset stomach, heartburn, indigestion, or nausea. For diarrhea, two tablets every 30 minutes or four tablets every hour may be taken. Do not exceed 16 tablets (eight doses) within 24 hours.
Dosage for Younger Individuals
Pepto-Bismol, containing bismuth subsalicylate, is generally not recommended for children under 12 without consulting a doctor. The salicylate component, related to aspirin, poses a risk of Reye’s syndrome. This rare but serious condition can occur in individuals recovering from viral infections like chickenpox or the flu. Symptoms include changes in behavior, nausea, and vomiting.
For children aged 2 to 11, Pepto Kids is available. It contains calcium carbonate instead of bismuth subsalicylate. This formulation treats upset stomach, acid indigestion, sour stomach, and heartburn, but not diarrhea. Dosage varies by age and weight; follow label instructions. Consult a doctor for any child under 12 experiencing diarrhea due to dehydration risk.
Key Safety Warnings
Pepto-Bismol contains salicylates, so avoid use if allergic to aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen. Do not use if you have stomach ulcers, bleeding problems, gout, or diabetes. It can interact with medications such as blood thinners (e.g., warfarin), some diabetes medications, and other salicylate-containing products.
A temporary and harmless side effect of Pepto-Bismol is the darkening of the tongue and stool. This occurs when bismuth reacts with sulfur in the digestive system, forming black bismuth sulfide. This discoloration is not indicative of bleeding and typically resolves after discontinuing the medication. Ringing in the ears (tinnitus) is a less common but serious side effect; discontinue use and seek medical advice.
When to Consult a Doctor
If symptoms worsen or do not improve after two days of treatment, contact a healthcare provider. Seek immediate medical attention for severe abdominal pain, a high fever, or bloody stools. While Pepto-Bismol can cause black stools, consult a doctor if they have an unusual odor, tar-like consistency, or other concerning symptoms, to rule out gastrointestinal bleeding.
Persistent vomiting, significant behavioral changes, or ringing in the ears/hearing loss also warrant medical advice. Pregnant or breastfeeding individuals should consult a doctor before use, as safety is not fully established and salicylates may pass into breast milk.