Introduction

Chances are you’ve heard of “the pink stuff.” Pepto-Bismol is a well-known over-the-counter medication used to treat digestive problems.

If you’re feeling a bit queasy, read on to learn what to expect when taking Pepto-Bismol and how to use it safely.

Pepto-Bismol is used to treat diarrhea and relieve the symptoms of an upset stomach. These symptoms can include:

  • heartburn
  • nausea
  • indigestion
  • gas
  • belching
  • a feeling of fullness

The active ingredient in Pepto-Bismol is called bismuth subsalicylate. It belongs to a drug class called salicylates.

Pepto-Bismol is available in regular strength as a caplet, chewable tablet, and liquid. It’s available in maximum strength as a liquid and caplet. All forms are taken by mouth.

Pepto-Bismol is thought to treat diarrhea by:

  • increasing the amount of fluid your intestines absorb
  • reducing inflammation and overactivity of your intestines
  • preventing your body’s release of a chemical called prostaglandin that causes inflammation
  • blocking toxins produced by bacteria such as Escherichia coli
  • killing other bacteria that cause diarrhea

The active ingredient, bismuth subsalicylate, also has antacid properties that can help decrease heartburn, upset stomach, and nausea.

Adults and children 12 years and older can take the following forms of Pepto-Bismol for up to 2 days. The dosages below apply for all digestive problems Pepto-Bismol can help treat.

When treating diarrhea, be sure to drink plenty of water to replace lost fluid. Keep drinking fluids even if you’re using Pepto-Bismol.

If your condition lasts longer than 2 days or you have ringing in your ears, stop taking Pepto-Bismol and call your doctor.

Liquid suspension

Original strength:

  • Take 30 milliliters (mL) every 30 minutes, or 60 mL every hour as needed.
  • Do not take more than eight doses (240 mL) in 24 hours.
  • Do not use for more than 2 days. See your doctor if diarrhea lasts longer than this.
  • Original Pepto-Bismol liquid also comes in a cherry flavor, both of which have the same dosage instructions.

Pepto-Bismol Ultra (maximum strength):

  • Take 15 mL every 30 minutes, or 30 mL every hour as needed.
  • Do not take more than eight doses (120 mL) in 24 hours.
  • Do not use for more than 2 days. See your doctor if symptoms aren’t improving.
  • Pepto-Bismol Ultra also comes in cherry flavor with identical dosage instructions.

Another liquid option is known as Pepto Cherry Diarrhea. This product is designed to only treat diarrhea. It’s not the same product as cherry-flavored Pepto-Bismol Original or Ultra. It’s also for people 12 years and older.

Below is the recommended dosage for Pepto Cherry Diarrhea:

  • Take 10 mL every 30 minutes, or 20 mL every hour as needed.
  • Do not take more than eight doses (80 mL) in 24 hours.
  • Do not use for more than 2 days. See your doctor if diarrhea is still ongoing.

Chewable tablets

For Pepto Chews:

  • Take two tablets every 30 minutes, or four tablets every 60 minutes as needed.
  • Chew or dissolve the tablets in your mouth.
  • Do not take more than eight doses (16 tablets) in 24 hours.
  • Stop taking this medication and see your doctor if diarrhea doesn’t subside after 2 days.

Caplets

Original caplets:

  • Take two caplets (262 milligrams each) every 30 minutes, or four caplets every 60 minutes as needed.
  • Swallow the caplets whole with water. Do not chew them.
  • Do not take more than eight caplets in 24 hours.
  • Do not use for more than 2 days.
  • See your doctor if diarrhea doesn’t subside.

Ultra caplets:

  • Take one caplet (525 mg) every 30 minutes, or two caplets every 60 minutes as needed.
  • Swallow the caplets with water. Do not chew them.
  • Do not take more than eight caplets in 24 hours. Don’t use for more than 2 days.
  • See your doctor if diarrhea lasts longer than 2 days.

Pepto Diarrhea caplets:

  • Take one caplet every 30 minutes, or two caplets every 60 minutes as needed.
  • Swallow the caplets with water. Do not chew them.
  • Do not take more than eight caplets in 24 hours.
  • Do not take for longer than 2 days. See your doctor if diarrhea lasts beyond this time.

Pepto Original LiquiCaps or Diarrhea LiquiCaps:

  • Take two LiquiCaps (262 mg each) every 30 minutes, or four LiquiCaps every 60 minutes as needed.
  • Do not take more than 16 LiquiCaps in 24 hours.
  • Do not use for more than 2 days. See your doctor if diarrhea lasts longer than this.

For children

The above products and dosages are designed for people 12 years and older. Pepto-Bismol offers a separate product designed for children 12 and under in chewable tablets.

This product is designed to treat heartburn and indigestion in young children. Note that the dosages are based on weight and age.

Pepto Kids Chewable Tablets:

  • One tablet for children 24 to 47 pounds and 2 to 5 years of age. Do not exceed three tablets in 24 hours.
  • Two tablets for children 48 to 95 pounds and 6 to 11 years of age. Do not exceed six tablets in 24 hours.
  • Do not use in children under 2 years old or under 24 pounds, unless recommended by a doctor.
  • Call your child’s pediatrician if symptoms don’t improve within 2 weeks.

Most side effects from Pepto-Bismol are mild and go away shortly after you stop taking the medication.

More common side effects

The more common side effects of Pepto-Bismol include:

  • black stool
  • black, hairy tongue

These side effects are harmless. Both effects are temporary and go away within several days after you stop taking Pepto-Bismol.

Q:

Why can Pepto-Bismol give me black stool and a black, hairy tongue?

Reader-submitted question

A:

Pepto-Bismol contains a substance called bismuth. When this substance mixes with sulfur (a mineral in your body), it forms another substance called bismuth sulfide. This substance is black.

When it forms in your digestive tract, it mixes with food as you digest it. This makes your stool turn black. When bismuth sulfide forms in your saliva, it turns your tongue black. It also causes a buildup of dead skin cells on your tongue’s surface, which can make your tongue look furry.

Healthline Medical TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Serious side effect

Ringing in your ears is an uncommon but serious side effect of Pepto-Bismol. If you have this side effect, stop taking Pepto-Bismol and call your doctor right away.

Pepto-Bismol may interact with any other medications you may be taking. Talk to your pharmacist or doctor to see whether Pepto-Bismol interacts with any medications you take.

Examples of medications that can interact with Pepto-Bismol include:

  • angiotensin converting enzyme (ACE) inhibitors, such as benazepril, captopril, enalapril, fosinopril, lisinopril, and trandolapril
  • anti-seizure drugs, such as valproic acid and divalproex
  • blood thinners (anticoagulants), such as warfarin
  • diabetes medications, such as insulin, metformin, sulfonylureas, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sodium-glucose cotransporter-2 (SGLT-2) inhibitors
  • gout medications, such as probenecid
  • methotrexate
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, ibuprofen, meloxicam, indomethacin, and diclofenac
  • other salicylates, such as aspirin
  • phenytoin
  • tetracycline antibiotics, such as demeclocycline, doxycycline, minocycline, and tetracycline

Definition

An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

Pepto-Bismol is typically safe for most people, but avoid it if you have certain health conditions. Pepto-Bismol may make them worse.

Don’t take Pepto-Bismol if you:

  • are allergic to salicylates (including aspirin or NSAIDs such as ibuprofen, naproxen, and celecoxib)
  • have an active, bleeding ulcer
  • are passing bloody stools or black stools that aren’t caused by Pepto-Bismol
  • are a teenager who has or is recovering from chickenpox or flu-like symptoms

Bismuth subsalicylate may also cause problems for people with other health conditions.

Before taking Pepto-Bismol, tell your doctor if you have any of the following medical conditions. They can tell you if it’s safe to use Pepto-Bismol. These conditions include:

  • stomach ulcers
  • bleeding problems, such as hemophilia and von Willebrand disease
  • kidney problems
  • gout
  • diabetes

Stop taking Pepto-Bismol and call your doctor right away if you have vomiting and extreme diarrhea along with behavior changes, such as:

  • loss of energy
  • aggressive behavior
  • confusion

These symptoms could be early signs of Reye’s syndrome. This is a rare but serious illness that can affect your brain and liver.

Avoid using Pepto-Bismol to self-treat diarrhea if you have a fever or stools that contain blood or mucus. If you have these symptoms, call your doctor right away. They could be signs of a serious health condition, such as an infection.

In case of overdose

Symptoms of a Pepto-Bismol overdose can include:

  • ringing in your ears
  • loss of hearing
  • extreme drowsiness
  • nervousness
  • fast breathing
  • confusion
  • seizures

If you think you’ve taken too much, call your doctor or local poison control center. If your symptoms are severe, call 911 or local emergency services, or go to the nearest emergency room right away.

For many people, Pepto-Bismol is a safe, easy way to relieve common stomach problems. But if you have any concerns about whether Pepto-Bismol is a safe option for you, be sure to ask your doctor or pharmacist.

Also call your doctor if Pepto-Bismol doesn’t ease your symptoms after 2 days.