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Bismuth Subsalicylate (Pepto-Bismol®, Kaopectate®)

By: Dr. Mark Papich

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Kaopectate® WARNING FOR CAT OWNERS

Use only if your formulation does NOT contain salicylates. Pepto-Bismol® should not be used in cats since it contains salicylates, the active ingredient in aspirin. Cats are very sensitive to aspirin so it should be avoided. WARNING - PLEASE NOTE THAT THE NEW FORMULATIONS OF KAOPECTATE MAY ALSO HAVE SALICYLATES. Do not use if your formulations lists salicylates as an active ingredient. Any vomiting or diarrhea that persists for more than 24 hours needs your veterinarian's attention.

Overview

  • Bismuth subsalicylate, better known as Pepto-Bismol, is used to treat diarrhea and minor stomach problems, such as stomach inflammation.
  • The active ingredient in Pepto-Bismol and the new formulation of Kaopectate is salicylate. Two tablespoons of Pepto-Bismol contain almost as much salicylate as one aspirin tablet.
  • For information about the older formulation of Kaopectate that contains Kaolin and Pectin, click here.
  • The bismuth agent is a chalk-like compound designed to coat the lining of the stomach and intestines, however, there is little evidence that physical "coating" actually occurs.
  • Bismuth subsalicylate is available without a prescription but should not be administered unless under the supervision and guidance of a veterinarian.

    Brand Names and Other Names

  • This drug is registered for use in humans and animals.
  • Human formulations: Pepto-Bismol® (Procter & Gamble), Bismatrol® (Major), Kaopectate® (Pharmacia) and other generic formulations are available. Most preparations are pink in color.
  • Veterinary formulations: Corrective Suspension® (Phoenix)

    Uses of Bismuth Subsalicylate

  • Subsalicylate, an aspirin-like compound, can decrease diarrhea caused by intestinal infections.
  • The bismuth component of Pepto-Bismol has been shown to suppress the bacteria that cause ulcers and stomach inflammation in people. This bacterium is called Helicobacter. While this is beneficial for treatment of humans, the significance of Helicobacter and Helicobacter-like organisms in pets is not completely resolved.

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, bismuth subsalicylate can cause side effects in some animals.

  • Bismuth subsalicylate should not be used in animals with known hypersensitivity or allergy to the drug.
  • You should not use if your pet is allergic to aspirin or other salicylates.
  • There are no serious complications caused by giving Pepto-Bismol to dogs, although there is not complete agreement that it is helpful either.
  • Because salicylate-like compounds are slowly eliminated in cats, one should be careful not to exceed the recommended doses for cats. It should be used with great caution in cats and only under the direction of a veterinarian.
  • Bismuth subsalicylate may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with bismuth subsalicylate. Such drugs include tetracycline, steroids, non-steroidal anti-inflammatory drugs and aspirin.
  • Pet owners should be aware that the bismuth compound causes a discoloration, usually a darkening, of the pet's bowel movements.

    How Bismuth Subsalicylate Is Supplied

  • Oral suspensions of bismuth subsalicylate are available over-the-counter containing 262 milligrams (mg) per 15 ml (one tablespoon), or 525 mg per tablespoon in the "extra strength" form.
  • Pediatric suspensions of bismuth subsalicylate is available containing 87 mg per 5 ml (one teaspoon).
  • Tablets contain 262 mg bismuth subsalicylate per tablet.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian. Please do not administer to cats without first consulting with a veterinarian to avoid toxicity.
  • The typical dose administered to dogs is 0.5 to 1.5 ml per pound per day (1 to 3 ml/kg/day). The total daily dose should be divided into two to four doses. This amounts to approximately 2 teaspoons (10 ml total) per 10-pounds per day, ideally split between two to four doses.
  • The typical dose administered to cats is 0.125 ml per pound (0.25 ml/kg) per dose. Dosage can be repeated in 4 to 6 hours. Please note: Cats are senstitive to salicylates and should not recieve frequent or high doses.
  • The duration of administration depends on the condition being treated, response to the medication and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse.

    Tip: Refrigeration may increase the palatability of this drug, especially to cats and kittens.





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