Bismuth subsalicylate
Identification
- Name
- Bismuth subsalicylate
- Accession Number
- DB01294
- Description
Bismuth subsalicylate is the active ingredient in the popular medication Pepto-Bismol that is used to treat nausea, heartburn, indigestion, upset stomach, diarrhea, and other temporary discomforts of the stomach and gastrointestinal tract. It is also the main ingredient of Kaopectate. It displays anti-inflammatory action (due to salicylic acid) and also acts as an antacid and mild antibiotic.
- Type
- Small Molecule
- Groups
- Approved, Vet approved
- Structure
Structure for Bismuth subsalicylate (DB01294)
- Weight
- Average: 362.0926
Monoisotopic: 361.999166889 - Chemical Formula
- C7H5BiO4
- Synonyms
- 2-Hydroxy-benzo[1,3,2]dioxabismin-4-one
- Basic bismuth salicylate
- Bismuth oxide salicylate
- Bismuth oxysalicylate
- Bismuth Subsalicylate
- Pink bismuth
- Wismutsubsalicylat
Pharmacology
- Indication
Used to treat nausea, heartburn, indigestion, upset stomach, diarrhea, and other temporary discomforts of the stomach and gastrointestinal tract.
- Associated Conditions
- Contraindications & Blackbox Warnings
Learn about our commercial Contraindications & Blackbox Warnings data.
Learn More- Pharmacodynamics
Bismuth subsalicylate displays anti-inflammatory action (due to salicylic acid) and also acts as an antacid and mild antibiotic. It can also cause a black tongue and black stools in some users of the drug, when it combines with trace amounts of sulfur in their saliva and gastrointestinal tract. This discoloration is temporary and harmless.
- Mechanism of action
As an antidiarrheal, the exact mechanism has not been determined. Bismuth subsalicylate may exert its antidiarrheal action not only by stimulating absorption of fluid and electrolytes across the intestinal wall (antisecretory action) but also, when hydrolyzed to salicylic acid, by inhibiting synthesis of a prostaglandin responsible for intestinal inflammation and hypermotility. In addition, bismuth subsalicylate binds toxins produced by Escherichia coli. Both bismuth subsalicylate and the intestinal reaction products, bismuth oxychloride and bismuth hydroxide, are believed to have bactericidal action. As an antacid, bismuth has weak antacid properties.
- Absorption
Following oral administration, absorption of the salicylate component from the small intestine is generally rapid and complete (>90%).
- Volume of distribution
- Not Available
- Protein binding
- Not Available
- Metabolism
Based on in vitro dissociation data and in vivo animal data, bismuth subsalicylate is believed to be largely hydrolyzed in the stomach to bismuth oxychloride and salicylic acid. In the small intestine, nondissociated bismuth subsalicylate reacts with other anions (bicarbonate and phosphate) to form insoluble bismuth salts. In the colon, nondissociated bismuth subsalicylate and other bismuth salts react with hydrogen sulfide to produce bismuth sulfide, a highly insoluble black salt responsible for the darkening of the stools.
- Route of elimination
- Not Available
- Half-life
- Not Available
- Clearance
- Not Available
- Adverse Effects
Learn about our commercial Adverse Effects data.
Learn More- Toxicity
- Not Available
- Affected organisms
- Not Available
- Pathways
- Not Available
- Pharmacogenomic Effects/ADRs
- Not Available
Interactions
- Drug Interactions
- This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction Unlock Additional DataAbciximab The risk or severity of bleeding can be increased when Bismuth subsalicylate is combined with Abciximab. Acarbose Bismuth subsalicylate may increase the hypoglycemic activities of Acarbose. Aceclofenac The therapeutic efficacy of Bismuth subsalicylate can be decreased when used in combination with Aceclofenac. Acenocoumarol Bismuth subsalicylate may increase the anticoagulant activities of Acenocoumarol. Acetaminophen The risk or severity of adverse effects can be increased when Acetaminophen is combined with Bismuth subsalicylate. Acetazolamide The risk or severity of adverse effects can be increased when Bismuth subsalicylate is combined with Acetazolamide. Acetohexamide Bismuth subsalicylate may increase the hypoglycemic activities of Acetohexamide. Acetophenazine Acetophenazine may increase the neurotoxic activities of Bismuth subsalicylate. Acetyldigitoxin The serum concentration of Acetyldigitoxin can be decreased when it is combined with Bismuth subsalicylate. Acetylsalicylic acid The therapeutic efficacy of Bismuth subsalicylate can be decreased when used in combination with Acetylsalicylic acid. Additional Data Available- Extended DescriptionExtended DescriptionAvailable for Purchase
Extended description of the mechanism of action and particular properties of each drug interaction.
Learn more - SeveritySeverityAvailable for Purchase
A severity rating for each drug interaction, from minor to major.
Learn more - Evidence LevelEvidence LevelAvailable for Purchase
A rating for the strength of the evidence supporting each drug interaction.
Learn more - ActionActionAvailable for Purchase
An effect category for each drug interaction. Know how this interaction affects the subject drug.
Learn more
- Food Interactions
- No interactions found.
Products
- Active Moieties
Name Kind UNII CAS InChI Key Salicylic acid unknown O414PZ4LPZ 69-72-7 YGSDEFSMJLZEOE-UHFFFAOYSA-N Bismuth cation ionic ZS9CD1I8YE 23713-46-4 JDIBGQFKXXXXPN-UHFFFAOYSA-N - International/Other Brands
- Maalox Multi-Action
- Over the Counter Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image Unlock Additional Data7 Select Pink Bismuth Suspension 1050 mg/30mL Oral 7-Eleven 2014-04-17 2019-10-31 US 
7-Select Pepto Bismol Tablet, chewable 262 mg/1 Oral Lil' Drug Store Products, Inc. 2011-08-01 2017-12-31 US Anti-Diarrheal Tablet 262 mg/1 Oral Lil' Drug Store Products, Inc. 2019-02-21 Not applicable US Anti-Diarrheal Maximum Strength Tablet 525 mg/1 Oral WAL-MART STORES INC 2020-04-06 Not applicable US Basic Care Stomach Relief Tablet, chewable 262 mg/1 Oral L. Perrigo Company 2019-01-11 Not applicable US Being Well stomach relief original strength Suspension 525 mg/30mL Oral Save-A-Lot Food Stores Ltd 2006-02-25 2019-08-01 US Bismatrol Tablet, chewable 262 mg/1 Oral Preferred Pharmaceuticals Inc. 2018-04-19 Not applicable US Bismatrol Tablet, chewable 262 mg/1 Oral Major Pharmaceuticals 2003-01-03 Not applicable US Bismatrol Liquid 262 mg/15mL Oral Major Pharmaceuticals 2008-05-30 2021-02-28 US Bismatrol Liquid 262 mg/15mL Oral Proficient Rx LP 2008-05-30 Not applicable US Additional Data Available- Application NumberApplication NumberAvailable for Purchase
A unique ID assigned by the FDA when a product is submitted for approval by the labeller.
Learn more - Product CodeProduct CodeAvailable for Purchase
A governmentally-recognized ID which uniquely identifies the product within its regulatory market.
Learn more
- Mixture Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image Bismed Chewable Tablets Bismuth subsalicylate (300 mg) + Calcium carbonate (350 mg) Tablet Oral Technilab Pharma Inc. 1993-12-31 1998-09-14 Canada 
Bismuth + Antacid (chewable Tablets) Bismuth subsalicylate (262 mg) + Calcium carbonate (675 mg) Tablet, chewable Oral Perrigo International 2000-09-27 Not applicable Canada Bismuth Chewable Tablets Bismuth subsalicylate (262 mg) + Calcium carbonate (308 mg) Tablet Oral Vita Health Products Inc 2001-04-01 2004-07-26 Canada Bismuth Subsalicylate/Metronidazole/Tetracycline Hydrochloride Bismuth subsalicylate (262.4 mg/1) + Metronidazole (250 mg/1) + Tetracycline hydrochloride (500 mg/1) Kit Oral Ailex Pharmaceuticals, Llc 2018-11-30 Not applicable US Bismuth Tablets With Calcium Carbonate Bismuth subsalicylate (262 mg) + Calcium carbonate (350 mg) Tablet, chewable Oral Tanta Pharmaceuticals Inc Not applicable Not applicable Canada Cherry Flavour Pepto-bismol Tab Bismuth subsalicylate (262 mg) + Calcium carbonate (350 mg) Tablet Oral Procter And Gamble 1992-12-31 1997-10-31 Canada Chewable Bismuth Tablets With Calcium Carbonate Bismuth subsalicylate (262 mg) + Calcium carbonate (350 mg) Tablet, chewable Oral Cellchem Pharmaceuticals Inc. 2009-09-24 Not applicable Canada HELIDAC Therapy Bismuth subsalicylate (262.4 mg/1) + Metronidazole (250 mg/1) + Tetracycline hydrochloride (500 mg/1) Kit Oral Prometheus Laboratories 1996-08-15 2014-02-01 US HELIDAC Therapy Bismuth subsalicylate (262.4 mg/1) + Metronidazole (250 mg/1) + Tetracycline hydrochloride (500 mg/1) Kit Oral Casper Pharma Llc 2020-06-11 Not applicable US Pepto-Bismol Bismuth subsalicylate (525 mg/30mL) + Bismuth subsalicylate (262 mg/1) Oral The Procter & Gamble Manufacturing Company 2012-03-05 2021-12-01 US
Categories
- Drug Categories
- Acids, Carbocyclic
- Antacids and Adsorbents
- Antidiarrheals
- Benzene Derivatives
- Benzoates
- Bismuth containing drugs
- Elements
- Elements, Radioactive
- Gastrointestinal Agents
- Helicobacter Infections
- Hydroxy Acids
- Hydroxybenzoates
- Isotopes
- Metals
- Metals, Heavy
- Neurotoxic agents
- Phenols
- Radioisotopes
- Salicylates
- Chemical TaxonomyProvided by Classyfire
- Description
- This compound belongs to the class of organic compounds known as benzenoids. These are aromatic compounds containing one or more benzene rings.
- Kingdom
- Organic compounds
- Super Class
- Benzenoids
- Class
- Not Available
- Sub Class
- Not Available
- Direct Parent
- Benzenoids
- Alternative Parents
- Carboxylic acid salts / Oxacyclic compounds / Organic metal salts / Monocarboxylic acids and derivatives / Metalloheterocyclic compounds / Organooxygen compounds / Organic oxides / Hydrocarbon derivatives
- Substituents
- Aromatic heteropolycyclic compound / Benzenoid / Carboxylic acid derivative / Carboxylic acid salt / Hydrocarbon derivative / Metalloheterocycle / Monocarboxylic acid or derivatives / Organic metal salt / Organic oxide / Organic oxygen compound
- Molecular Framework
- Aromatic heteropolycyclic compounds
- External Descriptors
- salicylates, bismuth coordination entity (CHEBI:261649)
Chemical Identifiers
- UNII
- 62TEY51RR1
- CAS number
- 14882-18-9
- InChI Key
- ZREIPSZUJIFJNP-UHFFFAOYSA-K
- InChI
- InChI=1S/C7H6O3.Bi.H2O/c8-6-4-2-1-3-5(6)7(9)10;;/h1-4,8H,(H,9,10);;1H2/q;+3;/p-3
- IUPAC Name
- 2-hydroxy-2H,4H-benzo[d]1,3-dioxa-2-bismacyclohexan-4-one
- SMILES
- O[Bi]1OC(=O)C2=CC=CC=C2O1
References
- Synthesis Reference
Richard William Hess, "Pigmentary bright primrose yellow monoclinic bismuth vanadate and processes for the preparation thereof." U.S. Patent US4115142, issued December, 1925.
US4115142- General References
- Goldenberg MM, Honkomp LJ, Burrous SE, Castellion AW: Protective effect of Pepto-Bismol liquid on the gastric mucosa of rats. Gastroenterology. 1975 Sep;69(3):636-40. [PubMed:1158081]
- External Links
- Human Metabolome Database
- HMDB0015408
- KEGG Drug
- D00728
- KEGG Compound
- C07870
- PubChem Compound
- 16682734
- PubChem Substance
- 46507128
- ChemSpider
- 17215772
- 19478
- ChEBI
- 261649
- ChEMBL
- CHEMBL1120
- PharmGKB
- PA164774805
- RxList
- RxList Drug Page
- Drugs.com
- Drugs.com Drug Page
- Wikipedia
- Bismuth_subsalicylate
- AHFS Codes
- 56:04.00 — Antacids and Adsorbents
- 56:08.00 — Antidiarrhea Agents
- MSDS
- Download (73.6 KB)
Clinical Trials
- Clinical Trials
Phase Status Purpose Conditions Count 4 Active Not Recruiting Prevention Helicobacter Pylori Infection / Obesity, Morbid 1 4 Completed Treatment Cure Rate of Helicobacter Pylori Infection 1 4 Completed Treatment Helicobacter Pylori Infection 1 4 Withdrawn Treatment Clostridium Difficile Infection (CDI) 1 3 Completed Treatment Optimization of Second Line Treatment Protocol for H Pylori Eradication 1 3 Recruiting Prevention Antibiotic Resistant Infection / Traveler's Diarrhea 1 2 Completed Treatment Malignant Lymphomas 1 2, 3 Completed Treatment Female Genital Diseases 1 1 Completed Treatment Healthy Volunteers 1 Not Available Completed Health Services Research Diarrhea 1
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Amend
- Chattem Chemicals Inc.
- Dispensing Solutions
- Kroger Co.
- Major Pharmaceuticals
- Novartis AG
- Pharma Pac LLC
- Procter & Gamble
- Publix Super Markets
- Walgreen Co.
- Dosage Forms
Form Route Strength Suspension Oral 1.7 g Tablet, chewable Buccal 262 mg Suspension Oral 1750 mg Tablet Oral Tablet Oral 262 mg/434mg Suspension Oral 17.5 mg Suspension Oral 17.6 mg Liquid Oral Capsule, gelatin coated Oral 262 mg/1 Tablet Oral Tablet, chewable Oral 262 mg Tablet Oral 262 mg Tablet, chewable Oral 262 mg/1 Tablet, chewable Buccal 262.5 mg Powder Oral 262 mg/1 Liquid Oral 1050 mg/30mL Tablet Oral 524 mg Suspension Oral 524 mg/15mL Tablet Oral 1.048 g Kit Oral Tablet, coated Oral 262 mg/1 Liquid Oral 35.0 mg/1mL Liquid Oral 17.47 mg/1mL Liquid Oral 525 mg/15mL Suspension Oral 1050 mg/30mL Tablet, film coated Oral 187.125 MG Tablet Oral 125 MG Suspension Oral 17.5 mg/1mL Suspension Oral 262 mg/15mL Tablet Oral 262 mg/1 Suspension Oral 525 mg/15mL Suspension Oral 1.75 g Capsule Oral 262 mg Capsule, liquid filled Oral 262 mg/1 Liquid Oral 525 mg/30mL Tablet Oral 525 mg/21 Tablet, chewable Oral Suspension Oral Tablet Oral 262.4 mg Tablet Oral 525 mg/1 Tablet, chewable Oral Liquid Oral 1050 mg/10mL Liquid Oral 262 mg/15mL Tablet, film coated Oral 262 mg/1 Tablet Oral 375 MG Liquid Oral 262 mg/30mL Suspension Oral 525 mg/30mL Powder Oral 525 mg/1 Liquid Oral - Prices
Unit description Cost Unit Kaopectate 262 mg caplet 0.37USD caplet Gas-x with maalox chew tablet 0.25USD tablet Bismuth subsalicylate powdr 0.17USD g Jr maalox plus antigas tablet chew 0.17USD tablet Calcium carb 500 mg tablet chew 0.14USD tablet Pepto-bismol caplet 0.14USD caplet Soothe caplets 0.12USD caplet Bismatrol 262 mg tablet 0.09USD tablet Maalox advanced tablet chew 0.09USD tablet Maalox quick dissolve tablet 0.09USD tablet Maalox max quick dissolve tablet 0.06USD tablet Stomach relief tablet 0.06USD tablet Magnesium-aluminum suspension 0.03USD ml Bismuth 262 mg/15ml susp 0.02USD ml Maalox max strength multi symp 0.02USD ml Maalox maximum strength susp 0.02USD ml Pepto-bismol max str susp 0.02USD ml Pub calcium carb 1000 mg tablet 0.02USD tablet Maalox plus x-strength susp 0.01USD ml Maalox total relief (bismuth) 0.01USD ml DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.- Patents
- Not Available
Properties
- State
- Solid
- Experimental Properties
- Not Available
- Predicted Properties
Property Value Source Water Solubility 59.7 mg/mL ALOGPS logP 0.37 ALOGPS logP 1.11 ChemAxon logS -0.78 ALOGPS pKa (Strongest Acidic) 14.3 ChemAxon pKa (Strongest Basic) -3.1 ChemAxon Physiological Charge 0 ChemAxon Hydrogen Acceptor Count 3 ChemAxon Hydrogen Donor Count 1 ChemAxon Polar Surface Area 55.76 Å2 ChemAxon Rotatable Bond Count 0 ChemAxon Refractivity 35.72 m3·mol-1 ChemAxon Polarizability 15.66 Å3 ChemAxon Number of Rings 2 ChemAxon Bioavailability 1 ChemAxon Rule of Five Yes ChemAxon Ghose Filter No ChemAxon Veber's Rule No ChemAxon MDDR-like Rule No ChemAxon - Predicted ADMET Features
Property Value Probability Human Intestinal Absorption + 0.9086 Blood Brain Barrier + 0.9387 Caco-2 permeable + 0.5187 P-glycoprotein substrate Non-substrate 0.7003 P-glycoprotein inhibitor I Non-inhibitor 0.8865 P-glycoprotein inhibitor II Non-inhibitor 0.9885 Renal organic cation transporter Non-inhibitor 0.9091 CYP450 2C9 substrate Non-substrate 0.7983 CYP450 2D6 substrate Non-substrate 0.8434 CYP450 3A4 substrate Non-substrate 0.6608 CYP450 1A2 substrate Non-inhibitor 0.5106 CYP450 2C9 inhibitor Non-inhibitor 0.6648 CYP450 2D6 inhibitor Non-inhibitor 0.8639 CYP450 2C19 inhibitor Non-inhibitor 0.7378 CYP450 3A4 inhibitor Non-inhibitor 0.7081 CYP450 inhibitory promiscuity Low CYP Inhibitory Promiscuity 0.887 Ames test Non AMES toxic 0.6317 Carcinogenicity Non-carcinogens 0.8734 Biodegradation Not ready biodegradable 0.8052 Rat acute toxicity 2.6494 LD50, mol/kg Not applicable hERG inhibition (predictor I) Weak inhibitor 0.7517 hERG inhibition (predictor II) Non-inhibitor 0.9359
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
Spectrum Spectrum Type Splash Key Predicted GC-MS Spectrum - GC-MS Predicted GC-MS Not Available Predicted MS/MS Spectrum - 10V, Positive (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 20V, Positive (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 40V, Positive (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 10V, Negative (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 20V, Negative (Annotated) Predicted LC-MS/MS Not Available Predicted MS/MS Spectrum - 40V, Negative (Annotated) Predicted LC-MS/MS Not Available
Carriers
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Binder
- General Function
- Toxic substance binding
- Specific Function
- Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
- Gene Name
- ALB
- Uniprot ID
- P02768
- Uniprot Name
- Serum albumin
- Molecular Weight
- 69365.94 Da
References
- Sun H, Li H, Mason AB, Woodworth RC, Sadler PJ: Competitive binding of bismuth to transferrin and albumin in aqueous solution and in blood plasma. J Biol Chem. 2001 Mar 23;276(12):8829-35. Epub 2000 Dec 7. [PubMed:11110794]
- Sun H, Szeto KY: Binding of bismuth to serum proteins: implication for targets of Bi(III) in blood plasma. J Inorg Biochem. 2003 Feb 1;94(1-2):114-20. [PubMed:12620681]
- Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352]
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- General Function
- Transferrin receptor binding
- Specific Function
- Transferrins are iron binding transport proteins which can bind two Fe(3+) ions in association with the binding of an anion, usually bicarbonate. It is responsible for the transport of iron from si...
- Gene Name
- TF
- Uniprot ID
- P02787
- Uniprot Name
- Serotransferrin
- Molecular Weight
- 77063.195 Da
References
- Sun H, Li H, Mason AB, Woodworth RC, Sadler PJ: Competitive binding of bismuth to transferrin and albumin in aqueous solution and in blood plasma. J Biol Chem. 2001 Mar 23;276(12):8829-35. Epub 2000 Dec 7. [PubMed:11110794]
- Sun H, Szeto KY: Binding of bismuth to serum proteins: implication for targets of Bi(III) in blood plasma. J Inorg Biochem. 2003 Feb 1;94(1-2):114-20. [PubMed:12620681]
- Zhang M, Gumerov DR, Kaltashov IA, Mason AB: Indirect detection of protein-metal binding: interaction of serum transferrin with In3+ and Bi3+. J Am Soc Mass Spectrom. 2004 Nov;15(11):1658-64. [PubMed:15519234]
- Miquel G, Nekaa T, Kahn PH, Hemadi M, El Hage Chahine JM: Mechanism of formation of the complex between transferrin and bismuth, and interaction with transferrin receptor 1. Biochemistry. 2004 Nov 23;43(46):14722-31. [PubMed:15544343]
- Ge R, Sun H: Bioinorganic chemistry of bismuth and antimony: target sites of metallodrugs. Acc Chem Res. 2007 Apr;40(4):267-74. Epub 2007 Mar 2. [PubMed:17330963]
Drug created on June 30, 2007 08:17 / Updated on January 25, 2021 22:38