If your children have a penchant for eating sweets and fast food, you might often get complaints about stomach aches from them. During such times, you might seek solace in the familiar, over-the-counter pink medication Pepto-Bismol. Pepto-Bismol is an effective diarrhea and upset stomach reliever.
However, medications that are suitable for adults might not be ideal for children. So, how safe is Pepto-Bismol for kids? Read this post to understand how Pepto-Bismol works and learn about its safety profile for children, including the dosage, side effects, and the alternatives available.
At What Age Can A Child Take Pepto-Bismol?
Pepto-Bismol is used to treat several digestive problems such as diarrhea, indigestion, nausea, gas, burping, heartburn, and the feeling of fullness. However, only children aged 12 years and above can take Pepto-Bismol. Do not administer it to younger children without a doctor’s consultation (1).
Bismuth subsalicylate, the active ingredient in Pepto-Bismol, can have harmful effects on young children. Hence, for children aged between 2–11 years, an alternative medication called Pepto Kids can be given instead (2). It is a formulation made specifically for younger children. The main ingredient of this medication is calcium carbonate, which is considered safe for children.
How Does Pepto-Bismol Work?
The key ingredient of Pepto-Bismol is bismuth subsalicylate, which helps (3)
- Inhibit the production of prostaglandin, a group of compounds that cause inflammation and increased movement of the gastrointestinal tract.
- Reduce the loss of fluids by increasing the reabsorption of fluids, sodium, and chloride.
- Block secretions from the intestine.
- Inhibit the function of H. pyroli bacteria in the body and blocks its adhesion to the mucosal cells.
- Promote healing of stomach ulcers.
Pepto Bismol Dosage For Children
For children aged 12 years or older and adults, the following dosage of Pepto-Bismol can be given. The doctor’s recommendations or the label instructions should be strictly followed while taking the medication (1) (2) (4) (5) (6).
A. Pepto-Bismol liquid
- Pepto-Bismol regular strength suspension: A single dose is 30ml (two tablespoons or the dose cup provided), and it should be taken every 30 minutes to one hour as per requirement. Shake well before use, and restrict your intake to eight doses (240ml) per day (24 hours).
- Pepto-Bismol Ultra suspension: For diarrhea or traveler’s diarrhea, take one dose (15ml) every 30 minutes or two doses (15x2ml) every hour. Problems due to overindulgence in food/drink can be relieved by taking 15ml every half an hour. The maximum dosage should be restricted to eight doses (120ml) in 24 hours.
B. Pepto-Bismol chewable tablets or caplets
- Take two chewable tablets or regular-strength caplets every 30 minutes to one hour, depending on the requirement.
- Do not take more than eight doses (16 tablets) of regular-strength caplets in 24 hours.
- While chewable tablets should be chewed or dissolved in the mouth, regular-strength caplets must be swallowed with water.
- In the case of Pepto-Bismol Ultra caplets for diarrhea, take one caplet every 30 minutes or two caplets every hour. For problems related to overeating, take one caplet every 30 minutes. Dosage should be restricted to eight caplets per 24 hours.
- Do not take the medication for more than two days. Consult a doctor if diarrhea persists beyond two days.
- Pepto-Bismol could cause dehydration in children suffering from diarrhea. Hence, ensure your child drinks clear fluids frequently.
C. Pepto Kids
Pepto Kids is the child-safe version of Pepto-Bismol. It is suitable for children aged 2-11 years. The following is the dosage for Pepto-Kids.
- Children weighing 24–47lb and aged between 2–5 years should have one tablet. The maximum dosage is three tablets per day (24 hours).
- Children weighing 48–95lb and aged 6–11 years should have two tablets. The maximum dosage is six tablets in 24 hours.
Why Should Kids Not Have Pepto-Bismol? (Side Effects)
If Pepto-Bismol is taken by children younger than 12 years, it can cause harmful complications.
- Reye’s Syndrome
The active ingredient of the medicine is bismuth subsalicylate. It shows limited effectiveness in children and poses a high risk for Reye’s syndrome (1). Reye’s syndrome is characterized by acute elevation of pressure in the brain and liver damage due to fat accumulation.
- Other side effects
Here are a few other side effects of Pepto-Bismol (9).
- Darkening of stools and tongue may occur due to the reaction of its ingredient bismuth with sulfur in your saliva and digestive system. The reaction may form black-colored bismuth sulfide. It is generally harmless. However, if the effect lasts for more than three days, consult a medical professional.
- Overdose can result in deafness, ringing of ears, exhaustion or dizziness, and confusion.
Pepto-Bismol should be avoided in the following cases, even for older children (1).
- Children and teens who recently had chickenpox or flu-like symptoms and are recovering from them
- Children who are allergic to salicylates and aspirin
- Children who are currently on any other salicylate medication/products
- Children who have an ulcer, preexisting black or bloody stools, or a bleeding issue
Children and adults taking medication for the following medical conditions should consult a doctor before taking Pepto-Bismol (1).
Pepto-Bismol may have interactions with other drugs. So, if your child is on any medications, it is best to talk to a doctor before giving them Pepto-Bismol (1).
When your little one falls sick, it is natural to worry and seek immediate help. Although over-the-counter medications such as Pepto-Bismol are easily available, they are not always safe for children.
If you have any concerns about your child’s health, consult the pediatrician without any hesitation. They can offer the diagnosis and treatment based on your child’s age, weight, and medical history.
2. PEPTO KIDS- calcium carbonate tablet, chewable; National Institutes of Health
3. Patrick Budisak and Malak Abbas; Bismuth Subsalicylate; StatPearls (2021).
4. PEPTO-BISMOL ULTRA- bismuth subsalicylate suspension; National Institutes of Health
5. PEPTO BISMOL- bismuth subsalicylate tablet; National Institutes of Health
6. PEPTO-BISMOL ULTRA- bismuth subsalicylate tablet; National Institutes of Health
7. Reye’s Syndrome Information Page; National Institute of Neurological Disorders and Stroke
8. Reye Syndrome; American Academy of Pediatrics
9. Pepto-Bismol (bismuth subsalicylate); NHS
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