Pepto Bismol For Children: Safety, Uses, Dosage And Side Effects

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It is not uncommon to have children complain of frequent stomach aches, especially if they eat out often. Parents may consider over-the-counter medications, such as Pepto-Bismol for kids, in such cases. Pepto-Bismol (Bismuth Subsalicylate) is considered a safe and effective medication for gastrointestinal troubles such as acid reflux, diarrhea, and indigestion. But can kids take Pepto-Bismol? What should be the dosage of Pepto-Bismol for children?

Read on to find out the mechanism of action, the recommended dosage, safety, side effects, and alternatives for Pepto-Bismol in children.

At What Age Can A Child Take Pepto-Bismol?

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Pepto-Bismol is used to treat several digestive problems such as diarrhea, indigestion, nausea, gas, burping, an upset stomach, 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, is a derivative of Aspirin (Acetylsalicylic Acid or ASA), which 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 carbonateⁱXA calcium-containing mineral used as an ingredient in drugs , which is considered safe for children.

Quick fact

Pepto kids is effective in reducing symptoms associated with hyperacidity and does not cover the entire range of uses for Pepto-Bismol (2).

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 block 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: Take 30ml (two tablespoons or the dose cup provided) every 30 minutes to one hour as per, with a maximum of eight doses (240ml) per day (24 hours). Shake the suspension well before use.
• Pepto-Bismol Ultra suspension: For diarrhea or traveler’s diarrhea, take 15ml every 30 minutes or 30ml every hour, with a maximum of eight doses (120ml) in 24 hours. Problems due to overindulgence in food/drink can be relieved by taking 15ml every half an hour.

B. Pepto-Bismol chewable tablets or caplets

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• 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 or indigestion, take one caplet every 30 minutes. Kids’ pepto dosage should be restricted to eight caplets per 24 hours.

Additional instructions

• 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 and provides relief to 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 as needed. The maximum dosage is three tablets per day (24 hours).
• Children weighing 48–95lb and aged 6–11 years should have two tablets as needed. 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.

It can cause symptoms such as convulsionsⁱXUncontrolled and violent shaking in the body due to rapid contraction and relaxation of the muscles , deliriumⁱXA sudden and intense disturbance in a person’s mental status, resulting in confusion and unawareness , fainting, vomiting, crankiness, lethargy, and confusion and is often preceded by a viral infection, such as flu, chickenpox, or influenza (7) (8).

• Other side effects

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Here are a few other side effects of Pepto-Bismol (8).

• 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.

Warnings

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

Image: IStock

• 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).

• Diabetes
• GoutⁱXA complex form of arthritis causing pain and inflammation in the joints
• Arthritis
• Thinning of blood (anticoagulation)

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).

You should also consult a doctor before giving your child Pepto-Bismol if they have any health concerns such as fever or mucus in the stool (1).

Point to consider

Protect the medication from freezing and temperatures 104°F (40ºC) and above to ensure drug stability and effectiveness (1).

Infographic: Quick Overview Of Pepto-Bismol For Children

Pepto-Bismol is a go-to OTC medication for many parents when their child complains of stomach problems. Check out the following infographic to quickly understand:

• What Pepto-Bismol can treat
• Its side effects
• Who should not use it

Illustration: Momjunction Design Team

Image: Dall·E/MomJunction Design Team

Learn how to effectively use Pepto Bismol to relieve stomach discomfort and digestive problems. Follow these clear instructions for quick relief and better overall health.

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Maria Carmela Villania-MamauagMD, DPPS

Maria Carmela Villania-Mamauag is a board certified diplomate of the Philippine Pediatric Society with a degree of Doctor of Medicine from Our Lady of Fatima University, Valenzuela City and a Bachelor in Science in Psychology from Saint Louis University, Baguio City which was augmented by a year of Bachelor in Science in Family Life and Child development at the University...more

• Dr. Christina JohnsMD, MEd, FAAP

  Dr. Christina Johns is the vice-president of Communications at PM Pediatrics, a specialized pediatric urgent care provider. The pediatric emergency physician did her education at Johns Hopkins University School of Medicine and has over 25 years experience in the field.
  
  Dr. Christina Johns is the vice-president of Communications at PM Pediatrics, a specialized pediatric urgent care provider. The pediatric emergency physician did her education at Johns Hopkins University School of Medicine and has over 25 years experience in the field.

Shivali KarandeBPharm, MBA

Shivali holds a bachelor’s degree in pharmacy and a master’s in management from Chetana's R.K Institute of Management and Research Mumbai. After working for nearly five years in the market research sector, she discovered her passion for writing and started freelancing in 2020. Her knowledge about medicines and biology, coupled with her experience in research, helps her write well-researched, informative,...more

Dr. Ritika ShahBDS, CLC

Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to...more

Dr. Joyani DasM.Pharm, PhD

Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer. Her research work was published in international journals and publications, such...more