Chemical: Drug
bismuth subsalicylate

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Generic Names
  • Bismuth oxide salicylate
  • Bismuth oxysalicylate
  • Bismuth(III) subsalicylate
  • Bismuthi subsalicylas
  • Bismutum subsalicylicum
  • bismuth
Trade Names
  • Bismatrol
  • Bismed
  • Bismuth caplets
  • Bismuth chewables
  • Extra strength bismuth
  • Extra-strength bismuth
  • Maalox multi action
  • PMS-bismuth subsalicylate
  • Pepto-bismol
  • Spiromak forte
  • Stabisol
  • Vismut
  • Wismutsubsalicylat
Brand Mixture Names
  • Bismuth + Antacid [Chewable Tablets] (Bismuth Subsalicylate + Calcium Carbonate)
  • Pepto-Bismol Chewables (Bismuth Subsalicylate + Calcium Carbonate)
  • Watkins Settelz (Bismuth Subsalicylate + Pectin + Phenyl Salicylate)

PharmGKB Accession Id





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.

Source: Drug Bank


Used to treat nausea, heartburn, indigestion, upset stomach, diarrhea, and other temporary discomforts of the stomach and gastrointestinal tract.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

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.

Source: Drug Bank


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.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity


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.

Source: Drug Bank


Following oral administration, absorption of the salicylate component from the small intestine is generally rapid and complete (>90%).

Source: Drug Bank

Chemical Properties

Chemical Formula


Source: Drug Bank

Isomeric SMILES


Source: Drug Bank


Source: Drug Bank

Canonical SMILES


Source: Drug Bank

Average Molecular Weight


Source: Drug Bank

Monoisotopic Molecular Weight


Source: Drug Bank



Source: Drug Bank

InChI String


Source: Drug Bank


Web Resource:
KEGG Compound:
KEGG Drug:
PubChem Compound:
PubChem Substance:
Drugs Product Database (DPD):

Clinical Trials

These are trials that mention bismuth subsalicylate and are related to either pharmacogenetics or pharmacogenomics.

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Sources for PharmGKB drug information: DrugBank, PubChem.