Bismarex

This medication should not be given to a child or teenager who has a fever, especially if the child also has flu symptoms or chicken pox. Subsalicylate can cause a serious and sometimes fatal condition called Reye's syndrome in children.

You should not use bismuth subsalicylate if you are allergic to it, or if you have:

• a stomach ulcer;

• a recent history of stomach or intestinal bleeding; or

• if you are allergic to salicylates such as aspirin, Doan's Extra Strength, Salflex, Tricosal, and others.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

• fever;

• mucus in your stools;

• diabetes;

• arthritis; or

• gout.

Ask a doctor before using bismuth subsalicylate if you are pregnant.

Bismuth subsalicylate can pass into breast milk and may harm a nursing baby. Ask a doctor before using this medicine if you are breast-feeding a baby.

Since bismuth subsalicylate is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. Do not take more than 8 doses in one day (24 hours).

Applies to bismuth subsalicylate: oral suspension, oral tablet, oral tablet chewable

Along with its needed effects, bismuth subsalicylate (the active ingredient contained in Bismarex) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking bismuth subsalicylate:

In some patients bismuth subsalicylate may cause dark tongue and/or grayish black stools. This is only temporary and will go away when you Stop taking bismuth subsalicylate.

• Anxiety
• any loss of hearing
• confusion
• constipation (severe)
• diarrhea (severe or continuing)
• difficulty in speaking or slurred speech
• dizziness or lightheadedness
• drowsiness (severe)
• fast or deep breathing
• headache (severe or continuing)
• increased sweating
• increased thirst
• mental depression
• muscle spasms (especially of face, neck, and back)
• muscle weakness
• nausea or vomiting (severe or continuing)
• ringing or buzzing in ears (continuing)
• stomach pain (severe or continuing)
• trembling
• uncontrollable flapping movements of the hands (especially in elderly patients) or other uncontrolled body movements
• vision problems

524 mg orally every 30 to 60 minutes as needed not to exceed 8 doses in any 24 hour period.
Alternatively, 1048 mg to 1050 mg may be given orally every hour not to exceed 4 doses in any 24 hour period.

Comments:
-Use until diarrhea stops but not longer than 2 days.
-Bismuth subsalicylate may be useful in the prevention of traveler's diarrhea during periods of risk. The duration of use for traveler's diarrhea should not exceed approximately 3 weeks.
-Shake liquid formulations well before using.

524 mg orally every 30 to 60 minutes as needed not to exceed 8 doses in any 24 hour period.
Alternatively, 1048 mg to 1050 mg may be given orally every hour not to exceed 4 doses in any 24 hour period.

Comments:
-Use until diarrhea stops but not longer than 2 days.
-Bismuth subsalicylate may be useful in the prevention of traveler's diarrhea during periods of risk. The duration of use for traveler's diarrhea should not exceed approximately 3 weeks.
-Shake liquid formulations well before using.

524 mg orally 4 times a day.

Dosage in children with Helicobacter Pylori Infection is not well established, the following doses have been used in conjunction with ampicillin and metronidazole.

<= 10 years: 262 mg four times a day for six weeks

> 10 years: 524 mg four times a day for six weeks

Use is not recommended. Excreted into human milk: Yes Comments: -Bismuth is not expected to appear in high concentrations in breast milk due to poor systemic absorption. -Salicylates are excreted in breast milk.