What are bismuth compounds?

Bismuth compounds (brand names: Pepto-Bismol®, BSS, Bismu-kote®, Bismukote®, Bismupaste®, Bismatrol®, Bismed®, Bismusal®, Bismylate®, Bisval®, Corrective®, Equi-Phar®, Gastrocote®, Jatrox®, Kalbeten®, Kaopectate®, Katulcin-R®, Oral-Pro Biz-Cote®, PalaBIS®, Peptic Relief®, Pink Biscoat®, Pink Bismuth Rose®, or Ulcolind Wismut®) are antidiarrheal and stomach protectants used to treat diarrhea and infections caused by the bacteria Helicobacter. 

Its use in dogs, cats, ferrets, and horses at certain doses to treat diarrhea is sometimes ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How are bismuth compounds given?

Bismuth compounds are given by mouth in the form of a liquid, paste, tablet or capsule. It may be given with or without food; however, if vomiting occurs when dosed on an empty stomach, give future doses with food. Shake liquid forms thoroughly and measure liquids carefully. Do not give this medication within two hours of other medications.

This medication should take effect within 1 to 2 days, and improvements in clinical signs should follow.

What if I miss giving my pet the medication?

Give the missed dose as soon as you remember, and then wait the recommended amount of time between doses. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

Side effects include discolored stools that appear gray-black or greenish-black, or constipation.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Do not use in pets that are allergic to it or other nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin. Do not use in pets that have a stomach or intestinal ulcer. Use cautiously in cats, in pets with bleeding disorders, or in pets that are pregnant or nursing. Use cautiously in young and debilitated pets as constipation and fecal impaction can occur.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with bismuth compounds: aspirin, ACE inhibitors, loop diuretics, NSAIDs, or tetracycline.

Bismuth compounds may also interact with laboratory tests such as urine glucose and ketone tests. It can also interfere with X-rays/radiographs.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working. If the diarrhea is severe, hydration and electrolytes should be monitored.

How do I store bismuth compounds?

Store this medication at room temperature between 68°F and 77°F (20°C and 25°C), protected from light and freezing.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.