Kola-Pectin (Oral)

Bismuth subsalicylate is used to treat diarrhea in adults and teenagers. It is also used to help relieve upset stomach symptoms like heartburn, indigestion, and nausea in adults and teenagers.

This medicine is available without a prescription.

Check the labels of all over-the-counter (OTC), nonprescription, and prescription medicines you are currently taking. If any contain aspirin or other salicylates, be very careful. Using other products that have salicylates while taking this medicine may result in an overdose. If you have any questions about this, consult your health care professional.

For diabetic patients:

• False urine sugar test results may happen if you are regularly taking large amounts of bismuth subsalicylate or other salicylates.
• Smaller doses or occasional use of bismuth subsalicylate typically will not affect urine sugar tests. However, consult your health care professional (especially if your diabetes is not well-controlled) if: you are unsure how much salicylate you are taking each day. you notice any changes in your urine sugar test results. you have any other questions regarding this potential issue.

If you think that you or someone else may have taken an overdose, seek emergency help immediately. Taking an overdose of this medicine can cause unconsciousness or death. Signs of overdose include convulsions (seizures), hearing loss, confusion, ringing or buzzing in the ears, severe drowsiness or tiredness, extreme excitement or nervousness, and rapid or deep breathing.

If you are taking this medicine for diarrhea, consult your doctor:

• if your symptoms do not improve within 2 days or if they worsen.
• if you also have a high fever.

In deciding to use this medicine, you and your doctor need to consider the risks of taking it compared to the benefits it may provide.

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your health care professional know if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

This medicine should not be used in children younger than 12 years old. The fluid loss from diarrhea can lead to a serious condition. In older children with diarrhea, this medicine may be used, but it is very important to give enough liquids to replace what the body has lost. If you have any questions about this, consult your health care professional.

Children are usually more sensitive to salicylates, especially if they have a fever or have lost a lot of body fluid due to vomiting, diarrhea, or sweating.

The bismuth in this medicine may cause severe constipation in children.

Additionally, do not use this medicine to treat nausea or vomiting in children or teenagers who have or are recovering from the flu or chickenpox. If nausea or vomiting occurs, contact the child's doctor immediately, as this may be an early sign of Reye's syndrome.

Geriatric

The fluid loss from diarrhea can lead to a serious condition. Therefore, elderly individuals with diarrhea should not use this medicine without first consulting their doctor. It is also very important to drink enough liquids to replace what the body has lost. If you have any questions about this, consult your health care professional.

Elderly individuals may be more sensitive to salicylates, which could increase the risk of side effects during treatment. Furthermore, the bismuth in this medicine may cause severe constipation in the elderly.

Breast Feeding

Studies in breastfeeding women have shown harmful effects on infants. You should be prescribed an alternative to this medicine or stop breastfeeding while using it.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might happen. In these situations, your doctor may want to adjust the dose, or other precautions may be necessary. When using this medicine, it is particularly important that your healthcare professional knows if you are taking any of the following medicines. The following interactions are based on their potential significance and may not include all possible interactions.

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medicines.

• Aceclofenac
• Acemetacin
• Amtolmetin Guacil
• Balsalazide
• Bromfenac
• Bufexamac
• Celecoxib
• Choline Magnesium Trisalicylate
• Choline Salicylate
• Clonixin
• Dexibuprofen
• Dexketoprofen
• Diflunisal
• Digoxin
• Dipyrone
• Droxicam
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Furosemide
• Ibuprofen
• Ketoprofen
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Magnesium Salicylate
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Mesalamine
• Morniflumate
• Nabumetone
• Naproxen
• Nepafenac
• Niflumic Acid
• Nimesulide
• Nimesulide Beta Cyclodextrin
• Olsalazine
• Oxaprozin
• Oxyphenbutazone
• Parecoxib
• Phenylbutazone
• Phenyl Salicylate
• Piketoprofen
• Piroxicam
• Proglumetacin
• Propyphenazone
• Proquazone
• Rofecoxib
• Salicylamide
• Salicylic Acid
• Salsalate
• Sodium Salicylate
• Sulfasalazine
• Sulindac
• Tenoxicam
• Tiaprofenic Acid
• Tolfenamic Acid
• Tolmetin
• Trolamine Salicylate
• Valdecoxib

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medicines.

• Doxycycline
• Omadacycline
• Probenecid
• Sulfinpyrazone
• Tamarind

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used around mealtime or with certain types of food as interactions may occur. Using alcohol or tobacco with certain medicines may also lead to interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Other medical issues may affect the use of this medicine. Be sure to inform your doctor if you have any other medical problems, especially:

• Dysentery—This condition may worsen; a different treatment may be necessary.

• Gout—The salicylate in this medicine may worsen gout and make gout medications less effective.

• Hemophilia or other bleeding problems—The salicylate in this medicine may increase the risk of bleeding.

• Kidney disease—There is a higher chance of side effects because the body may struggle to eliminate bismuth subsalicylate.

• Stomach ulcer—Using this medicine may make the ulcer worse.

Along with its needed effects, a medicine may cause some unwanted effects. Not all of these side effects may occur, but if they do, they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

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

• 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

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Bismatrol
• Diotame
• Kaopectate
• Kapectolin
• Kola-Pectin
• Pepto Bismol

In Canada

• Bismuth Extra Strength
• Bismuth Original Formula
• Compliments Bismuth - Regular Strength
• Exact Bismuth - Extra Strength
• Exact Bismuth - Regular Strength
• GoodSense Bismuth - Regular Strength
• Life Brand Bismuth - Extra Strength
• Life Brand Bismuth - Regular Strength
• Option+ Bismuth - Regular Strength
• Pepto-Bismol
• Pharmasave Bismuth - Regular Strength
• Selection Bismuth - Regular Strength

Available Dosage Forms:

• Suspension
• Tablet, Chewable
• Capsule, Liquid Filled
• Tablet

Therapeutic Class: Antacid, Bismuth Containing

Chemical Class: Salicylate, Non-Aspirin

Make certain your health care professional knows if you are on any special diet, such as a low-sodium or low-sugar diet.

For safe and effective use of this medicine:

• Follow your doctor's instructions if this medicine was prescribed.
• Follow the manufacturer's package directions if you are treating yourself.

For patients using this medicine to treat diarrhea:

• It is very important that the fluid lost by the body be replaced and that a proper diet be followed. For the first 24 hours you should drink plenty of clear liquids, such as ginger ale, decaffeinated cola, decaffeinated tea, broth, and gelatin. During the next 24 hours you may eat bland foods, such as cooked cereals, bread, crackers, and applesauce. Fruits, vegetables, fried or spicy foods, bran, candy, and caffeine and alcoholic beverages may make the diarrhea worse.
• If too much fluid has been lost by the body due to the diarrhea a serious condition may develop. Check with your doctor as soon as possible if any of the following signs of too much fluid loss occur: Decreased urination Dizziness and lightheadedness Dryness of mouth Increased thirst Wrinkled skin

If you are taking the oral suspension: Use the dose cup that is included to measure out the right amount of medicine. If you are unsure, contact your doctor or pharmacist.

If you are taking the oral tablets: Swallow the tablet whole with a glass of water. Do not crush or chew the tablet.

If you are taking the chewable tablets: Chew up the tablet or allow it to completely disintegrate in your mouth before swallowing it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (suspension): For diarrhea or upset stomach: Adults and teenagers—The usual dose is 2 tablespoonfuls every half-hour to one hour if needed. You should not take more than 16 tablespoonfuls of the regular-strength suspension or 8 tablespoonfuls of the concentrate in twenty-four hours. Children—Should not be used in children younger than 12 years of age.
• For oral dosage forms (tablets or chewable tablets): For diarrhea or upset stomach: Adults and teenagers—The usual dose is 2 tablets every half-hour to one hour. You should not take more than 16 tablets in twenty-four hours. Children—Should not be used in children younger than 12 years of age.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

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