Bismuth (Pepto) advice

[Lucy_B]

Hi, friends! I'm about to start the bismuth regimen and have a few questions (will number them just to keep thing easy):

1) Do you believe that the Pepto brand is better than generic, or does it not make any difference?

2) My doc said to take 8 chewable tablets a day, but I'm wondering if it would be reasonable to start with 6/day and see how that does? I tend to always get SE's from medications. Plus the cost adds up (although I will probably start ordering from Amazon to save $$).

3) I don't see anything on the box about timing of doses. Dose it matter whether they're taken with food or not?

4) Do you feel like it's better to take the pills throughout the day, or would one 3-4 pill dose in the morning and another one in the evening work just as well?

5) I read somewhere that chewable bismuth can discolor the tongue, so I plan to swallow the tablets whole. Any issue with effectiveness when doing this, you think? I'm assuming the body would still break it down the same way...

6) Is anyone aware of a pill version (non-chewable) that doesn't contain all the unnecessary dyes/flavorings? I haven't been able to find anything other that the liquid and the chewables.

Thanks so much, PP's!

[tex]

1) Do you believe that the Pepto brand is better than generic, or does it not make any difference?

There are many brands available. I haven't compared, but I doubt that there is much difference between any of them.

2) My doc said to take 8 chewable tablets a day, but I'm wondering if it would be reasonable to start with 6/day and see how that does? I tend to always get SE's from medications. Plus the cost adds up (although I will probably start ordering from Amazon to save $$).

Larger doses bring faster remission, but a lower dose might work almost as well. Some people reduce the dose after they get control. You can also use the liquid equivalent, with exactly the same results.

3) I don't see anything on the box about timing of doses. Dose it matter whether they're taken with food or not?

That probably doesn't matter, though there is one school of thought that says that the medication coats the lining of the intestines to protect against irritation, so that would suggest taking it on an empty stomach.

4) Do you feel like it's better to take the pills throughout the day, or would one 3-4 pill dose in the morning and another one in the evening work just as well?

I would take them at regular intervals during the day (in order to maintain the effectiveness of the "coating".

5) I read somewhere that chewable bismuth can discolor the tongue, so I plan to swallow the tablets whole. Any issue with effectiveness when doing this, you think? I'm assuming the body would still break it down the same way...

Effectiveness may not depend on chewing (depending on whether or not you currently have a "rapid transit" issue with your digestive system motility, but a black tongue is not the only change you will see — everything from the tongue downstream will also be black — all the way down to and including the contents of the toilet.

6) Is anyone aware of a pill version (non-chewable) that doesn't contain all the unnecessary dyes/flavorings? I haven't been able to find anything other that the liquid and the chewables.

One would think that a pure version would be available. It is available on a wholesale basis, but purity seems to range from 98–99 %. One can only wonder what the other 1 or 2 % might be (since most suppliers are located in China). Presumably it should be possible to get a compounded formulation from a compounding pharmacy, but in order to do that, you would need a prescription from a doctor, describing the exact formulation needed. In order to accomplish that, you would need to consult with your pharmacist to find out if such a formulation is chemically practical, and ask her or him to specify the formulation, so that your doctor could write a prescription for it. IOW, your doctor almost surely wouldn't have the foggiest idea how to write a script for specially-compounded bismuth subsalicylate, but your pharmacist should know what can be done.

There's a good possibility that without some additives to mask the taste, "pure" bismuth subsalicylate might be totally unpalatable. At one time, pharmacists could sell ingredient chemicals to consumers, but these days FDA rules have surely squelched all of those options. I could be wrong, however, so it might not hurt to ask your pharmacist if she/he can sell you any "pure" bismuth subsalicylate to try.

I hope that some of this is helpful.

Tex

[Lucy_B]

Awesome, thanks so much, Tex! Very helpful indeed.

[kd025]

It's been a while since I took it, but I took the caplets (not chewable) in Target's generic store brand. It seemed to work for me--the ingredients were comparable to the name brand stuff, and it was cheaper. Hope you can find something that works for you!

Kristen

[Lucy_B]

Good to know, thanks!! I will definitely look for those.

[Marcia K]

Hi, Lucy. I took 6 per day, two at a time at regular intervals. I took Pepto Bismol, I didn't check into generic. I broke them in 1/2 and swallowed them with water. As Tex said, your stool will turn black. I reduced the dosage to 4 per day once my stool was hard to pass. I continued with 4 until the end of the 8 weeks that were recommended by my G.I. I don't remember if I took it with food, I don't think that really matters. It worked for me, good luck to you!

[Lucy_B]

Thanks, Marcia! 8 seemed to make for some additional bathroom runs, so I reduced it to 6 yesterday. We'll see how that goes. I'm still using Imodium (4 pills per day) in addition to the Pepto. Anyone see issues with doing that, as long as I'm not constipated? The plan is to gradually wean myself off the Imodium when (if) the Pepto starts to work. Appreciate the feedback!

Lucy

[tex]

Lucy,

That sounds like a practical plan. I'm not aware of any significant risk of interactions between Imodium and any other medications or supplements.

Tex

[Lucy_B]

Thanks, Tex!