Pepto Bismol For Children: Safety, Dosage, And Side Effects

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It is not uncommon to have children complain of frequent stomach aches, especially if they eat out often. Parents may consider over-the-counter medications, such as Pepto-Bismol for kids, in such cases. Pepto-Bismol (Bismuth Subsalicylate) is considered a safe and effective medication for gastrointestinal troubles such as acid reflux, diarrhea, and indigestion. But can kids take Pepto-Bismol? What should be the dosage of Pepto-Bismol for children?

Read on to find out the mechanism of action, the recommended dosage, safety, side effects, and alternatives for Pepto-Bismol in children.

In This Article

At What Age Can A Child Take Pepto-Bismol?

Child consuming medicine

Image: Shutterstock

Pepto-Bismol is used to treat several digestive problems such as diarrhea, indigestion, nausea, gas, burping, an upset stomach, heartburn, and the feeling of fullness. However, only children aged 12 years and above can take Pepto-Bismol. Do not administer it to younger children without a doctor’s consultation (1).

Bismuth subsalicylate, the active ingredient in Pepto-Bismol, is a derivative of Aspirin (Acetylsalicylic Acid or ASA), which can have harmful effects on young children. Hence, for children aged between 2–11 years, an alternative medication called Pepto Kids can be given instead (2). It is a formulation made specifically for younger children. The main ingredient of this medication is calcium carbonateiA calcium-containing mineral used as an ingredient in drugs , which is considered safe for children.

protip_icon Quick fact
Pepto kids is effective in reducing symptoms associated with hyperacidity and does not cover the entire range of uses for Pepto-Bismol (2).

How Does Pepto-Bismol Work?

The key ingredient of Pepto-Bismol is bismuth subsalicylate, which helps (3)

  • Inhibit the production of prostaglandin, a group of compounds that cause inflammation and increased movement of the gastrointestinal tract.
  • Reduce the loss of fluids by increasing the reabsorption of fluids, sodium, and chloride.
  • Block secretions from the intestine.
  • Inhibit the function of H. pyroli bacteria in the body and block its adhesion to the mucosal cells.
  • Promote healing of stomach ulcers.

Pepto Bismol Dosage For Children

For children aged 12 years or older and adults, the following dosage of Pepto-Bismol can be given. The doctor’s recommendations or the label instructions should be strictly followed while taking the medication (1) (2) (4) (5) (6).

A. Pepto-Bismol liquid

  • Pepto-Bismol regular strength suspension: Take 30ml (two tablespoons or the dose cup provided) every 30 minutes to one hour as per, with a maximum of eight doses (240ml) per day (24 hours). Shake the suspension well before use.
  • Pepto-Bismol Ultra suspension: For diarrhea or traveler’s diarrhea, take 15ml every 30 minutes or 30ml every hour, with a maximum of eight doses (120ml) in 24 hours. Problems due to overindulgence in food/drink can be relieved by taking 15ml every half an hour.

B. Pepto-Bismol chewable tablets or caplets

Pepto Bismol chewables

Image: Shutterstock

  • Take two chewable tablets or regular-strength caplets every 30 minutes to one hour, depending on the requirement.
  • Do not take more than eight doses (16 tablets) of regular-strength caplets in 24 hours.
  • While chewable tablets should be chewed or dissolved in the mouth, regular-strength caplets must be swallowed with water.
  • In the case of Pepto-Bismol Ultra caplets for diarrhea, take one caplet every 30 minutes or two caplets every hour. For problems related to overeating or indigestion, take one caplet every 30 minutes. Kids’ pepto dosage should be restricted to eight caplets per 24 hours.

Additional instructions

  • Do not take the medication for more than two days. Consult a doctor if diarrhea persists beyond two days.
  • Pepto-Bismol could cause dehydration in children suffering from diarrhea. Hence, ensure your child drinks clear fluids frequently.

C. Pepto Kids

Pepto Kids is the child-safe version of Pepto-Bismol. It is suitable and provides relief to children aged 2-11 years. The following is the dosage for Pepto-Kids.

  • Children weighing 24–47lb and aged between 2–5 years should have one tablet as needed. The maximum dosage is three tablets per day (24 hours).
  • Children weighing 48–95lb and aged 6–11 years should have two tablets as needed. The maximum dosage is six tablets in 24 hours.

Why Should Kids Not Have Pepto-Bismol? (Side Effects)

If Pepto-Bismol is taken by children younger than 12 years, it can cause harmful complications.

  • Reye’s Syndrome

The active ingredient of the medicine is bismuth subsalicylate. It shows limited effectiveness in children and poses a high risk for Reye’s syndrome (1). Reye’s syndrome is characterized by acute elevation of pressure in the brain and liver damage due to fat accumulation.

It can cause symptoms such as convulsionsiUncontrolled and violent shaking in the body due to rapid contraction and relaxation of the muscles , deliriumiA sudden and intense disturbance in a person’s mental status, resulting in confusion and unawareness , fainting, vomiting, crankiness, lethargy, and confusion and is often preceded by a viral infection, such as flu, chickenpox, or influenza (7) (8).

  • Other side effects
Discoloration of the tongue is a side effect of Pepto Bismol

Image: IStock

Here are a few other side effects of Pepto-Bismol (8).

  • Darkening of stools and tongue may occur due to the reaction of its ingredient bismuth with sulfur in your saliva and digestive system. The reaction may form black-colored bismuth sulfide. It is generally harmless. However, if the effect lasts for more than three days, consult a medical professional.
  • Overdose can result in deafness, ringing of ears, exhaustion or dizziness, and confusion.

Warnings

Pepto-Bismol should be avoided in the following cases, even for older children (1).

  • Children and teens who recently had chickenpox or flu-like symptoms and are recovering from them
Pepto Bismol should be avoided during chicken pox in kids

Image: IStock

  • Children who are allergic to salicylates and aspirin
  • Children who are currently on any other salicylate medication/products
  • Children who have an ulcer, preexisting black or bloody stools, or a bleeding issue

Children and adults taking medication for the following medical conditions should consult a doctor before taking Pepto-Bismol (1).

  • Diabetes
  • GoutiA complex form of arthritis causing pain and inflammation in the joints
  • Arthritis
  • Thinning of blood (anticoagulation)

Pepto-Bismol may have interactions with other drugs. So, if your child is on any medications, it is best to talk to a doctor before giving them Pepto-Bismol (1).

You should also consult a doctor before giving your child Pepto-Bismol if they have any health concerns such as fever or mucus in the stool (1).

protip_icon Point to consider
Protect the medication from freezing and temperatures 104°F (40ºC) and above to ensure drug stability and effectiveness (1).

Frequently Asked Questions

1. Which is better, Tums or Pepto-Bismol?

Tums and Pepto-Bismol are effective antacids with different compositions and mechanisms. While Tums works faster, Pepto-Bismol treats infections. Pepto-Bismol contains bismuth subsalicylate, the anti-inflammatory properties of which work on the stomach lining to treat infections. In comparison, Tums contain calcium carbonate, which neutralizes stomach acid. Hence, the suitability of either medication depends on the purpose.

2. Can Pepto-Bismol treat stomach bugs?

The over-the-counter medication Pepto-Bismol can treat viral gastroenteritis or stomach bug. However, it is recommended to consult a doctor before taking any medications for a stomach ache (10).

3. Can I give my child Pepto and Tylenol at the same time?

In general, it is safe for adults to take Pepto-Bismol with Tylenol (paracetamol) after the doctor’s suggestion (9). However, it is unknown if the combination is safe for children. Hence, seek the advice of a doctor before administering them.

4. Does Pepto help with food poisoning?

According to Dr. Christina Johns, pediatric emergency physician from Annapolis, Maryland, “The active ingredient in Pepto Bismol (bismuth subsalicylate) can decrease discomfort associated with gastrointestinal symptoms such as nausea, diarrhea, stomach ulcers, and heartburn. Therefore, it can help manage some effects and symptoms of food poisoning once they occur. It cannot, however, prevent or cure food poisoning. In addition, due to the potential for salicylate toxicity, Pepto Bismol should not be given to young children.

5. Does Pepto work on an empty stomach?

Dr. Johns says, “Pepto can be effective on an empty stomach. Rather than interacting with the food itself, it forms antimicrobial compounds, increases fluid reabsorption, and decreases intestinal secretions in the stomach.”

Pepto Bismol for kids has aspirin derivatives, which can have harmful effects on younger kids, so it is not to be used on children below 12 years of age without a doctor’s consultation. It is available as chewable tablets and caplets, and the dosage recommendations should be strictly followed. Pepto Bismol has a few side effects and should be avoided by kids who recently recovered from chickenpox or flu, have allergies to aspirin, ulcers, and any pre-existing long-term illnesses. Usage is usually recommended for two days, and you may seek medical care if symptoms persist.

Infographic: Quick Overview Of Pepto-Bismol For Children

Pepto-Bismol is a go-to OTC medication for many parents when their child complains of stomach problems. Check out the following infographic to quickly understand:

  • What Pepto-Bismol can treat
  • Its side effects
  • Who should not use it
can i give pepto bismol for kids (Infographic)

Illustration: Momjunction Design Team

Key Pointers

  • Pepto-Bismol is used to treat digestive problems, and it is recommended for children above 12 years of age.
  • Pepto-Bismol is available as chewable tablets and caplets
  • Ensure the dosage recommendations are not exceeding the recommended limits.
  • Pepto-Bismol is recommended for two days, and you may seek medical care if symptoms persist.
Pepto Bismol For Kids_illustration

Image: Dall·E/MomJunction Design Team


Learn how to effectively use Pepto Bismol to relieve stomach discomfort and digestive problems. Follow these clear instructions for quick relief and better overall health.

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. PEPTO-BISMOL- bismuth subsalicylate kit; National Institutes of Health
2. PEPTO KIDS- calcium carbonate tablet, chewable; National Institutes of Health
3. Patrick Budisak and Malak Abbas; Bismuth Subsalicylate; StatPearls (2021).
4. PEPTO-BISMOL ULTRA- bismuth subsalicylate suspension; National Institutes of Health
5. PEPTO BISMOL- bismuth subsalicylate tablet; National Institutes of Health
6. PEPTO-BISMOL ULTRA- bismuth subsalicylate tablet; National Institutes of Health
7. Reye’s Syndrome Information Page; National Institute of Neurological Disorders and Stroke
8. Reye Syndrome; American Academy of Pediatrics
9. Pepto-Bismol (bismuth subsalicylate); NHS
10. Treatment of Viral Gastroenteritis (“Stomach Flu”); National Institutes of Health.

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Maria Carmela Villania-Mamauag is a board certified diplomate of the Philippine Pediatric Society with a degree of Doctor of Medicine from Our Lady of Fatima University, Valenzuela City and a Bachelor in Science in Psychology from Saint Louis University, Baguio City which was augmented by a year of Bachelor in Science in Family Life and Child development at the University of the Philippines, Diliman, Quezon City.

Read full bio of Maria Carmela Villania-Mamauag
  • Dr. Christina Johns
    Dr. Christina JohnsMD, MEd, FAAP Dr. Christina Johns is the vice-president of Communications at PM Pediatrics, a specialized pediatric urgent care provider. The pediatric emergency physician did her education at Johns Hopkins University School of Medicine and has over 25 years experience in the field.
    Dr. Christina Johns is the vice-president of Communications at PM Pediatrics, a specialized pediatric urgent care provider. The pediatric emergency physician did her education at Johns Hopkins University School of Medicine and has over 25 years experience in the field.
Shivali Karande
Shivali KarandeBPharm, MBA
Shivali holds a bachelor’s degree in pharmacy and a master’s in management from Chetana's R.K Institute of Management and Research Mumbai. After working for nearly five years in the market research sector, she discovered her passion for writing and started freelancing in 2020.

Read full bio of Shivali Karande
Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College.

Read full bio of Dr. Ritika Shah
Dr. Joyani Das
Dr. Joyani DasM.Pharm, PhD
Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

Read full bio of Dr. Joyani Das