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This safety and warning information outlines critical precautions for the use of bismuth subsalicylate (commonly known as Pepto-Bismol). Please carefully consider these points and discuss any concerns with your healthcare provider.

• Reye's Syndrome in Children: Bismuth subsalicylate is associated with Reye's syndrome, a rare but serious condition in children, particularly those recovering from viral infections such as the flu or chickenpox. Symptoms begin with vomiting, headache, and confusion, potentially escalating to seizures and unconsciousness. Avoid giving this medication to a child with flu-related upset stomach. Consult a healthcare provider for suitable alternatives for sick children.

• Salicylate Toxicity: Overconsumption of bismuth subsalicylate or other salicylate-containing products, like aspirin or certain pain relief patches, can result in salicylate toxicity. Be vigilant about the ingredients in your medications, including over-the-counter options. Symptoms of toxicity include headache, dizziness, and tinnitus (ringing in the ears). Inform your healthcare provider if these symptoms occur.

• Allergic Reactions: Severe allergic reactions to bismuth subsalicylate are possible, including anaphylaxis. Seek emergency medical assistance if you experience hives, difficulty breathing, or swelling of the lips or tongue. Notify your healthcare provider of any known allergies to aspirin or NSAIDs before starting this medication.

Contraindications: Avoid using bismuth subsalicylate if you have any of the following conditions, as it may pose significant health risks:

• Stomach ulcers
• Bleeding disorders
• Bloody or black stools
• Allergies to or concurrent use of other medications containing salicylates (e.g., aspirin)

Consult with your healthcare provider to ensure safe use of this medication.

Bismatrol, containing bismuth subsalicylate, is commonly used to treat digestive issues like diarrhea, heartburn, and indigestion. However, it's important to be aware of potential interactions with other medications and substances.

Interactions with Other Medications:

• Aspirin and Other Salicylates: Combining Bismatrol with aspirin or other salicylate-containing drugs can increase the risk of gastrointestinal side effects, such as inflammation, pain, bleeding, and ulcers. It's generally advised to avoid using these medications together.

• Anticoagulants (Blood Thinners): Bismatrol may enhance the effects of blood-thinning medications like Warfarin, increasing the risk of bleeding. If you're on anticoagulants, consult your doctor before using Bismatrol.

• Tetracycline Antibiotics: Bismatrol can interfere with the absorption of tetracycline antibiotics, potentially reducing their effectiveness. To minimize this interaction, it's recommended to take these antibiotics at least two hours before or after Bismatrol.

• Methotrexate: Using Bismatrol with methotrexate may increase the risk of methotrexate toxicity. If you're undergoing treatment with methotrexate, discuss the use of Bismatrol with your healthcare provider.

Interactions with Alcohol:

Consuming alcohol while taking Bismatrol can heighten the risk of stomach bleeding. It's advisable to avoid alcohol during treatment with Bismatrol.

Other Considerations:

• Children and Teenagers: Bismatrol should not be given to children or teenagers recovering from chickenpox or flu-like symptoms due to the risk of Reye's syndrome, a rare but serious condition.

• Existing Medical Conditions: If you have a history of stomach ulcers, bleeding disorders, or kidney disease, consult your doctor before using Bismatrol, as it may exacerbate these conditions.

Always inform your healthcare provider about all medications, supplements, and over-the-counter drugs you're currently taking to avoid potential interactions. If you experience symptoms like unusual bleeding, black or tarry stools, or ringing in the ears while using Bismatrol, seek medical attention promptly.