1 Kaopectate

Kaopectate is an antacid and anti-diarrheal medication. It causes nausea, diarrhea, heartburn, indigestion and upset stomach. For a child with fever, flu or chicken pox, this medication should not be given. Serious conditions, such as Reye’s syndrome, can be caused by salicyclates. If you have a recent history of intestinal bleeding or a stomach ulcer, then do not take this medicine. Kaopectate may cause allergic reactions. If the stomach symptoms worsen or diarrhea lasts for more than two days after taking the medication, or if you experience hearing loss, then seek immediate medical attention. Some of the most common side effects with kaopectate are constipation, black tongue and dark colored stool.

Subsalicyclate is the most active ingredient in Busmuth, a popular form of kaopectate. This medicine is used for the treatment of upset stomach, indigestion, heartburn, diarrhoea, discomfort of the gastrointestinal tract and other stomach discomfort. Also this substance is one of the most important ingredients of kaopectate. It functions as an antacid and possesses anti-inflammatory properties. Also, it works as a mild antibiotic.

This drug is most commonly used to treat discomfort in the stomach, like upset stomach, heart burn, nausea, indigestion, and issues of the gastrointestinal tract.  Also kaopectate is used in the treatment of associated conditions, such as nausea, traveler’s diarrhea, severe diarrhea, intestinal infection, flatulence and bacterial infection.

2 Pharmacodynamics

Bismuth subsalicyclate has anti-inflammatory properties. Also this medication works as an antacid and is a mild antibiotic. In some users it combines with a slight amount of Sulphur present in the saliva and gastrointestinal tract, which causes the stools and tongue to turn black.

3 Mechanism of action

It has not been determined what causes this medication works. The antidiarrheal action is exerted by bismuth subsalicyclate, and it does this in two ways. First, the absorption of fluid and electrolytes across the intestinal wall is stimulated when hydrolyzed to salicyclic acid, or when the synthesis of prostaglandin is inhibited. For intestinal inflammation, hypermobility prostaglandoin is responsible. Also, other actions carried out by bismuth subsalicyclate is binding to other toxins produced by E. coli. Bismuth oxychloride and bismuth hydroxide are intestinal reaction products of bismuth subsalicyclate. All these product compounds are believed to have bactericidal action. It is also believed that antacid properties of bismuth are weak.

4 Absorption and elimination

After administering the drug orally, rapid and complete absorption takes place of the salicyclate component from the small intestine.

5 Metabolism

Based on in-vitro and in-vivo animal studies, the stomach's hydrolysis converts bismuth subsalicyclate to bismuth oxychloride and salicyclic acid. Further reaction takes place in the small intestine. This reaction takes place between the anions and the non-dissociated bismuth subsalicyclate. They further form bismuth salts that are insoluble. Another reaction takes place in the colon, this reaction takes place between non-dissociated subsalicyclate, bismuth salts with hydrogen sulphide. They form the product bismuth sulphide. This black salt is highly insoluble and causes the stools to become black.

From Chattern Inc this medication is taken orally. The main purpose of this medicine is to treat diarrhea. In certain cases, it can also be used to treat stomach ulcers, nausea and indigestion. Over time, the active ingredients of bismuth have been changing. In the United States and Canada, the active ingredients are different. Kaolinite and pectin are the actual priginal active ingredients of kaopectate. Now, the active ingredient in the United States in kaopectate is bismuth subsalicyclate. But attapulgite is the active ingredient in Switzerland in the same medicine.

From the time the medicine was originally created, the ingredients have been changing. Originally the adsorbent used was kaolinite and the emollinite used was pectin. In the 1980s, thekaolinite was replaced by attapulgite but it did not prove to be very effective. Since then, kaopectate bismuth subsalicyclate has been used as an active ingredient. But in Canada, attapulgite is used as an active ingredient.

To treat upset stomach, nausea, and heartburn, this medication is used. Also traveler’s diarrhea can be prevented with this medication and diarrhea can be treated by kaopectate suspension. It slows the growth of bacteria that causes diarrhea. If there is blood in the stool, mucus in the stool or fever, then you should not take this medication as it could be indicative of a bigger issue. To treat stomach ulcers caused by H pylori, this medication is prescribed by a doctor. Bismuth subsalicyclate belongs to the class of salicyclate, which, when used alone in patients with ulcers, can cause serious bleeding. Sometimes the ingredients may vary in the product, so make sure to check the label when buying the product. Also, different ingredients with a similar name may be present, so check the ingredients carefully on the label. It could be very harmful if you take the wrong product.

The medicine is taken orally and as directed by the doctor. The dosage of the medication depends on age, medical condition and how effectively the person responds to treatment. Bismuth subsalicylcate is available in many brands and forms. For each product, read the dosage carefully because the directions may vary. This ingredient reacts mostly with tertracycline antibiotics. If you are having issues with the medication, speak with your doctor. If you take this medication daily, then you can benefit from it easily. If you still have the condition even when taking the medication, then inform your doctor. If, for more than two days, you continue to have diarrhea after taking the medication, then inform your doctor as well. 

If you overdose on it, then seek medical attention immediately. Do not share this medication if you have been prescribed by the doctor. Diarrhea causes dehydration, which can be prevented by drinking plenty of water while taking the medication. If you miss a dose, do not take double your dosage. Keep the bottle away from light and moisture. The storage needs of each bottle may be different. Talk to your pharmacist on how to store the product. Dispose the medicine when it's finished using it.

To treat chronic intractable diarrhea, a report was prepared on the effect of oral bismuth.

6 Uses

For the treatment of an upset stomach, heartburn, nausea, indigestion, diarrhea and other symptoms you can use kaopectate. Also by using this drug, you will reduce the number of bowel movements your experience to treat diarrhea. For other uses, kaopectate can be used. However, this is determined by the doctor.

Kaopectate was combined with barium and its positive and negative effects on enteric contrast was studied.

7 How to take kaopectate

Directions on how take your prescription will be on the label. Do not take this medicine for longer than prescribed and do not alter the dose of this medication on your own. In order to prevent diarrhea-related dehydration, drink an  adequate amount of fluids. On the chart, find the right dose. To determine the dose, the doctor may consider your age or weight. Before using the medication, shake the bottle well. Dosing is provided along with this bottle, which can determine the dose of this medication. Any other dosage device should not be used, with or without food, this medicine can be taken. Before or after taking kaopectate, do not take tetracycline.

If you notice that symptoms are becoming worse, then stop the medication. Also, stop taking it, if you have diarrhea for more than two days, if your abdomen bulges, or if there is swelling of the abdomen.

When a comparative study was done to find the most effective treatment, it was found that loperamide was very effective.

8 Precautions

You should inform your doctor, if you are breastfeeding or pregnant. Take the medication as recommended by the doctor while you are expecting a baby or feeding a baby. Make a list of all the medication that you take and share with the doctor. If you are allergic to any ingredient of kaopectate then inform the doctor. Also, inform the doctor about any medical condition that you have or had in the past. Inform the doctor if you have mucus in the stool, diabetes, gout, arthritis, diabetes, stomach inflammation, Kawasaki syndrome, chicken pox, kidney problem or flu. If you have a bleeding problem, bloody stools, black stools or bleeding ulcer then do not take this medicine.

For determining when it is safe to take this medicine during pregnancy or breastfeeding, there have yet to be adequate studies. This will be determined by the doctor. According to the FDA, kaopectate has been put in the risk category.

9 Side effects of kaopectate

There are many side effects associated with this drug, but most of the side effects are temporary and harmless. If any of the side effects become severe, then seek medical attention. Side effects are:

10 Nervous system

A common feature of bismuth is nervous system toxicity. It causes weakness, fatigue, depression, anxiety, insomnia, irritability, unsteady gait, loss of motor skills, memory loss, and jerky movements. Mental confusion, trouble walking, disorientation, trouble speaking, myoclonic jerks, tremors and incontinence may occur due to acute toxicity. In patients who have ingested bismuth for several months or years, they experienced mycoclonic encephalopathy. After discontinuing the medicine, it may take several months for the patient to recover from bismuth encephalopathy.

Chronic ingestion of bismuth subsalicyclate has been reported to cause salicyclism. Also other problems reported are lethargy, hearing becomes diminished, vertigo, confusion, dysfunction of the central nervous system, tinnitus, vomiting and abdominal pain. Also there may be reports of metabolic acidosis, respiratory alkalosis, azotemia and hypoprothrombonemia. Elderly patients are more at risk for developing salicyclism.

Those who take kaopectate usually complain of black stool. It's a very common side effect among patients. Black tongue is another common side effect. However, there have been no reports of nausea and vomiting.

11 Drug interactions

Kaopectate may interact negatively with other drugs the patient is taking. The risk of side effects may increase due to these drugs. Keep a list of all the medications you take in order to avoid any potential interactions. Share with your doctor the list of drugs you are taking. Do not stop or start any drug without your doctor's knowledge. Kaopectate may interact with the following:

  • Valproic acid, methotrexate and carbonic anhydrase inhibitors
  • Blood thinners, anti-platelet drugs, fever reducers, and pain relievers
  • Alcohol and certain foods may alter the way the drug works or may increase the chances of side effects by interacting with kaopectate.

Also if you have any health condition, inform your doctor. The drug may work differently depending on your health condition.

12 Dosage of kaopectate

For children over 12 years of age and adults, you should take about two tablespoons, or 30 ml. In every half hour to an hour, the dose can be repeated as needed. Within 24 hours, do not take more than eight doses. Until the diarrhea stops, you can take the medication, but not for more than two days. To know about the dosage of the medicine for children below 12 years of age, find out from the doctor. This medicine can be found in different forms and strengths.

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