Bismuth compounds: Bismuth oxide, Bismuth subgallate, Bismuth subcarbonate

Contraindications 

• Hypersensitivity to the active ingredient or any of its excipients
• Children

Cautions 

• Pregnancy
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Rectal bleeding
• Bloody stool

Pregnancy

• Caution
• Should only be used when potential benefit to the mother outweighs foetal risk
• There is no formal study on the risk in pregnancy, and there is no epidemiological evidence of adverse effect

Breastfeeding

• Caution
• No data available to determine risk to breastfeeding infants

Renal Impairment

• Caution; no dose adjustment recommended 

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• No dose adjustment recommended

Central Nervous System Disorders

• Encephalopathy

Gastrointestinal Disorders

• Nausea and vomiting
• Discolouration of mucous membranes

Genitourinary Disorders

• Renal failure

Hepatobiliary Disorders

• Liver damage

Skin and Subcutaneous Tissue Disorders

• Burn
• Erythema
• Exfoliation
• Irritation
• Pruritus
• Rash
• Urticaria

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity

No significant interactions

Bismuth
Bismuth is weakly astringent, and has possible antiseptic qualities.  This results in a protective effect on mucous membranes and raw surfaces.  Bismuth improves stool consistency and odour through an unclear mechanism of action.