Over-the-counterLower-cost generic availableClass: Gastrointestinal

Pepto-Bismol Alternatives

(bismuth subsalicylate)

Over-the-counterLower-cost generic availableClass: Gastrointestinal
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Compare Pepto-Bismol (bismuth subsalicylate) to alternatives

These medications are comparable to Pepto-Bismol (bismuth subsalicylate) or used for similar purposes.

Pepto-Bismol
(bismuth subsalicylate)

Alka-Seltzer Original
(aspirin / citric acid / sodium bicarbonate)

Imodium
(loperamide)

Maalox
(aluminum / magnesium / simethicone)

Pepcid
(famotidine)

Rolaids
(calcium carbonate / magnesium hydroxide)

Tums
(calcium carbonate)

Zantac 75
(ranitidine)

Relieves heartburn, upset stomach, and diarrhea. Pepto-Bismol (bismuth subsalicylate) can help for many stomach and intestinal problems, but may take longer to work compared to some other anti-diarrheal medicines.Relieves heartburn, headache, and body pains. Alka-Seltzer Original (Aspirin / Citric Acid / Sodium Bicarbonate) gives quick relief for headache, body pains, and upset tummies, but might be hard to swallow if you don't like the taste or fizz.Treats diarrhea. One day is too many days to have diarrhea. Having Imodium (Loperamide) on hand to relieve your symptoms can be a life-saver.Relieves heartburn and indigestion. Maalox (aluminum / magnesium / simethicone) gives quick relief for heartburn, gas, and bloating, but it may not be as effective or last as long as other antacids.Relieves heartburn. Pepcid (Famotidine) works well for heartburn but may not last as long or start working as quickly as other antacids.Relieves heartburn and acid tummy. Rolaids (Calcium Carbonate / Magnesium Hydroxide) gives quick relief for heartburn, but don't expect it to last all day.Relieves heartburn. Tums (Calcium carbonate) gives quick relief for heartburn, but does not last all day. Talk to your doctor or pharmacist about other medicines if you need additional relief.Relieves heartburn and stomach ulcers. Zantac 75 (ranitidine) is an effective and inexpensive medicine for hearburn with few side effects, but may interfere with other drugs.
Reviews & ratings
Filter group. All currently selected
Filter group. All currently selected
5.33Pepto-Bismol
Reviews for Pepto-Bismol
84%
of people (All ages) say Pepto-Bismol is worth it
48%
say it works well
6%
say it's a big hassle
1376 reviews
Have you used Pepto-Bismol (bismuth subsalicylate)?
Worth itNot sureNot worth it
Reviews for Alka-Seltzer
81%
+3% better vs. Pepto-Bismol
52%
-4% worse vs. Pepto-Bismol
8%
+2% better vs. Pepto-Bismol
1055 reviews
Have you used Alka-Seltzer Original (aspirin / citric acid / sodium bicarbonate)?
Worth itNot sureNot worth it
Reviews for Imodium
89%
-5% worse vs. Pepto-Bismol
65%
-17% worse vs. Pepto-Bismol
6%
Same vs. Pepto-Bismol
285 reviews
Have you used Imodium (loperamide)?
Worth itNot sureNot worth it
Reviews for Maalox
69%
+15% better vs. Pepto-Bismol
30%
+18% better vs. Pepto-Bismol
9%
+3% better vs. Pepto-Bismol
213 reviews
Have you used Maalox (aluminum / magnesium / simethicone)?
Worth itNot sureNot worth it
Reviews for Pepcid
75%
+9% better vs. Pepto-Bismol
41%
+7% better vs. Pepto-Bismol
8%
+2% better vs. Pepto-Bismol
853 reviews
Have you used Pepcid (famotidine)?
Worth itNot sureNot worth it
Reviews for Rolaids
75%
+9% better vs. Pepto-Bismol
37%
+11% better vs. Pepto-Bismol
7%
+1% better vs. Pepto-Bismol
1089 reviews
Have you used Rolaids (calcium carbonate / magnesium hydroxide)?
Worth itNot sureNot worth it
Reviews for Tums
82%
+2% better vs. Pepto-Bismol
43%
+5% better vs. Pepto-Bismol
5%
-1% worse vs. Pepto-Bismol
1373 reviews
Have you used Tums (calcium carbonate)?
Worth itNot sureNot worth it
Reviews for Zantac
72%
+12% better vs. Pepto-Bismol
44%
+4% better vs. Pepto-Bismol
7%
+1% better vs. Pepto-Bismol
1062 reviews
Have you used Zantac 75 (ranitidine)?
Worth itNot sureNot worth it
Side effects
Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac

The Pepto-Bismol FDA package insert doesn’t have numbers about how common side effects are.

More about Pepto-Bismol side effects »

We haven’t found good data for Alka-Seltzer side effects.

FDA side effect reports for Alka-Seltzer »
  • Constipation 3%
  • Nausea 3%
  • Abdominal cramp 3%
More Imodium side effects »

The Maalox FDA package insert doesn’t have numbers about how common side effects are.

More about Maalox side effects »
  • Headache 5%
  • Diarrhea 2%
More Pepcid side effects »

We haven’t found good data for Rolaids side effects.

FDA side effect reports for Rolaids »

We haven’t found good data for Tums side effects.

FDA side effect reports for Tums »

The Zantac FDA package insert doesn’t have numbers about how common side effects are.

More about Zantac side effects »
How it works
Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
Pepto-Bismol (bismuth subsalicylate) reduces inflammation and irritation in the stomach by reducing the amount of water that goes into the stool. It also has antibacterial and antacid properties.Alka-Seltzer Original (Aspirin / Citric Acid / Sodium Bicarbonate) is a combination medicine. Sodium bicarbonate is an antacid that relieves heartburn and acid tummy (indigestion). Aspirin is a pain reliever that treats headache and body pains.Imodium (Loperamide) is an antidiarrheal medicine. It's actually an opioid related to morphine, though it doesn't affect the brain like opioid pain medicines do. Instead, it works directly on muscles in your large intestine to stop contractions and increase the time it takes for stool to move through. The result is less diarrhea and more formed stool.Maalox (aluminum / magnesium / simethicone) is a combination medicine for heartburn and indigestion. Aluminum and magnesium are antacids that treat heartburn and indigestion. Simethicone relieves gas and bloating.Pepcid (Famotidine) is a type of antacid called an H2 blocker. It blocks the chemical histamine, which lowers acid production in your stomach. This treats heartburn and helps ulcers heal.Rolaids (Calcium Carbonate / Magnesium Hydroxide) is an antacid. It counteracts the effects of stomach acid to relieve heartburn and acid tummy (indigestion).Tums (Calcium carbonate) is an antacid. It relieves heartburn and indigestion by neutralizing stomach acid.Zantac 75 (ranitidine) reduces the production of acid by blocking a chemical from acting on the acid-producing cells in your stomach.
Type of medication
Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
Over-the-counterOver-the-counterOver-the-counterOver-the-counterPrescription or OTCOver-the-counterOver-the-counterPrescription or OTC
Available as
Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
  • Chewable tablet
  • Liquid
  • Pill
  • Chewable tablet
  • Effervescent tablet
  • Pill
  • Chewable tablet
  • Liquid
  • Chewable tablet
  • Liquid
  • Pill
  • Chewable tablet
  • Liquid
  • Chewable tablet
  • Liquid
  • Chewable tablet
  • Liquid
  • Pill
  • Oral solution
  • Oral syrup
  • Injection
Used for
Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
Risk factors for serious side effects
Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
  • Children or teenagers that have or are recovering from flu/flu-like symptoms or chickenpox
  • Aspirin allergy
  • NSAID allergy
  • Age 60 or older
  • Anticoagulants
Detailed Pepto-Bismol (bismuth subsalicylate) risks & warnings »
  • Current kidney disease
  • Kidney dialysis
  • Age 65 or older
  • Congestive heart failure (CHF)
  • High blood pressure
Detailed Alka-Seltzer Original (aspirin / citric acid / sodium bicarbonate) risks & warnings »
  • Allergy to loperamide
  • Taking with alcohol
  • Taking other medicines that make you less alert
  • Current liver problems
  • Taking HIV medicines
Detailed Imodium (loperamide) risks & warnings »
  • Kidney problems
  • Taking more than the recommended daily maximum
Detailed Maalox (aluminum / magnesium / simethicone) risks & warnings »
  • Current kidney disease
Detailed Pepcid (famotidine) risks & warnings »
  • Current kidney disease
  • Kidney dialysis
  • Hyperparathyroid disease
  • Taking high doses of Vitamin D
  • Previous kidney stones
Detailed Rolaids (calcium carbonate / magnesium hydroxide) risks & warnings »
    Coming soon.
    • Aged 60 years or older
    • Kidney conditions
    • Liver conditions
    • Acute Porphyria
    • Asthma
    Detailed Zantac 75 (ranitidine) risks & warnings »
    Pregnancy

    The FDA hasn’t classified this medicine’s effects on unborn babies. Talk with your doctor about this medicine if you’re pregnant or planning on it.

    Research studies with animals found harmful effects on unborn babies. It hasn’t been properly studied in humans. The benefits might outweigh the risks even if you’re pregnant. Talk with your doctor.

    Research studies with animals haven’t found a risk to unborn babies, but it hasn’t been properly studied in humans.

    The FDA hasn’t classified this medicine’s effects on unborn babies. Talk with your doctor about this medicine if you’re pregnant or planning on it.

    Interactions
    Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
    No interactions related info.No interactions related info.No interactions related info.No interactions related info.
    • Few drug interactions.
    No interactions related info.No interactions related info.
    • Zantac 75 (ranitidine) can interact with certain prescription and over-the-counter medications. Let your doctor or pharmacist know about the medicines you are currently taking.
    Alcohol
    Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
    No alcohol related info.No alcohol related info.No alcohol related info.No alcohol related info.No alcohol related info.No alcohol related info.No alcohol related info.
    • The syrup product may contain up to 7.5% of alcohol.
    Food
    Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
    No food related info.
    • Take it with food to lower the chance of an upset stomach.
    No food related info.
    • Talk to your doctor or pharmacist about foods to avoid that can help prevent heartburn.
    No food related info.No food related info.No food related info.No food related info.
    Kidneys and liver
    Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
    No kidneys and liver related info.
    • If you have kidney or hyperparathyroid disease Alka-Seltzer Original (Aspirin / Citric Acid / Sodium Bicarbonate) can build up in your blood. This may can cause toxic levels of sodium in your body. This is more likely if you have severe kidney disease (defined as a kidney function blood test called GFR of less than 30ml/min). If you have severe kidney disease or are on kidney dialysis don't use Alka-Seltzer Original (Aspirin / Citric Acid / Sodium Bicarbonate); a different antacid would be better for you.
    • Ask your doctor before taking Imodium if you have a fever, liver problems, mucus in your stool or are taking antibiotics.
    • Maalox (aluminum / magnesium / simethicone) contains aluminum and magnesium that can build up in your kidneys if you have kidney problems which can be dangerous. Talk to your doctor or pharmacist before taking Maalox (aluminum / magnesium / simethicone) to see if it is right for you. Don't take more than the maximum amount per day as shown on the label.
    • Because Pepcid (Famotidine) is processed by the kidney it can cause some worrisome side effects for people with kidney problems. These include confusion, delirium, and a dangerous irregular heartbeat known as QT prolongation. If you have kidney problems, you may need a different dose to prevent this increased risk for side effects.
    • Can cause more serious side effects for people with kidney disease. Ask your doctor to give you a lower dose or choose a different option.
    • If you have kidney or hyperparathyroid disease Rolaids (Calcium Carbonate / Magnesium Hydroxide) can build up in your blood. This may can cause toxic levels of calcium in your body. This is more likely if you have severe kidney disease (defined as a kidney function blood test called GFR of less than 30ml/min). If you have severe kidney disease or are on kidney dialysis don't use Rolaids (Calcium Carbonate / Magnesium Hydroxide); a different antacid would be better for you.
    • Rolaids (Calcium Carbonate / Magnesium Hydroxide) contains calcium. Calcium can be an ingredient in some kidney stones. If you have had kidney stones in the past (especially the calcium-containing kind) be careful using Rolaids (Calcium Carbonate / Magnesium Hydroxide). Use the lowest dose for the shortest time possible or just play it safe and use a different antacid instead.
    • People with kidney disease on dialysis may need to take a lower dose or avoid use. Your doctor can do blood tests to see if it's safe to use.
    • May increase calcium levels too much in people with kidney or thyroid conditions.
    No kidneys and liver related info.
    Pain
    Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
    No pain related info.No pain related info.
    • Do not use if you have diarrhea with a high fever, blood in your stool, pain, swelling or bulging in your belly. People taking HIV medicine together with Imodium (Loperamide) can have a serious intestinal problem called toxic megacolon. Call your doctor or get medical care right away if you develop these symptoms or your diarrhea gets worse after 2 days.
    No pain related info.No pain related info.No pain related info.No pain related info.No pain related info.
    Weight
    Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
    No weight related info.No weight related info.
    • The correct dose of Imodium may be different depending on age. Use the dosing chart to find the right amount of medicine based on age and weight.
    No weight related info.No weight related info.No weight related info.No weight related info.No weight related info.
    Upsides and benefits
    Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
    • Pepto-Bismol (bismuth subsalicylate) works well to alleviate stomach and intestinal problems and doesn't have many side effects.
    • Comes in easy to take chewable pills or liquid, if you do not like swallowing pills.
    • Is inexpensive and available over the counter.
    • Coupons are available. Speak to your doctor or pharmacist.
    • Works great if you have an upset stomach and a headache or body pain at the same time.
    • Works really fast.
    • Available over the counter without a prescription.
    • Cheap.
    • Most people who take Imodium feel there's no hassle and it's definitely worth it!
    • Non-habit forming and available over-the-counter.
    • It comes in caplets, liquid, and chewable tablets so you can use it anywhere you need it.
    • Imodium is used for short-term, chronic and traveler's diarrhea. It's also used for people who have diarrhea caused by cancer or certain medicines that treat cancer.
    • Works quickly.
    • Inexpensive and available over-the-counter.
    • Is one of the first choice medications for heartburn relief if you are pregnant.
    • Most people can take Famotidine without any noticeable day-to-day side effects.
    • Famotidine lasts longer than many other antacids like Maalox and Tums, and you only need to take it once or twice a day.
    • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
    • Available as both a generic and over-the-counter option, so it's pretty affordable.
    • Few drug interactions.
    • Works really fast.
    • Available over the counter without a prescription.
    • Cheap.
    • Tums (Calcium carbonate) is an effective, first-line medication for hearburn.
    • Tums (Calcium carbonate) starts working in seconds.
    • Has minimal side effects.
    • Available in chewable form.
    • Is inexpensive and readily available over-the-counter.
    • Coupons are available – speak to your doctor or pharmacist.
    • Zantac 75 (ranitidine) works well to relieve heartburn symtoms and is quite tolerable.
    • You can take it in combination with a quick-acting antacid (like Maalox or Tums) if you need relief right away.
    • If you have trouble swallowing pills you may find the liquid product a good option.
    • Inexpensive with over-the-counter and generic options.
    • Coupons are available for the brand product - speak to your doctor or pharmacist.
    Downsides and risks
    Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
    • May not be as strong as other anti-diarrheal or antacid medications.
    • Should not be used for more than 2 days if your diarrhea does not go away or if you have a fever.
    • For symptoms other than diarrhea, should not be used for more than 7 days without your doctor's approval. Speak to your doctor if symptoms persist.
    • Doesn't last very long.
    • Other antacids like Zantac (H2 blockers) and omeprazole (proton pump inhibitors) can work better and last longer.
    • Because it has aspirin in it, it increases the risk of bleeding, especially if you take any other blood thinning medicine.
    • Can't be used by people with allergy to aspirin.
    • You may not like the taste or fizz.
    • Imodium only treats your diarrhea symptoms. Diarrhea may be caused by a number of conditions and will need specific treatment that deals with the underlying issue.
    • Studies in people taking Imodium for chronic diarrhea showed if the maximum number of doses didn't relieve symptoms in 10 days, then it probably won't work for that condition. You can talk to your doctor about other treatment options.
    • Doesn't last very long. Talk to your doctor or pharmacist if you need longer lasting relief.
    • Is not a good option if you have frequent symptoms (more than 2 times a week). Talk to your doctor or pharmacist about stronger medications.
    • Other antacids like Maalox, Tums, or Rolaids often start to work more quickly than Famotidine.
    • Medication like omeprazole (proton pump inhibitors) works better at healing and preventing stomach ulcers than medication like Famotidine (H2 blockers).
    • Can cause more serious side effects for people with kidney disease. Ask your doctor to give you a lower dose or choose a different option.
    • Doesn't last very long.
    • Other antacids like Zantac (H2 blockers) and omeprazole (proton pump inhibitors) can work better and last longer.
    • Some chalky aftertaste.
    • Because Tums (Calcium carbonate) only lasts for 1 to 2 hours, you may need additional doses.
    • May increase calcium levels too much in people with kidney or thyroid conditions.
    • May have a chalky taste.
    • Zantac 75 (ranitidine) doesn't work as quickly as some other acid reducers. Speak to your doctor or pharmacist if you need quicker relief.
    • Zantac 75 (ranitidine) does not last as long as some other acid reducers. Speak to your doctor or pharmacist if you need longer relief.
    • May not be as effective in healing the esophagus when it is inflammed or torn, known as erosive esophagitis. Your doctor will assess which medication is best for you.
    • Can lower your vitamin B12 levels if you use Zantac 75 (ranitidine) for a long time. Your doctor can order lab tests to monitor your vitamin B12 levels.
    Tips from our pharmacists for people taking the medication
    Pepto-BismolAlka-SeltzerImodiumMaaloxPepcidRolaidsTumsZantac
    • If you have the liquid product, make sure to shake well before use.
    • Non-chewable pills should be taken with a full glass of water.
    • Pepto-Bismol (bismuth subsalicylate) may cause your tongue and stool to become dark, this is normal. However, contact your doctor right away if you notice bloody stools, or if you are vomiting blood or a substance that looks like coffee grounds.
    • Diarrhea can cause you to be dehyrated and lose electrolytes. Make sure to stay hydated. Rehydration solutions are available over-the-counter. Speak to your doctor or pharmacist.
    • Eating smaller meals and avoiding eating 3 hours before bedtime can help prevent heartburn.
    • Don't take Alka-Seltzer if you're allergic to aspirin.
    • Take it with food to lower the chance of an upset stomach.
    • This medicine isn't recommended for kids 12 and younger because it has aspirin in it.
    • Stop taking this right away and talk to your doctor if you have ringing in your ears, rash, trouble breathing, unusual bleeding, or nausea or vomiting that doesn't go away.
    • Having a dental or medical procedure? You may need to stop taking this before the big day. Ask your dentist or doctor.
    • Alka-Seltzer contains sodium. If you need to follow a low sodium diet a different medication would be better for you.
    • Not a good choice if you have stomach bleeding, bleeding problems, diabetes, or gout, or if you're taking medicines to thin your blood.
    • Try to drink plenty of clear liquids. Having diarrhea can make you dehydrated.
    • The correct dose of Imodium may be different depending on age. Use the dosing chart to find the right amount of medicine based on age and weight.
    • Shake Imodium liquid well before using. Use dosing cup that comes with bottle to get the best dose.
    • Imodium lowers your ability to focus, think, and react. Avoid activities that require you to be alert, such as driving a car or operating machinery, until you know how this medication affects you.
    • Check with your baby doctor before using if you're breastfeeding.
    • Ask your doctor before taking Imodium if you have a fever, liver problems, mucus in your stool or are taking antibiotics.
    • Don't use if you have blood in your stool or it's dark or black in color.
    • Stop using Imodium and call your doctor if you have pain, swelling or bulging in your belly or your symptoms get worse after 2 days. This could be serious.
    • Starts working within minutes, and lasts for 1-2 hours.
    • If you are using the liquid product, shake well before using.
    • Don't take more than the recommended amount per day on the package. If you need to take this for more than 2 weeks, talk to your doctor.
    • People on a magnesium-restricted diet may need to avoid Maalox. Ask your doctor.
    • Talk to your doctor or pharmacist about foods to avoid that can help prevent heartburn.
    • Eating smaller portion sizes and not eating 3 hours before bedtime can help prevent heartburn.
    • Short-term treatment of ulcers and acid reflux.
    • Take at the first sign of discomfort.
    • You might need to take more than once a day but pay attention to the instructions on your bottle to avoid overdosing.
    • Take 1-2 hours apart from other medication that you take by mouth.
    • If heartburn doesn't improve or lasts more than 2 weeks, talk to your doctor.
    • People with kidney disease on dialysis may need to take a lower dose or avoid use. Your doctor can do blood tests to see if it's safe to use.
    • Don't take if you have high blood calcium levels.
    • Take at the first sign of discomfort.
    • You may need to separate Tums (Calcium carbonate) from some medicines to avoid interactions. Talk to your doctor or pharmacist about all the medicines you're taking, including prescription, supplements, and over the counter medicines.
    • Eating smaller, more frequent meals can help alleviate some symptoms of heartburn.
    • Certain spicy or fatty foods increase your risk of heartburn. Talk to your doctor or pharmacist to find out which foods you should avoid.
    • Avoiding eating 3 hours before bedtime can also help prevent heartburn.
    • If heartburn doesn't improve or lasts more than 2 weeks, talk to your doctor.
    • To prevent a heartburn attack, take Zantac 75 (ranitidine) 30 minutes before eating.
    • Works within 30 to 60 minutes. Relief lasts up to 12 hours.
    • Do not use Zantac 75 (ranitidine) for more than 14 days. Talk to your doctor if your symptoms do not improve after 2 weeks of using the over-the-counter product, as this may indicate a more serious problem.
    • The syrup product may contain up to 7.5% of alcohol.
    • Speak to your doctor or pharmacist about lifestyle and dietary changes that can help prevent heartburn.
    Learn more
    More about Pepto-BismolSide effectsReviews & ratingsAlternativesFDA package insert
    Have you used Pepto-Bismol (bismuth subsalicylate)?
    Worth itNot sureNot worth it
    More about Alka-SeltzerSide effectsReviews & ratingsFDA package insert
    Have you used Alka-Seltzer Original (aspirin / citric acid / sodium bicarbonate)?
    Worth itNot sureNot worth it
    More about ImodiumSide effectsReviews & ratingsFDA package insert
    Have you used Imodium (loperamide)?
    Worth itNot sureNot worth it
    More about MaaloxSide effectsReviews & ratingsFDA package insert
    Have you used Maalox (aluminum / magnesium / simethicone)?
    Worth itNot sureNot worth it
    More about PepcidSide effectsReviews & ratingsFDA package insert
    Have you used Pepcid (famotidine)?
    Worth itNot sureNot worth it
    More about RolaidsSide effectsReviews & ratingsFDA package insert
    Have you used Rolaids (calcium carbonate / magnesium hydroxide)?
    Worth itNot sureNot worth it
    More about TumsSide effectsReviews & ratingsFDA package insert
    Have you used Tums (calcium carbonate)?
    Worth itNot sureNot worth it
    More about ZantacSide effectsReviews & ratingsFDA package insert
    Have you used Zantac 75 (ranitidine)?
    Worth itNot sureNot worth it