Salicylate absorption from a bismuth subsalicylate preparation

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Abstract
The active ingredient in Pepto-Bismol (PB), a common antidiarrheal, is bismuth subsalicylate. The absorption of salicylate after oral PB was studied in 6 fasted men. Plasma concentrations of total salicylate and the urinary excretion profile of salicylate were determined as a function of time and dose. After 60 ml PB, 500.1 .+-. 33.6 mg (.hivin.x [mean] .+-. SD) salicylate were recovered in urine, representing 95.0 .+-. 6.4% of salicylic acid equivalents in 60 ml of the formulation. Peak plasma salicylate levels were reached 0.5-3 h after ingestion and averaged 40.1 .+-. 17.3 .mu.g/ml. Absorption of salicylate was essentially complete after 15- and 30-ml doses of the antidiarrheal preparation and a linear relationship between dose and recovery of salicylate in the urine was found. Salicylate kinetics was nonlinear after a multiple-dose regimen of 60 ml every 6 h for 5 doses.