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Omeprazole vs. Bismuth subsalicylate

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Omeprazole (Prilosec) and bismuth subsalicylate (Pepto-Bismol) are both used to treat stomach-related issues, but they work in different ways and treat different conditions. Omeprazole is a proton pump inhibitor (PPI) that reduces stomach acid and is used for conditions like GERD, stomach ulcers, and heartburn. It is available both over-the-counter and by prescription. Bismuth subsalicylate, on the other hand, is an antidiarrheal medication that treats diarrhea and symptoms of an upset stomach, such as nausea and gas. It is only available over-the-counter. Omeprazole is typically taken once daily before breakfast, while bismuth subsalicylate can be taken every 30 minutes to an hour as needed. Omeprazole is not recommended for long-term use due to potential serious side effects, whereas bismuth subsalicylate should not be taken for more than two days. Additionally, bismuth subsalicylate can cause dark-colored stools and tongue, while omeprazole may cause headaches and stomach pain.

Omeprazole

(Prilosec)

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Bismuth subsalicylate

(Pepto-Bismol)

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Summary for Omeprazole

Prescription or over-the-counter

Omeprazole (Prilosec) is a proton pump inhibitor (PPI). Over-the-counter (OTC) omeprazole (Prilosec) can ease heartburn, while the prescription version can treat gastroesophageal reflux disease (GERD) and other conditions involving too much stomach acid. Omeprazole (Prilosec) is taken by mouth, typically once daily 30 minutes before breakfast. Some of the more common side effects of omeprazole (Prilosec) include headache, stomach pain, and nausea. It's available as both brand name and generic medications.

Indications for Omeprazole

For adults only:

For adults and children:

  • Gastroesophageal reflux disease (GERD)
  • Inflamed esophagus due to GERD

Pros and Cons for Omeprazole

Pros

  • Typically few to no noticeable day-to-day side effects
  • Provides longer-lasting relief than some other heartburn medications
  • Can use for adults, as well as children with certain medical conditions
  • Available as over-the-counter and lower-cost generic options

Cons

Common Side Effects for Omeprazole

Adults

  • Headache (7%)
  • Belly pain (5%)
  • Nausea (4%)
  • Diarrhea (4%)
  • Vomiting (3%)
  • Passing gas (3%)

Children — similar to the above, with the addition of:

  • Respiratory system problems (up to 75%)
  • Fever (up to 33%)
  • Ear infection (up to 22%)

Warnings for Omeprazole

  • Risk of hiding symptoms of a more serious problem
  • Sudden kidney problems
  • Severe infectious diarrhea
  • Bone fractures
  • Skin reactions
  • Lupus
  • Low vitamin B12 and magnesium levels
  • Interaction with other medications
  • Inaccurate lab work

Summary for Bismuth subsalicylate

Over-the-counter

Bismuth subsalicylate (Pepto-Bismol) is a salicylate antidiarrheal medication. It's used to ease diarrhea and symptoms of an upset stomach (e.g., gas, nausea) in adults and kids ages 12 years and older. This medication is taken by mouth, typically once every 30 minutes to an hour, as needed. Bismuth subsalicylate (Pepto-Bismol) is found over the counter in several different formulations, such as chewable tablets and oral solutions. Side effects of this medication include nausea, changes in taste, dark-colored tongue, and black stool.

Indications for Bismuth subsalicylate

Pros and Cons for Bismuth subsalicylate

Pros

  • Treats a wide variety of stomach-related symptoms
  • Available as a lower-cost generic medication
  • Available in chewable tablets or liquid for people who have difficulty swallowing pills
  • Can be taken with or without food

Cons

  • Shouldn’t be taken for longer than 2 days
  • Can cause darkening of the tongue or stools
  • Might need to take it multiple times per day
  • Not for children less than 12 years of age due to higher risk of Reye's syndrome

Common Side Effects for Bismuth subsalicylate

  • Nausea
  • Bitter taste in mouth
  • Diarrhea
  • Dark-colored stools

Warnings for Bismuth subsalicylate

  • Reye's syndrome in children
  • Salicylate toxicity
  • Allergic reactions

Prices with our coupons for Omeprazole vs. Bismuth subsalicylate

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Omeprazole30 capsules / 40mg
$8.60$104.49
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Bismuth Subsalicylate112 chewable tablets / 262mg
$17.18-
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