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Zofran vs. Bismuth subsalicylate

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

Key takeaways

Ondansetron (Zofran) and bismuth subsalicylate (Pepto-Bismol) are both used to treat nausea, but they belong to different medication classes and have distinct uses. Ondansetron is an antiemetic that is FDA-approved to prevent nausea and vomiting caused by chemotherapy, radiation therapy, and surgery. It works by blocking serotonin in the brain. Bismuth subsalicylate, on the other hand, is an antidiarrheal that treats diarrhea and upset stomach symptoms like gas and indigestion. Ondansetron is available by prescription in various forms, including tablets, orally disintegrating tablets, and injections, while bismuth subsalicylate is available over-the-counter in chewable tablets and liquid form. Ondansetron can cause side effects like headache and fatigue, and it may interact with medications that affect serotonin levels. Bismuth subsalicylate can cause dark stools and tongue, and it should not be used in children under 12 due to the risk of Reye's syndrome. Additionally, bismuth subsalicylate is not recommended during pregnancy, whereas ondansetron may be used off-label for nausea during pregnancy if other treatments fail.

Ondansetron

(Zofran)

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Bismuth subsalicylate

(Pepto-Bismol)

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Summary for Zofran

Prescription only

Ondansetron (Zofran) is an antiemetic (or anti-nausea) medication. It's used to prevent nausea and vomiting after surgery or cancer treatments. It works by stopping a chemical called serotonin from binding to receptors in the brain that cause the feeling of nausea and vomiting. Ondansetron (Zofran) is taken by mouth, typically every 8 to 12 hours. It comes in different formulations, including orally disintegrating tablet (ODT) and oral solution. It can also be given as injection by a healthcare professional (HCP) in a hospital setting. Side effects of this medication include headache, tiredness, and constipation or diarrhea.

Indications for Zofran

  • Prevention of nausea and vomiting due to cancer medications (chemotherapy) or radiation therapy
  • Prevention of nausea and vomiting after surgery

Pros and Cons for Zofran

Pros

  • Can use for both adults and children
  • Available as a lower-cost generic
  • Available as a liquid, dissolvable tablet, and injection for people who have problems swallowing pills or are too nauseous to keep medication down
  • Possible option during pregnancy and breastfeeding

Cons

Common Side Effects for Zofran

  • Headache (up to 24%)
  • Fatigue (up to 13%)
  • Constipation (up to 9%)
  • Diarrhea (up to 6%)

Warnings for Zofran

  • Severe allergic reactions
  • Life-threatening abnormal heart rhythm (QT prolongation)
  • Serotonin syndrome
  • Risk of heart attack
  • Masking of gut blockage and stomach bloating
  • Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only

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 Zofran vs. Bismuth subsalicylate

Price Card Drug Icon
Ondansetron20 orally disintegrating tabs / 4mg
$10.99$116.03
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Price Card Drug Icon
Bismuth Subsalicylate112 chewable tablets / 262mg
$17.18-
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