Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
Whether you’ve experienced mild indigestion or occasional heartburn, you’ve probably come across Pepto-Bismol and Tums at some point. These drugs are two of the most common over-the-counter (OTC) medicines for heartburn.
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Both Pepto-Bismol and Tums have antacid effects, which help neutralize stomach acid. Too much stomach acid after eating spicy foods or large meals can sometimes cause a burning sensation or discomfort in the chest and upper abdominal region. Antacids can help relieve these symptoms.
What are the main differences between Pepto-Bismol and Tums?
Pepto-Bismol is the brand name for bismuth subsalicylate. Bismuth has antimicrobial effects against certain diarrhea-causing bacteria while subsalicylate has antisecretory effects against fluid and electrolyte loss. Bismuth subsalicylate also has anti-inflammatory actions on the stomach and intestinal lining. For these reasons, Pepto-Bismol can be used as an antacid or antidiarrheal agent.
Pepto-Bismol is notably found as an oral liquid. However, it also comes in regular tablets and chewable tablets. It’s important to note that, while most forms of Pepto-Bismol contain bismuth subsalicylate, Children’s Pepto-Bismol often contains calcium carbonate.
Tums is a brand name for calcium carbonate. It’s considered a potent antacid that directly neutralizes stomach acid. Calcium carbonate reacts with stomach acid to form calcium chloride, carbon dioxide, and water. Because of excess carbon dioxide production in the stomach, belching and gas (flatulence) are common side effects of Tums.
Unlike Pepto-Bismol, Tums is mainly found as a chewable tablet in regular-strength and extra-strength forms. Tums is typically used by those older than 12 years old, but children’s versions of Tums are also available. Some versions of Children’s Tums contains simethicone to help relieve gas.
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Main differences between Pepto-Bismol and Tums Pepto-Bismol Tums Drug class Antacid Antidiarrheal agent Antacid Brand/generic status Brand and generic versions available Brand and generic versions available What is the generic name? Bismuth subsalicylate Calcium carbonate What form(s) does the drug come in? Oral suspension liquid Oral tablet Oral chewable tablet Oral chewable tablet What is the standard dosage? 2 tablespoons of liquid or 2 tablets containing 262 mg (for a total of 524 mg per dose) every 30 to 60 minutes as needed. Maximum of 8 doses per day. 2 to 4 chewable 750 mg tablets as needed for symptoms. Maximum of 10 tablets in a day. How long is the typical treatment? For occasional short-term use. Self-treatment should last no longer than 14 days of consistent use. For occasional short-term use. Self-treatment should last no longer than 14 days of consistent use. Who typically uses the medication? Adults and children 12 years and older Adults and children 12 years and older
Conditions treated by Pepto-Bismol and Tums
Pepto-Bismol is FDA approved to treat heartburn, a digestive problem that can also be a symptom of acid reflux and GERD (gastroesophageal reflux disease). Pepto-Bismol can treat acid indigestion, which includes symptoms like abdominal discomfort, bloating, and nausea. In addition, Pepto-Bismol can treat traveler’s diarrhea and occasional diarrhea, as well as peptic ulcer disease caused by Helicobacter pylori. When used for H. pylori, bismuth subsalicylate is taken with other antibiotics to treat the infection.
Tums is labeled to treat heartburn and indigestion. It helps neutralize and decrease the amount of acid in the stomach to relieve symptoms such as bloating and abdominal discomfort. Calcium carbonate is sometimes combined with simethicone to relieve symptoms of gas and flatulence associated with indigestion.
Because Pepto-Bismol can sometimes contain calcium carbonate—the same ingredient in Tums—it’s important to check the package labeling and ask your healthcare provider to make sure you’re taking the right product.
Condition Pepto-Bismol Tums Heartburn Yes Yes Indigestion Yes Yes Diarrhea Yes No
Is Pepto-Bismol or Tums more effective?
Currently, there are no comprehensive reviews directly comparing Pepto-Bismol and Tums. Studies have shown that bismuth subsalicylate and calcium carbonate are commonly used to treat indigestion because of their acid-reducing effects.
Compared with H2 blockers like Pepcid (famotidine) and Zantac (ranitidine), Tums works faster and relieves symptoms for a shorter period of time. Compared with other antacids like Alka-Seltzer (sodium bicarbonate) and Maalox (aluminum hydroxide/magnesium hydroxide), Tums has a slightly slower onset of action, but its effects may last longer.
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Pepto-Bismol is more effective for other uses such as treating diarrhea and H. pylori infections. Bismuth subsalicylate has been shown to help heal peptic ulcers while fighting bacteria, especially when combined with antibiotics like metronidazole and clarithromycin.
Consult a healthcare provider for the best treatment option for occasional heartburn and indigestion. More serious cases of heartburn, such as acid reflux disease or GERD, may require other medications like proton pump inhibitors (PPIs). Drugs labeled as PPIs include Prevacid (lansoprazole) and Prilosec (omeprazole).
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Coverage and cost comparison of Pepto-Bismol vs. Tums
Medicare and insurance plans rarely cover over-the-counter (OTC) medications like Pepto-Bismol and Tums. In cases where a prescription version of an OTC drug is available, insurance plans may decide to cover it.
Get the SingleCare coupon card
The average costs of Pepto-Bismol and Tums vary depending on which pharmacy you go to. However, these drugs are relatively inexpensive. Still, you may be able to save more with a SingleCare Pepto-Bismol coupon or SingleCare Tums coupon if prescribed by a doctor.
Pepto-Bismol Tums Typically covered by insurance? No No Typically covered by Medicare? No No Standard dosage 2 262 mg tablets every 30 to 60 minutes as needed 2 to 4 500 mg or 750 mg tablets as needed Typical Medicare copay N/A N/A SingleCare cost $5+ $4+
Common side effects of Pepto-Bismol vs. Tums
Pepto-Bismol can often cause a darkened color of the stool or tongue. This is because bismuth subsalicylate can react with small amounts of sulfur to create bismuth sulfide, a black substance. While darkened stool may be confused with bloody stool (a serious condition), this side effect is temporary and harmless. Some people also report mild constipation after taking Pepto-Bismol.
Side effects of Tums include belching and gas (flatulence). Tums may also cause constipation and dry mouth.
Rare but serious effects of Pepto-Bismol may include tinnitus or a constant ringing in the ear that could indicate hearing problems. Other serious side effects of Tums include symptoms of high calcium levels (hypercalcemia), such as weakness, bone pain, and fatigue.
Pepto-Bismol Tums Side effect Applicable? Frequency Applicable? Frequency Black or darkened stool Yes * No * Black or darkened tongue Yes * No * Belching and flatulence No * Yes * Constipation Yes * Yes * Dry mouth No * Yes *
This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.
Source: NIH (Pepto-Bismol), NIH (Tums)
Drug interactions of Pepto-Bismol vs. Tums
Pepto-Bismol can interact with many of the same medications that aspirin interacts with. Bismuth subsalicylate can interact with warfarin and increase the risk of bleeding. When taken with anti-gout agents like probenecid, bismuth subsalicylate can decrease anti-gout effects. Pepto-Bismol can also decrease the absorption and effectiveness of tetracycline and quinolone antibiotics.
Tums can decrease the effects of tetracycline and quinolone antibiotics. Calcium cations can also bind with antifungals, like itraconazole, and decrease their absorption and effectiveness. Certain antibiotics, antifungal agents, and iron supplements should be avoided at least two hours before or after taking calcium carbonate.
Drug Drug class Pepto-Bismol Tums Doxycycline Minocycline Ciprofloxacin Levofloxacin Antibiotics Yes Yes Itraconazole Ketoconazole Antifungals No Yes Warfarin Anticoagulants Yes No Probenecid Antigout Yes No Ferrous sulfate Ferrous gluconate Ferric citrate Iron No Yes
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Consult a healthcare professional for other possible drug interactions.
Warnings of Pepto-Bismol and Tums
Those who are sensitive to aspirin products should avoid taking Pepto-Bismol and other salicylate drugs. Otherwise, hypersensitivity reactions, such as rashes, are a potential adverse effect.
Pepto-Bismol should be avoided in children younger than 12 years old. Children who are recovering from chickenpox or influenza are at an increased risk of Reye’s syndrome after taking bismuth subsalicylate. In very rare cases, Pepto-Bismol can lead to neurotoxicity, especially in those with AIDS. Signs and symptoms of neurotoxicity may include tremors, confusion, or seizures.
Since Tums contains calcium carbonate, it should be avoided or monitored with other calcium-containing products. In severe cases, too much calcium can damage the kidneys, weaken bones, and affect the functions of the brain and heart.
Consult your healthcare provider for other precautions to be aware of while taking Pepto-Bismol or Tums.
Frequently asked questions about Pepto-Bismol vs. Tums
What is Pepto-Bismol?
Pepto-Bismol is an over-the-counter drug that contains bismuth subsalicylate. It’s used to treat mild, infrequent heartburn, indigestion, and diarrhea. Bismuth subsalicylate is also approved to treat H. pylori infections when used along with other antibiotics. Pepto-Bismol is available in an oral suspension, oral tablet, and oral chewable tablet.
What is Tums?
Tums is the brand for calcium carbonate. It is used to treat occasional heartburn and indigestion. Tums is available in regular-strength and extra-strength chewable tablets.
Are Pepto-Bismol and Tums the same?
Pepto-Bismol and Tums are not the same. They contain different active ingredients and come in different formulations. However, some versions of Pepto-Bismol may contain calcium carbonate, the same active ingredient in Tums. Check the label of the drug before purchasing to make sure it contains the ingredients you’re looking for.
Is Pepto-Bismol or Tums better?
Pepto-Bismol and Tums are both effective drugs for treating occasional symptoms of heartburn or indigestion. They both work relatively quickly and work for a short duration. One may be preferred over the other depending on sugar contents and inactive ingredients, as well as whether it comes in a liquid or chewable tablet. Cost may also play a role in determining the best option.
Can I use Pepto-Bismol or Tums while pregnant?
Pepto-Bismol is not generally recommended for pregnant women due to a possible increased risk of bleeding. Tums may be taken occasionally for indigestion in recommended doses. However, it’s important for pregnant women to be aware of calcium intake since they may be taking other prenatal vitamins or supplements. Get medical advice from your healthcare provider if you’re experiencing heartburn or indigestion while pregnant.
Can I use Pepto-Bismol or Tums with alcohol?
Alcohol should be avoided while taking Pepto-Bismol or Tums. Alcohol may irritate the lining of the stomach or intestines and alter the overall effectiveness of antacids and antidiarrheal agents.
Is Tums good for an upset stomach?
Tums is an affordable, effective option for treating an upset stomach. Chewable Tums tablets start working within five minutes and can be taken as needed. Tums should only be used for mild, occasional heartburn and indigestion. If you’re needing to use Tums consistently for more than 14 days, consult a healthcare provider.
Is Pepto Bismol an antacid?
Pepto-Bismol has mild antacid effects to help relieve symptoms of heartburn and indigestion. It also works as an antidiarrheal agent that is commonly used to treat traveler’s diarrhea. Pepto-Bismol works by coating the lining of the digestive tract while preventing fluid and electrolyte loss.
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