次水楊酸鉍

Bismuth Subsalicylate

Bismuth subsalicylate

別名: Pepto-Bismol · Kaopectate · Bismu-kote · Bismupaste · Bismatrol · Corrective Suspension · PalaBIS · BSS · basic bismuth salicylate · bismuth oxysalicylate · bismuthi subsalicylas

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

0.25 mL/kg up to 2 mL/kgPO· q4-6h (0.25 mL/kg) or q6-8h (2 mL/kg)

體重— 🐕

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症	劑量	途徑	頻次	療程	地區
For acute diarrhea	1 mL per 5 kg of body weight	PO	3 times a day	should probably not exceed 5 days of therapy	🌎 NA
For acute diarrhea	0.25 mL/kg up to 2 mL/kg	PO	q4-6h (0.25 mL/kg) or q6-8h (2 mL/kg)	—	🌎 NA
For treating Helicobacter gastritis infections (triple therapy)	0.22 mL/kg	PO	q4-6h	3 weeks	🌎 NA
For treating Helicobacter gastritis infections (triple therapy)	262 mg tablets given based upon body weight (<5kg = 0.25 tablet; 5-9.9 kg = 0.5 tablet; 10-24.9kg = 1 tablet; >25kg = 2 tablets)	PO	q12h	2 weeks	🌎 NA
As a gastroprotectant/coating agent in the adjunctive treatment of uremic gastritis	2 mL/kg	PO	q6-8h	—	🌎 NA

For acute diarrhea: Dose based on 17.5 mg/mL liquid
For acute diarrhea: Pepto-Bismol
For treating Helicobacter gastritis infections (triple therapy): Given with Metronidazole 15.4 mg/kg q8h and amoxicillin 11 mg/kg q8h
For treating Helicobacter gastritis infections (triple therapy): Given with Metronidazole 10 mg/kg PO q12h and amoxicillin 15 mg/kg q12h

貓

適應症	劑量	途徑	頻次	療程	地區
For diarrhea	0.25 mL/kg	PO	q4-6h	—	🌎 NA
For diarrhea	0.5-1 mL/kg	PO	q12h	3 days	🌎 NA
For diarrhea in kittens and young cats	1-2 mL	PO	3-4 times a day	—	🌎 NA
For eliminating Helicobacter gastritis infections (triple therapy)	0.22 mL/kg	PO	q4-6h	3 weeks	🌎 NA

For diarrhea: Cats are sensitive to salicylates and probably should not receive frequent or high dosages
For diarrhea: Using 'Pepto-Bismol Regular' or equivalent strength (17.5 mg/mL) liquid
For diarrhea in kittens and young cats: Refrigeration may increase palatability
For eliminating Helicobacter gastritis infections (triple therapy): Given with Metronidazole 15.4 mg/kg q8h and amoxicillin 11 mg/kg q8h

雪貂

適應症	劑量	途徑	頻次	療程	地區
For eliminating Helicobacter gastritis infections (triple therapy)	7.5 mg/kg	PO	q8h	3-4 weeks	🌎 NA
For eliminating Helicobacter gastritis infections (triple therapy)	17.5 mg/kg	PO	q8h	21 days	🌎 NA

For eliminating Helicobacter gastritis infections (triple therapy): Given with Metronidazole 20 mg/kg and amoxicillin 30 mg/kg
For eliminating Helicobacter gastritis infections (triple therapy): Given with Metronidazole 20 mg/kg PO q12h, amoxicillin 20 mg/kg PO q12h, famotidine 0.5 mg/kg PO once daily, and sucralfate 25 mg/kg PO q8h

馬

適應症	劑量	途徑	頻次	療程	地區
For diarrhea in foals	3-4 ounces per 45 kg (100 lb.) body weight	PO	q6-8h	—	🌎 NA
For diarrhea in foals or adults	1 ounce per 8 kg of body weight	PO	3-4 times daily	—	🌎 NA
For diarrhea in foals	3-4 oz.	PO	q6-8h	—	🌎 NA
For diarrhea in foals	60 mL	PO	two to four times a day	two days	🌎 NA

牛

適應症	劑量	途徑	頻次	療程	地區
For diarrhea in calves	60 mL	PO	two to four times a day	two days	🌎 NA
For diarrhea	2-3 ounces	PO	2-4 times a day	—	🌎 NA

豬

適應症	劑量	途徑	頻次	療程	地區
For diarrhea in baby pigs	2-5 mL	PO	two to four times a day	2 days	🌎 NA

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概覽

次水楊酸鉍是一種非處方胃腸道保護劑和止瀉藥。在獸醫學中，主要用於控制急性分泌性腹瀉，並作為根除幽門螺旋桿菌（Helicobacter）胃腸道感染的「三合一療法」成分之一。

臨床重點：

母體化合物在胃腸道中會被裂解，釋放出水楊酸。
貓咪需謹慎使用： 由於貓缺乏葡萄糖醛酸結合代謝途徑，對水楊酸高度敏感。高劑量或重複給藥極易引起水楊酸中毒。
具有放射線不透性，可能會干擾胃腸道X光檢查。
飼主常將鉍劑引起的無害黑色糞便誤認為黑便（胃腸道出血）。

作用機制

Bismuth subsalicylate is cleaved in the small intestine into bismuth carbonate and salicylate.

Bismuth component: Provides physical mucosal protection, binds bacterial endotoxins, and exhibits weak antibacterial properties (which contributes to its efficacy against Helicobacter spp.).
Salicylate component: Inhibits cyclooxygenase (COX) enzymes → decreases prostaglandin synthesis → reduces intestinal inflammation and hypersecretion, effectively mitigating clinical signs of secretory diarrhea.

安全性與警告

禁忌症

Pre-existing bleeding disorders
Known hypersensitivity to salicylates
Use with extreme caution, if at all, in cats

不良反應

Constipation or fecal impaction (especially in infants or debilitated patients)
Stool discoloration (gray-black or greenish-black)
Salicylism / salicylate toxicity (especially in cats or at high doses)

注意事項

Species Sensitivity: Use with extreme caution in cats due to the salicylate component; cats are highly susceptible to salicylate toxicity.

Bleeding Risk: Salicylate absorption occurs; use cautiously in patients with pre-existing bleeding disorders.

Diagnostics: Bismuth is radiopaque and may interfere with GI tract radiologic examinations. It may also cause false-positive or false-negative results on various urine glucose and ketone tests.

Pregnancy/Nursing: Use with caution in pregnant and nursing animals (refer to aspirin precautions).

General: Antidiarrheal products are not a substitute for adequate fluid and electrolyte therapy when required.

藥物相互作用

Tetracycline

Bismuth can decrease the absorption of orally administered tetracyclines. Separate administration by at least 2 hours and give tetracycline first.

Aspirin

Concomitant administration may increase salicylate serum levels, increasing the risk of toxicity.

監測

Clinical efficacy (resolution of diarrhea)
Fluid and electrolyte status in severe diarrhea
Signs of salicylate toxicity (especially in cats)

藥物動力學

吸收

The amount of bismuth absorbed is negligible, while the salicylate component is rapidly and completely absorbed.

分佈

Salicylates are highly bound to plasma proteins.

代謝

Salicylates are metabolized in the liver to salicylic acid.

排除

Salicylic acid, conjugated salicylate metabolites, and any absorbed bismuth are all excreted renally.

過量

Bismuth subsalicylate liquid/suspension contains approximately 8.7 mg/mL salicylate.

Note: Two tablespoonsful (30 mL) is approximately equivalent to one 325 mg aspirin tablet.

High doses can lead to salicylism (salicylate toxicity), which may manifest as gastrointestinal ulceration, bleeding, acid-base disturbances, and neurological signs. Cats are particularly vulnerable to overdose due to their deficient glucuronidation metabolism.

可用產品

劑型

Oral suspension
Oral paste
Tablets
Caplets

獸醫用

Bismuth Subsalicylate Paste: 5% (50 mg/mL), 10% (100 mg/mL), 20% (200 mg/mL)
Bismuth Subsalicylate Oral Suspension: 1.75% (17.5 mg/mL; 262 mg/15 mL)
Bismuth Subsalicylate Tablets: 262 mg

人用標示

Bismuth Subsalicylate Liquid/Suspension: 87 mg/5 mL, 130 mg/15 mL, 262 mg/15 mL, 524 mg/15 mL, 525 mg/15 mL
Bismuth Subsalicylate Tablets and Caplets: 262 mg (regular & chewable)

各地核准狀態

暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

Store protected from light at room temperature; do not freeze. Incompatible with mineral acids and iron salts. Decomposes with effervescence when exposed to alkali bicarbonates.

飼主須知

充分搖勻： 測量劑量前，請務必將液體產品充分搖勻。
適口性： 將懸浮液冷藏可能會讓寵物更容易接受。給藥前請勿與牛奶混合。
糞便變化： 此藥物可能會使寵物的糞便變成灰黑色或綠黑色，這是正常現象。然而，如果糞便變成「柏油樣」黑色或看到鮮血，請立即聯繫獸醫師。
何時聯繫獸醫： 如果腹瀉持續超過一兩天，或者寵物變得昏昏欲睡或停止喝水，請聯繫獸醫師。如果寵物已經脫水，請勿以此藥物替代正規的獸醫治療。

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