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Bismuth subsalicylate


Mechanism of action:

Bismuth subsalicylate exerts its effects through both the bismuth ion (Bi³⁺) and the salicylate component. In an acidic gastric environment, the bismuth ion binds to sulfhydryl (-SH) groups on proteins present on the mucosal surface or within ulcer exudates, forming an insoluble protective layer that adheres to the ulcer surface. This layer helps prevent erosion by gastric acid and pepsin, enhances mucus and bicarbonate secretion, and may support restoration of the mucosal barrier. The salicylate component may inhibit cyclooxygenase pathways, reducing prostaglandin synthesis and thereby affecting local inflammation-related responses.

Reference(s):

1. Goldenberg MM et al. (1975). Protective effect of Pepto-Bismol liquid on the gastric mucosa of rats. Gastroenterology. 


2. Budisak P et al. (n.d.). Bismuth subsalicylate. 


3. Bierer DW et al. (1990). Bismuth subsalicylate: history, chemistry, and safety. Rev Infect Dis.

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