Tums vs Pepto Bismol (2023)


For patients with upset stomachs, heartburn or other types of indigestion, certain drugs that neutralize or decrease stomach acid and alleviate symptoms can be helpful. Tums and Pepto Bismol are two such medications that are commonly used for these conditions. They each function in different ways but both aim to provide relief from digestive discomfort. Tums is a type of antacid, working by directly neutralizing existing stomach acid, which can help relieve symptoms like heartburn. It contains calcium carbonate as its active ingredient which acts quickly on the stomach contents to reduce acidity levels temporarily.

Pepto Bismol, on the other hand, has a broader range of action due to its main ingredient - bismuth subsalicylate. Not only does it have antacid properties similar to those of Tums (though less potent), it also promotes the absorption of fluids to combat diarrhea and has antimicrobial activity against bacteria causing gastritis and ulcers.

What is Tums?

Calcium carbonate, the active ingredient in Tums, has been a mainstay of over-the-counter heartburn relief for decades. First introduced to the market in 1930, Tums works by directly neutralizing stomach acid on contact, providing quick but temporary relief from symptoms such as burning and indigestion. It's commonly used for immediate relief from occasional heartburn.

On the other hand, Bismuth subsalicylate (commonly known as Pepto-Bismol) is an antacid and anti-diarrheal medication first approved by the FDA in 1918. Unlike Tums which only addresses excess stomach acid, Pepto-Bismol acts on both your digestive tract to reduce inflammation and your central nervous system to slow down diarrhea-causing spasms. This makes it more effective at treating a wider range of gastrointestinal issues including upset stomachs caused by overeating or drinking.

While both are safe for most people when used correctly, they do have different side effects profiles: excessive use of Tums can lead to high calcium levels or kidney stones while Pepto-Bismol may cause black stools or tongue discoloration due to its bismuth content.

What conditions is Tums approved to treat?

Tums and Pepto Bismol are approved for the treatment of various digestive disorders:

  • Tums is mainly used to provide quick relief from heartburn, indigestion, and gas. It works by neutralizing stomach acid.
  • Pepto Bismol can be used to treat diarrhea, nausea, heartburn, indigestion and upset stomach due to overindulgence in food and drink. It contains bismuth subsalicylate which has an antimicrobial effect on the gut helping control diarrhoea symptoms as well as reducing inflammation in the stomach lining.

How does Tums help with these illnesses?

Tums works to alleviate heartburn by neutralizing excess stomach acid. It does this through its key ingredient, calcium carbonate, which is an alkaline substance that reacts with and neutralizes the hydrochloric acid in your stomach. This can help relieve symptoms of heartburn such as a burning sensation in the chest or throat. The chemical reaction between calcium carbonate and hydrochloric acid also produces water and carbon dioxide, potentially causing you to burp, which for some people can provide additional relief from discomfort. Therefore, by reducing acidity levels within the stomach, Tums provides temporary relief from the pain associated with conditions like heartburn or gastroesophageal reflux disease (GERD), helping patients manage their symptoms more comfortably.

What is Pepto Bismol?

Pepto Bismol, or bismuth subsalicylate, is an antacid and anti-diarrhea medication that works by suppressing the activity of a certain enzyme in the stomach. This enzyme can stimulate the production of prostaglandins, which cause inflammation and other symptoms associated with upset stomach and diarrhea. Pepto Bismol was first approved by the FDA in 1918. Unlike Tums (calcium carbonate), which primarily acts as an antacid neutralizing stomach acid, Pepto Bismol has more comprehensive effects addressing several digestive discomforts including nausea, heartburn, indigestion, upset stomach and diarrhea. Its multi-symptom relief capability means its therapeutic actions are broader than those of typical calcium-based antacids like Tums. The side-effect profile of Pepto Bismol is also different from that of Tums; it may cause a harmless black discoloration to your tongue or stool but does not typically lead to constipation or bloating often associated with excessive use of calcium-based antacids.

What conditions is Pepto Bismol approved to treat?

Pepto Bismol is a popular over-the-counter medication approved for the treatment of multiple minor digestive system discomforts, including:

  • Heartburn
  • Indigestion
  • Upset stomach
  • Nausea
  • Diarrhea

Its broad coverage and effectiveness in handling these issues make it a go-to solution for many individuals experiencing common gastrointestinal disturbances.

How does Pepto Bismol help with these illnesses?

Bismuth subsalicylate, the active ingredient in Pepto-Bismol, serves multiple roles in the body to aid different digestive issues. It can act as a mild antacid, helping to neutralize stomach acid much like calcium carbonate does in Tums. This is beneficial for those experiencing heartburn or indigestion.

However, Pepto-Bismol's bismuth component also lends it additional properties not found with Tums. Bismuth has antimicrobial effects against bacteria and viruses that cause gastrointestinal problems such as traveler’s diarrhea or gastritis due to H.pylori infection. Furthermore, salicylates inhibit intestinal secretions and potentially inflammation contributing toward alleviating symptoms of diarrhea.

Pepto-Bismol therefore offers broader benefits beyond simple antacid action which may make it more suitable than traditional antacids like Tums for individuals with a wider range of digestive complaints.

How effective are both Tums and Pepto Bismol?

Both Tums (calcium carbonate) and Pepto Bismol (bismuth subsalicylate) have long-established histories of effectively treating common gastrointestinal symptoms, such as heartburn and upset stomach. They were approved by the FDA decades ago, with Tums in the 1930s and Pepto Bismol in the 1900s. Although they treat some similar symptoms, their mechanisms of action are different: Tums acts as an antacid to neutralize stomach acid while Pepto Bismol has several actions including mild antibacterial effects and reducing inflammation.

The effectiveness of both drugs in managing gastrointestinal discomfort is well-documented through years of clinical use; however, they may be chosen under different circumstances based on specific symptom profiles. For instance, a study from 1998 demonstrated that calcium carbonate was particularly effective at rapidly neutralizing gastric acid for relief from heartburn.

A review from 2007 reported that calcium carbonate remains one of the most commonly used over-the-counter treatments for occasional heartburn due to its immediate onset of action. Moreover, because it does not require a prescription and is well-tolerated even among children and pregnant women (under physician guidance), it continues to be a popular choice for those suffering from acute episodes of heartburn or indigestion.

However, bismuth subsalicylate's broader range of actions allows it to target more diverse symptoms like nausea or diarrhea while also providing anti-inflammatory benefits. Despite this versatility though, there still lacks robust evidence supporting its efficacy across all these areas compared to other first-line treatments like proton pump inhibitors for ulcer treatment or antibiotics for bacterial infections. However, due to its unique properties such as coating stomach lining which can protect against irritant substances along with its antimicrobial effect against H.Pylori bacteria known to cause ulcers- it may be optimal treatment choice where multiple GI symptoms are present or when certain side effects need avoiding.

At what dose is Tums typically prescribed?

Regular-strength Tums can be taken at a dosage of 2-4 tablets every hour as symptoms occur, but should not exceed 7 doses in a 24-hour period (or 3 doses if you're over the age of 60). Pepto Bismol, on the other hand, has a suggested dosage for adults and children over the age of 12 of two tablespoons or one dose cup every half an hour to an hour as needed. Do not take more than eight doses in a given 24-hour period. Dosages may need adjustment based on severity and frequency of symptoms; always consult your doctor before starting any new medication regimen.

At what dose is Pepto Bismol typically prescribed?

Pepto Bismol can be initiated with a dose of 30 mL (approximately two tablespoons) or 2 chewable tablets every half an hour to one hour, as needed. The dosage may then be increased to up to 8 doses in a 24-hour period for adults and children over the age of 12 years. For children under the age of twelve, consult with a healthcare provider before use. Do not exceed these recommendations unless directed by your doctor as excessive consumption could lead to side effects like blackened stools and constipation. If there is no relief from symptoms after two days of consistent usage, you should seek medical attention.

What are the most common side effects for Tums?

Common side effects of Tums include:

  • Constipation
  • Flatulence (gas)
  • Belching
  • Stomach cramps

Whereas, common side effects of Pepto Bismol can range from:

  • Darkened or black stools
  • Tongue discoloration (it might appear black)
  • Mild nausea or upset stomach
  • Temporary ringing in your ears

While these are typically mild and temporary, if you experience persistent discomfort or other concerning symptoms after taking either medication, it's wise to consult with a healthcare professional.

Are there any potential serious side effects for Tums?

While both Tums and Pepto-Bismol are over-the-counter medications used to help relieve symptoms of indigestion, they can have potential side effects in rare cases:

  • Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
  • Constipation or diarrhea
  • Stomach pain
  • Nausea or vomiting
  • Unusual bleeding or bruising
  • Dark-colored stools (Pepto-Bismol)
  • White appearance in the mouth or on the tongue (Tums)

More serious but less common side effects include:

  • Fast heartbeat, shortness of breath and sudden dizziness which may indicate a severe heart condition.
  • Confusion and unusual behavior could be signs of a severe nervous system reaction.

If you experience any these symptoms while taking either medication, it is recommended that you seek medical attention immediately.

What are the most common side effects for Pepto Bismol?

Pepto Bismol, a common choice for relief from digestive discomfort, can cause the following side effects:

  • A black or dark tongue
  • Dark-colored stools
  • Stomach pain or constipation
  • Nausea
  • Ringing in the ears or hearing loss (rare)

These symptoms are usually mild and go away on their own. However, if they persist or worsen, it's recommended to consult your healthcare provider immediately.

Are there any potential serious side effects for Pepto Bismol?

While Pepto Bismol is generally safe for most people when used as directed, there are some potential side effects to be aware of. These include:

  • A significant allergic reaction that could manifest as hives, difficulty breathing or swallowing, swelling in the face or throat, and skin rash.
  • Blackening of your tongue and/or dark stools: this is usually a harmless side effect but can sometimes indicate internal bleeding.
  • Hearing loss or ringing in your ears
  • Severe nausea or vomiting
  • Unusual bruising or bleeding; these may be signs of a rare blood disorder known as thrombotic thrombocytopenic purpura (TTP).
  • Diarrhea lasting longer than two days
  • Signs of Reye's syndrome in children and teenagers: this includes changes in behavior with nausea and vomiting.

If you experience any severe reactions while taking Pepto Bismol, immediately contact a healthcare professional.

Contraindications for Tums and Pepto Bismol?

Both Tums and Pepto Bismol, like many other over-the-counter antacids, can cause side effects in some people. If you notice a worsening in your symptoms or if new symptoms appear after starting these medications, seek immediate medical help.

Neither Tums nor Pepto Bismol should be taken if you are currently taking certain prescription drugs without consulting with your health care provider first. This is because certain medications might interact negatively with the ingredients found in both Tums and Pepto Bismol, leading to either reduced effectiveness of the medication or increased risk of side effects. Always inform your physician about all the medications that you are currently taking; this includes prescription drugs, over-the-counter medicines as well as any herbal supplements.

For instance, tetracycline antibiotics may interact poorly with calcium carbonate (found in Tums), while aspirin-allergic patients should avoid bismuth subsalicylate (found in Pepto Bismol). It's also important to note that prolonged use of these antacids could lead to imbalances of minerals such as calcium and magnesium.

How much do Tums and Pepto Bismol cost?

In the case of over-the-counter antacids:

  • A bottle of 150 Tums Extra Strength (750 mg) tablets typically costs around $10, which, depending on your dosage, can work out to about $0.07–$0.20 per day.
  • Pepto Bismol original liquid (16 oz), on the other hand, averages at around $9 - $12 and depending upon usage could last for several days.

Therefore, if you're using higher dosages of Tums regularly (i.e., taking more than six tablets a day), then Pepto Bismol might be less expensive in terms of cost per use basis. However, please note that these products treat slightly different symptoms and their effectiveness may vary from person to person.

For generic versions known as calcium carbonate (Tums) and bismuth subsalicylate (Pepto Bismol):

  • Generic calcium carbonate is available in bottles containing up to 500 tablets with prices starting from as low as $5 making it an economical choice.
  • Similarly priced generic versions of bismuth subsalicylate are also readily available in most pharmacies offering consumers budget-friendly options for symptom relief.

Popularity of Tums and Pepto Bismol

Calcium carbonate, most commonly known as Tums, is a popular over-the-counter medication used to neutralize stomach acid and provide relief from heartburn. In 2020, it was estimated that about 8 million people in the US purchased Tums for their digestive discomfort. While not prescribed like traditional medications, it is widely recognized by medical professionals as an effective antacid treatment.

Bismuth subsalicylate, better known by its brand name Pepto Bismol, is another frequently-used OTC medication that offers help with a broader range of digestive issues including diarrhea, upset stomach and nausea along with heartburn. An estimated 7 million Americans turned to Pepto Bismol for relief in 2020. The use of both these products has remained consistent over the past decade due to their effectiveness and ease of access without a prescription.


Both Tums (calcium carbonate) and Pepto Bismol (bismuth subsalicylate) have long-standing records of usage in patients with various digestive discomforts, and are backed by numerous clinical studies indicating that they provide symptomatic relief from conditions like heartburn, acid indigestion, sour stomach, and diarrhea. Due to their different mechanisms of action – Tums acts as an antacid neutralizing stomach acid while Pepto Bismol has both anti-inflammatory and antibacterial properties – they tend to be used under different circumstances.

Tums is often the first choice for quick relief from acute bouts of heartburn or acid reflux whereas Pepto Bismol might be considered for a broader range of symptoms including those caused by gastrointestinal infections or inflammation.

Both medications are available over-the-counter which provides cost savings especially for patients who must pay out-of-pocket. Immediate effects can usually be seen after administration but this may vary depending on individual metabolisms and the severity of symptoms.

The side effect profile is generally mild for both drugs; however, excessive use can lead to problems such as constipation with Tums or blackened stools/tongue with Pepto-Bismol. For both medications, if symptoms persist beyond two weeks it's recommended that users seek medical advice.


Tums vs Pepto Bismol? ›

The best upset stomach medicine for you depends on the symptoms you're experiencing and what's causing it. For example, antacids (such as Tums and Rolaids) are a good choice for heartburn and sour stomach. Medicines that have bismuth subsalicylate (like Pepto-Bismol) are most often used to treat diarrhea and nausea.

Should you take Pepto-Bismol and TUMS? ›

Interactions between your drugs

No interactions were found between Pepto-Bismol and Tums Chewy Bites.

Do TUMS help with upset stomach? ›

TUMS is an antacid used to relieve heartburn, sour stomach, acid indigestion, and upset stomach associated with these symptoms. The active ingredient in TUMS is calcium carbonate. TUMS starts to neutralize the heartburn-causing acid in your esophagus and stomach on contact, which provides fast relief.

Does anything work better than Pepto-Bismol? ›

There's some evidence that Imodium A-D works faster than Pepto-Bismol. But it can potentially interact with other medications you're taking.

Is Pepto-Bismol the best antacid? ›

If you're experiencing anything such as *cue the theme song* an upset stomach, indigestion, nausea, heartburn or diarrhea, then Pepto Bismol is one of the best over-the-counter treatment options and your first line of defense against gastrointestinal troubles.

Is TUMS or Pepto better for gas? ›

You can help a stomach ache by taking medications like Pepto Bismol, Gas-X, Gaviscon, Tums, and Rolaids. Pepto Bismol helps symptoms like nausea, Gaviscon can help heartburn, and Gas X is best for stomach aches caused by excess gas.

What settles an upset stomach quickly? ›

Treatment & Prevention
  • Sports drinks.
  • Clear, non-caffeinated sodas such as 7-Up, Sprite or ginger ale.
  • Diluted juices such as apple, grape, cherry or cranberry (avoid citrus juices)
  • Clear soup broth or bouillon.
  • Popsicles.
  • Decaffeinated tea.

How long does it take TUMS to kick in? ›

Antacids — such as Tums, Rolaids, Maalox and Mylanta — are the fastest-acting heartburn relievers. They take effect in less than five minutes by quickly neutralizing acid in the stomach. For mild heartburn after a meal, antacids offer quick relief that lasts about 20-30 minutes.

What not to take with Pepto-Bismol? ›

To make sure Pepto-Bismol is safe for you, tell your doctor or a pharmacist if you are taking:
  • an anticoagulant – medicines that help to prevent blood clots.
  • tablets or other oral medicines for diabetes.
  • medicine for gout.
  • doxycycline or minocycline, or any other tetracycline antibiotics.

When should you take a TUMS? ›

Take antacids about 1 hour after eating or when you have heartburn. If you are taking them for symptoms at night, do not take them with food. Antacids cannot treat more serious problems, such as appendicitis, a stomach ulcer, gallstones, or bowel problems.

What should you not mix Pepto with? ›

Cautions with other medicines
  • an anticoagulant – medicines that help to prevent blood clots.
  • tablets or other oral medicines for diabetes.
  • medicine for gout.
  • doxycycline or minocycline, or any other tetracycline antibiotics.

What should you not mix with Tums? ›

Some products that may interact with this drug include: digoxin, certain phosphate binders (such as calcium acetate), phosphate supplements (such as potassium phosphate), sodium polystyrene sulfonate.

When should Pepto-Bismol not be taken? ›

Do not take this medicine if you are pregnant or breastfeeding. Pepto-Bismol is not suitable for some people. To make sure this medicine is safe for you, tell your doctor or pharmacist if you have: ever had an allergic reaction to bismuth subsalicylate or any of the other ingredients in Pepto-Bismol or Pepti Calm.

Can I take Tums and Pepto and omeprazole? ›

To help relieve this pain, antacids may be taken with omeprazole, unless your doctor tells you otherwise. If you are taking this medicine to treat an ulcer that is associated with an H. pylori infection, take it together with antibiotics (eg, amoxicillin, clarithromycin) at the same time of day.


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