Pepto-Bismol vs. Tums: Differences, similarities, and which is better for you

Main differences | Conditions treated | Efficacy | Side effects | Drug interactions | Warnings | Insurance & costs | FAQs

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.

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.

How does Pepto-Bismol work?

Pepto-Bismol is the brand name for bismuth subsalicylate. Bismuth subsalicylate has antimicrobial effects against certain diarrhea-causing bacteria and 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. While most forms of Pepto-Bismol contain bismuth subsalicylate, Children’s Pepto-Bismol often contains calcium carbonate.

How do Tums work?

Tums is a brand name for calcium carbonate. It’s considered a potent antacid medication that directly neutralizes gastric acid. Calcium carbonate reacts with stomach acid to form calcium chloride, carbon dioxide, and water. Because of carbon dioxide production in the stomach, belching and excess 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 contain simethicone to help relieve gas.

Conditions treated by Pepto-Bismol and Tums

Both Pepto-Bismol and Tums are approved by the U.S. Food and Drug Administration to treat heartburn, indigestion, and upset stomach. These OTC medications may help relieve symptoms like stomach aches, nausea, and gas pains. 

Pepto-Bismol can also treat occasional diarrhea, including traveler’s diarrhea, and peptic ulcer disease caused by Helicobacter pylori. When used for H. pylori, bismuth subsalicylate is taken with other antibiotics to treat the bacterial infection.

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.

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 (Pepto-Bismol) and calcium carbonate (Tums) are commonly used to treat indigestion because of their acid-reducing effects.

Other medications, such as H2 blockers, may be considered alternatives to antacids like Pepto-Bismol and Tums. Compared with H2 blockers like Pepcid (famotidine) and Zantac (ranitidine), Tums works faster and relieves symptoms for a shorter period of time. 

RELATED: See a full list of H2 blockers

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.

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 gastroesophageal reflux disease (GERD), may require other medications like proton pump inhibitors (PPIs). Drugs labeled as PPIs include Prevacid (lansoprazole) and Prilosec (omeprazole), which may help lower the amount of acid produced in the stomach. They are available as over-the-counter medications and prescription drugs. 

RELATED: See a full list of PPIs

Side effects of Pepto-Bismol vs. Tums

Pepto-Bismol and Tums can cause constipation.

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.

Side effects of Tums include belching, gas (flatulence), 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.

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 decrease the absorption and effectiveness of tetracycline and quinolone antibiotics. Tums has a similar effect and can decrease the effects of these antibiotics. 

Additionally, Pepto-Bismol can interact with many of the same medications that aspirin interacts with, such as warfarin, and increase the risk of bleeding. The use of bismuth subsalicylate with anti-gout agents like probenecid may alter your body’s uric acid levels, so it’s recommended to monitor uric acid levels closely if these medications are taken together. 

Calcium cations can bind with antifungals, like itraconazole, and decrease their absorption and effectiveness. Certain antibiotics, antifungal agents, and iron supplements, including some prenatal supplements, should be avoided at least two hours before or after taking calcium carbonate.

Consult a healthcare professional for other possible drug interactions.

Can you take Pepto-Bismol and Tums together?

Yes, you can generally take Pepto-Bismol and Tums together as they work in different ways to help with digestive issues. There is no known drug interaction between Pepto-Bismol and Tums. However, you may want to consult with a healthcare professional before combining medications to ensure it’s safe for your condition. Consult the packaging or a healthcare provider to determine the right dose to take.

Warnings of Pepto-Bismol and Tums

People 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. Seek medical attention if you experience signs or symptoms of an allergic reaction, such as hives, swelling of the face or throat, or trouble breathing. 

Pepto-Bismol should be avoided in children younger than 12 years of age. Children, especially those who are recovering from chickenpox or influenza, may be at an increased risk of Reye’s syndrome after taking bismuth subsalicylate. With prolonged, high-dose use, Pepto-Bismol may lead to neurotoxicity with symptoms such as tremors, confusion, and 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.

Insurance coverage and cost comparison

Insurance, Medicaid, and Medicare plans rarely cover 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.

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 the medication is prescribed by a doctor.

RELATED: Get the SingleCare discount card

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. Click the coupon buttons to see updated drug prices.

You must have a valid prescription to use a SingleCare coupon. If you have chronic heartburn symptoms, ask your doctor if a prescription is right for you.

By signing up for SingleCare, you can save an extra $3 off your next prescription.

Frequently asked questions about Pepto-Bismol vs. Tums

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 it to make sure it contains the main ingredient 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 work within minutes for fast relief, although they may need to be taken multiple times per day due to their short-acting effects. 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. At the time of publishing, Tums ($0.66 per tablet) is slightly cheaper than Pepto-Bismol ($1.70 per tablet).

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 in recommended doses for indigestion in pregnant women. 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 in moderation may be safe while taking Pepto-Bismol or Tums. However, excessive or chronic alcohol use may irritate the lining of the stomach or intestines, which may worsen the stomach problems that Pepto-Bismol and Tums are designed to relieve. For this reason, you may want to avoid drinking alcohol while taking Pepto-Bismol or Tums.

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 cases of heartburn and indigestion. If you need to use Tums consistently for more than 14 days, consult a healthcare provider, as persistent heartburn may be indicative of a more serious underlying condition. 

Is Pepto Bismol an antacid?

Pepto-Bismol has mild antacid effects to help relieve uncomfortable 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.