HomeAnswersInternal Medicinedrug interactionsHow many hours after Xarelto can I take Pepto-Bismol and Ondansetron?

Can Xarelto cause irritable bowel syndrome flare-ups?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At May 7, 2022
Reviewed AtSeptember 16, 2023

Patient's Query

Hello doctor,

I am a healthy 45-year-old female who does not smoke. I had pain in my right calf over the last week. I went to the ER and had blood work done and an ultrasound. It was negative for a blood clot. A few days later, I still had the pain, and it was moving behind my knee, so as a precaution (in case it was a blood clot), my doctor sent me for another ultrasound and had me take a 10 mg dose of Xarelto. He said if the ultrasound showed no clot, I could stop taking the Xarelto. So I took one dose of Xarelto about 50 hours ago. The second ultrasound was also negative for a blood clot, so my doctor said I most likely had a muscle injury and asked me to stop taking the Xarelto.

Also, I have IBS. I think I am having a bit of a flare-up. Pepto-Bismol and Ondansetron often help my stomach pains and nausea. However, I saw online that you should not take Pepto-Bismol if you take Xarelto. I wondered if the Xarelto is out of my system now since it has been 50 hours since I took that one dose? Is it now safe for me to take a Pepto-Bismol? Is it safe to take 4 mg of Ondansetron? If not, how long do I need to wait until I can take those medications? My other medications include Bisoprolol 5 mg, Wellbutrin 150 mg, Dexilant 60 mg, and Marvelon 60 mg. Thank you. Any advice is appreciated.

Hi,

Welcome to icliniq.com.

Tablet Pepto-Bismol is broken down by body metabolism and divided into bismuth salts and salicylates. The bismuth salt's half-life is up to 11 days. But salicylates are the reason for the bleeding. Usually, the half-life of salicylates is six to ten hours. So within two to three days, salicylates are excreted entirely. So that is why you can take the medication after 72 hours. For example, a few high-risk people taking tablet Aminosalicylic acid are advised to stop the drug three to five days before surgery. This is how we prevent bleeding complications. If you still have queries, please feel free to ask. Take care.

Patient's Query

Hello doctor,

Thank you for your response. So should I wait another day before I can take Pepto-Bismol? By then, it will be 72 hours after taking the Xarelto. Can I take Ondansetron now, or do I need to wait another day to take that? Also, is there anything I can take for my nausea and stomach pain due to IBS within two days after taking the Xarelto? Could my IBS be flaring up from taking the Xarelto the other day? Does it cause stomach upset, constipation, or diarrhea? Thank you.

Hi,

Welcome back to icliniq.com.

Yes, you can take a tablet of Ondansetron in case of vomiting. Yes, you can wait another day to take this medication. Yes, tablet Normaxin (Chlordiazepoxide) is very helpful in IBS (Irritable bowel syndrome). You can take this medication after breakfast or dinner. No, tablet Xarelto may not aggravate IBS. Use probiotics along with tablet Normaxin. Use apple cider vinegar (10 ml with 150 ml warm water) before breakfast for IBS. Use L-glutamine 5 mg daily to reduce IBS symptoms. Avoid gluten and lactose contain food. If you still have queries, please feel free to ask. Take care.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Penchilaprasad Kandikattu
Dr. Penchilaprasad Kandikattu

Internal Medicine

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