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Kaopectate, known medically as bismuth subsalicylate in the United States and attapulgite in Canada, is an orally taken medication from Chattem, Inc. for the treatment of mild diarrhea. It is also sometimes used to treat indigestion, nausea and stomach ulcers. In the U.S., kaopectate is now equivalent to a tableted form of Pepto-Bismol, and is no longer made from kaolinite and pectin.
Children should not take medication with bismuth subsalicylate while recovering from influenza or chicken pox, as epidemiologic evidence points to an association between the use of salicylate-containing medications during certain viral infections and the onset of Reye's syndrome. For the same reason, it is typically recommended that nursing mothers not use medication containing bismuth subsalicylate because small amounts of the medication are excreted in breast milk and pose a theoretical risk of Reye's syndrome to nursing children.
The active ingredient in Kaopectate has changed since its original creation. Originally, kaolinite was used as the adsorbent and pectin as the emollient. Attapulgite (a type of absorbent clay) replaced the kaolinite in the 1980s, but was found to be unproven as to effectiveness by the FDA in a ruling made in April of 2003. As a consequence, since 2004, bismuth subsalicylate has been used as the active ingredient in U.S. marketed products. In Canada, McNeil Consumer Healthcare continues to market Kaopectate using attapulgite as the active ingredient.
The U.S. Food and Drug Administration (FDA) does not have a clear stance on the administration of Kaopectate products on animals such as dogs and cats that are suffering from diarrhea. However, the Journal of the American Veterinary Medical Association Journal news article noted in 2003 that the new subsalicylate formulation might be harmful to cats, which do not tolerate salicylates well. Kaolin-pectate, the original compound, was approved by the OTA (Organic Trade Association) for use in animals being produced for food.