Hidden Salicylates

Sir.—The media has educated the general public about the potential danger of Reye's syndrome with the use of aspirin, especially during influenza or chickenpox. What the media has not warned the public about is that an over-the-counter product may not list aspirin as an ingredient, but it may have salicylates in a combined form. The case in point is Pepto-Bismol, a common over-the-counter item found in many home medicine cabinets. This pleasant-tasting product is commonly used for upset stomach, nausea, and diarrhea. Many family practice physicians and pediatricians prescribe this medication for adults as well as children. In fact, children as young as 3 years old may take this medication. The problem lies in the fact that bismuth subsalicylate is the main ingredient in Pepto-Bismol and yields 130 mg of salicylate per tablespoon. The dosage for children ranges from 1 to 3 teaspoonfuls for up to eight doses a