Upset Stomach Relief-bismuth Subsalicylate 262 Mg Capsule, Liquid Filled
NDC Package 72090-053-01

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

Upset Stomach Relief-bismuth Subsalicylate 262 Mg (bismuth subsalicylate 262 mg) capsules is a medication used to treat occasional upset stomach, heartburn, and nausea. This formulation utilizes a capsule, liquid filled delivery system. Marketed by Pioneer Life Sciences, Llc, this product is identified by NDC 72090-053 and is authorized under FDA application M008.

Identification & Billing

NDC Package Code
72090-053-01
Package Description
48 CAPSULE, LIQUID FILLED in 1 BOTTLE
Product Code
72090-053
11-Digit Billing Format
72090005301
RxNorm Crosswalk
RxCUI: 2121072 - bismuth subsalicylate 262 MG Oral Capsule

Clinical Specifications

Proprietary Name
Upset Stomach Relief-bismuth Subsalicylate 262 Mg
Non-Proprietary Name
Bismuth Subsalicylate 262 Mg
Substance Name
Bismuth Subsalicylate
Dosage Form
Capsule, Liquid Filled - A solid dosage form in which the drug is enclosed within a soluble, gelatin shell which is plasticized by the addition of a polyol, such as sorbitol or glycerin, and is therefore of a somewhat thicker consistency than that of a hard shell capsule; typically, the active ingredients are dissolved or suspended in a liquid vehicle.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
BISMUTH SUBSALICYLATE 262 mg/1
Usage Information
This medication is used to treat occasional upset stomach, heartburn, and nausea. It is also used to treat diarrhea and help prevent travelers' diarrhea. It works by helping to slow the growth of bacteria that might be causing the diarrhea. This product should not be used to self-treat diarrhea if you also have a fever or blood/mucus in the stools. These could be signs of a serious health condition. Consult your doctor promptly for proper evaluation and treatment if you have these symptoms. This medication is used under a doctor's direction with other medication to treat stomach ulcers caused by a certain bacteria (Helicobacter pylori). Do not use this medication to self-treat ulcers. Bismuth subsalicylate is a salicylate. Salicylates can cause serious bleeding problems when used alone in patients with ulcers. Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.

Regulatory & Marketing

Labeler Name
Pioneer Life Sciences, Llc
Product Type
Human Otc Drug
FDA Application #
M008
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
06-27-2025
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 72090-053-01 identifies a specific commercial package of 48 capsule, liquid filled in 1 bottle of Upset Stomach Relief-bismuth Subsalicylate 262 Mg, a human over the counter drug labeled by Pioneer Life Sciences, Llc. This capsule, liquid filled is formulated for oral use and contains bismuth subsalicylate as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Pioneer Life Sciences, Llc on June 27, 2025. The current certification is valid through December 31, 2026.

What are the primary indications for this medication?

This medication is used to treat occasional upset stomach, heartburn, and nausea. It is also used to treat diarrhea and help prevent travelers' diarrhea. It works by helping to slow the growth of bacteria that might be causing the diarrhea. This product should not be used to self-treat diarrhea if you also have a fever or blood/mucus in the stools. These could be signs of a serious health condition. Consult your doctor promptly for proper evaluation and treatment if you have these symptoms. This medication is used under a doctor's direction with other medication to treat stomach ulcers caused by a certain bacteria (Helicobacter pylori). Do not use this medication to self-treat ulcers. Bismuth subsalicylate is a salicylate. Salicylates can cause serious bleeding problems when used alone in patients with ulcers. Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.

How is this Pioneer Life Sciences, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 72090005301. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
72090-053-01
11-Digit CMS (5-4-2)
72090-0053-01

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.