Drug information of Bismuth
Mechanism of effect
Bismuth subcitrateappears to act via several mechanisms. It has little acid-neutralizing effect and does not affect acid secretion. It is uncertain whether it affects pepsin secretion, but it does inhibit peptic activity. It causes an increase in mucus glycoprotein secretion and may also bind to the gastric mucus layer to act as a diffusion barrier to HCl.
It accelerates ulcer healing and causes an accumulation of epidermal growth factor around the ulcer. In addition, it has a cytoprotective effect and increases mucosal secretion of prostaglandins and bicarbonate. It has bactericidal effects against Helicobacter pylori (which is associated with gastritis and peptic ulcers).
It also prevents adhesion of H. pylori to epithelial cells and can inhibit enzymes secreted by H. pylori, such as proteases, lipases, glycosidases, and phospholipases.
Bismuth subcitrate is very effective in the treatment of gastroduodenal disorders and appears to act via several mechanisms. It has little acid-neutralizing effect and does not affect acid secretion.
The elimination half-life of bismuth is approximately 5 days. The mean peak whole-blood bismuth level is more than 50 mg/liter and occurred at 30 minutes.
Elimination of bismuth is primarily through urinary and biliary routes. Its Protein binding is over 90%.
Drug indicationspeptic ulcer
Usual Adult Dose for Dyspepsia diarrhea and traveler's diarrhea
524 mg orally every 30 to 60 minutes as needed not to exceed 8 doses in any 24 hour period.
Usual Adult Dose for Helicobacter pylori Infection
524 mg orally 4 times a day.
Usual Pediatric Dose for Diarrhea
Non-specific diarrhea :
<3 years: use with caution
3 to 6 years: 87 mg every 30 minutes to 1 hour as needed.
6 to 9 years: 175 mg every 30 minutes to 1 hour as needed.
9 to 12 years: 262 mg every 30 minutes to 1 hour as needed.
Usual Pediatric Dose for Diarrhea – Chronic
Chronic Infantile Diarrhea :
2 to 24 months: 44 mg every 4 hours
24 to 48 months: 87 mg every 4 hours
48 to 70 months: 175 mg every 4 hours
Drug contraindicationshypersensitivity to drug or its components.
Interactionsinsulin , Phenytoin , probenecid , Tetracycline , Dorzolamide , Methazolamide , Demeclocycline , Ramucirumab , Bromfenac , Gefitinib , Bacampicillin , Nicotine
Before taking Bismuth Subcitrate tell your doctor if you are pregnant or breastfeeding. Using too much Bismuth Subcitrate or using it for too long may cause poisoning. Do not take it for longer than 6 weeks. Large doses may lead to confusion, changes in memory and mood, hallucinations, seizures, and even death.
Points of recommendation
Before using this medication tell your doctor if you are allergic to bismuth salts, are pregnant or plan to become pregnant while using this medicine, are breast feeding, have high blood pressure, liver or kidney problems or heart and blood vessel diseases.