Bismuth subcitrate

Bismuth subcitrate is a compound used in medicine, primarily as an antiseptic and antiemetic. This compound includes bismuth and citrate, which is the salt representative of citrate acid.

Bismuth subcitrate is commonly used to treat various gastrointestinal disorders such as heartburn, indigestion and diarrhea. It acts protectively on the gastric mucosa, creating a protective layer and reducing irritation.

It is important to note, however, that bismuth subcitrate should only be used under medical supervision, as improper use or overdosage may cause unwanted side effects such as deposition of bismuth in tissues (including the brain), which can lead to toxic effects. p>

Indications Bismuth subcitrate

1. Dyspepsia: Including heartburn, nausea, vomiting, stomach pain and nonspecific dyspepsia (functional digestive disorders).
2. Diarrhea: For short-term or acute diarrhea, especially when it is caused by infection or irritation of the intestinal lining.
3. Gastrointestinal ulcers: As a protective agent for the mucous membrane of the stomach and intestines during peptic ulcers.
4. Prevention of toxic effects of drugs: Including to protect the mucous membrane of the stomach and intestines from the irritating effects of certain drugs, such as nextradol, aspirin and some NSAIDs.
5. Other digestive disorders: Including irritable bowel syndrome and dysbiosis.

Release form

Bismuth subcitrate is usually available in powder or crystal form for the preparation of various dosage forms such as suspensions or tablets. It may also be included in some medications intended to treat various gastrointestinal disorders, including peptic ulcers.

Pharmacodynamics

1. Antimicrobial effect: Bismuth subcitrate has an antimicrobial effect, helping to suppress the growth of various pathogenic microorganisms in the gastrointestinal tract. It may be effective in treating infections caused by Helicobacter pylori, a bacterium that can cause gastric and duodenal ulcers.
2. Anti-inflammatory effect: Bismuth subcitrate also has the ability to reduce inflammation in the mucous membrane of the stomach and intestines. This helps reduce symptoms associated with mucosal irritation and inflammation, such as pain, discomfort and diarrhea.
3. Protective effect on the mucosa: Bismuth subcitrate can form a protective coating on the lining of the stomach and intestines, which helps prevent further irritation and damage.
4. Toxin Binding: Bismuth subcitrate has the ability to bind and neutralize toxins that may be the cause of various gastrointestinal diseases such as irritable bowel syndrome.
5. Stimulate Ulcer Healing: In addition to reducing inflammation and protecting the mucosa, bismuth subcitrate may also promote the healing of ulcers and improve the condition of the mucous membrane after injury.
6. Minimal Absorption: Because bismuth subcitrate has low absorption from the gastrointestinal tract, its action is limited primarily to the gastrointestinal mucosa, thereby minimizing systemic side effects.

Pharmacokinetics

The pharmacokinetics of bismuth subcitrate describes how the body perceives, metabolizes, and excretes this drug. However, given that bismuth subcitrate is commonly used in combination medications, data on its pharmacokinetics may be limited or unavailable.

Dosing and administration

1. Tablets or capsules:

   • The dosage is usually 120-300 mg bismuth subcitrate two or three times a day.
   • Take the tablets or capsules after meals with a full glass of water.
   • Follow package directions or your doctor's orders regarding frequency and duration of treatment.

2. Suspension:

   • If you are using a suspension, it is important to shake the bottle well before each use to ensure even distribution of the drug.
   • Measure the required amount of suspension using the dispenser or measuring spoon provided in the package.
   • Follow your doctor's instructions regarding dosage and frequency.

3. Duration of treatment:

   • The duration of treatment with bismuth subcitrate is determined by your doctor and depends on the nature of your disease and response to treatment. Typically, treatment can last several days or weeks.

Use Bismuth subcitrate during pregnancy

The use of bismuth subcitrate during pregnancy should be discussed with your doctor, since the safety of this drug for pregnant women has not been established. The use of bismuth subcitrate can only be justified if the benefits of use outweigh the potential risks for fetal development.

Contraindications

1. Individual intolerance: People with a known individual intolerance to bismuth subcitrate or any other component of the drug should avoid its use.
2. Allergic reactions: In patients with a history of allergic reactions to bismuth or other drugs containing bismuth, the use of bismuth subcitrate may be contraindicated.
3. Kidney Damage: Due to the fact that bismuth is partially excreted through the kidneys, the use of bismuth subcitrate may be limited or contraindicated in patients with severe kidney disease or impaired kidney function.
4. Pregnancy and breastfeeding: Data on the use of bismuth subcitrate during pregnancy and breastfeeding are limited, so its use during these periods may be contraindicated without consulting a physician.
5. Children: The use of bismuth subcitrate in children may be contraindicated due to insufficient data on efficacy and safety in this age group.
6. Unstudied Conditions: The use of bismuth subcitrate may be contraindicated in patients with certain conditions, such as acute pancreatitis or acute bleeding diathesis, where the safety and effectiveness of its use have not been sufficiently studied.

Side effects Bismuth subcitrate

1. Changes in stool: Including black discoloration of stool (melena), which is common with bismuth. This is due to the formation of bismuth compounds, which color stool black. This is usually temporary and harmless, but may be important in differentiating it from gastrointestinal bleeding.
2. Systemic side effects: Including rare reactions such as allergic reactions, nausea, vomiting, diarrhea and other gastrointestinal disorders.
3. Bismuth Deposition: Long-term or excessive consumption of bismuth can lead to its deposition in the body, which in turn can lead to toxic effects. This may manifest as flu-like symptoms (such as fever, weakness, seizures) or more serious side effects such as kidney and nervous system damage.
4. Other side effects: May include anemia, taste disturbances, skin changes, and rarely arthritis or vasculitis.

Overdose

1. Bismuth Toxicity: An overdose can lead to bismuth toxicity, which manifests itself as a variety of symptoms, including nausea, vomiting, diarrhea, anemia, confusion, shaking, abdominal pain, headaches, incoordination and even extreme cases - more serious complications such as neurological disorders and kidney damage.
2. Activation of systemic inflammation: A systemic inflammatory response may develop, which can lead to damage to organs and body systems.
3. Kidney and Liver Damage: Bismuth can accumulate in the kidneys and liver, which can cause kidney damage and dysfunction.
4. Electrolyte disturbances: Overdose can lead to disturbances in the body's electrolyte balance, including hyperkalemia and hypocalcemia.
5. Cardiac complications: In rare cases, overdose can cause cardiac arrhythmias and heart failure.
6. Convulsive syndrome: Convulsive syndrome may develop.

Interactions with other drugs

1. Tetracyclines and fluoroquinolones: Bismuth subcitrate may reduce the absorption of tetracyclines and fluoroquinolones due to the formation of complexes between them in the stomach.
2. Medicines containing iron or zinc: Bismuth subcitrate may reduce the absorption of iron and zinc due to the formation of insoluble compounds.
3. Salicylate preparations: Bismuth subcitrate can enhance the effect of salicylates, which can lead to an increase in their toxic effect.
4. Antiulcer drugs: Bismuth subcitrate is often used in combination with antacids, proton pump blockers and prokinetics to treat peptic ulcers and dyspepsia. In such combinations the therapeutic effect can be enhanced.
5. Drugs that affect gastric pH: Drugs that alter gastric pH (such as antacids) may affect the solubility of bismuth subcitrate and its ability to form complexes with other substances.