Bismuth Subcitrate

Benign gastric and duodenal ulceration
Adult: 240 mg bid or 120 mg 4 times daily for 4 wk, may be extended to 8 wk if needed. May also be repeated after one mth of drug-free interval.
Renal impairment: Moderate-severe impairment: Avoid use.
H.pylori infection
Adult: 120 mg 4 times daily in combination with other drugs given for 2 wk.
Renal impairment: Moderate-severe impairment: Avoid use.
Moderate-severe renal insufficiency. Pregnancy, child <14 yr.
Warnings / Precautions
Lactation. Monitor renal function regularly.
Adverse Reactions
Darkening of tongue or stools. Nausea, vomiting, bone and joint toxicity.
Potentially Fatal: Possibility of bismuth poisoning and fatal encephalopathy in patients with renal impairment or if given over prolonged periods. Renal failure and liver damage.
Overdose Reactions
Overdosage may lead to serious adverse effects such as renal failure, encephalopathy and neurotoxicity. May consider gastric lavage, purgation and hydration. Chelating agents may be useful.
Drug Interactions
Food, milk, antacids, tetracyclines and H2-receptor antagonists reduce activity of drug.
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Mechanism of Actions
Bismuth subcitrate is used in the management of gastric and duodenal ulcers and specifically against H.pylori as part of a triple drug regimen. It exerts bactericidal action against H.pylori which is accepted to be the causative factor in chronic gastritis and duodenal ulcer.
Absorption: Slightly absorbed (oral); increased absorption with increased gastric pH.
Distribution: Throughout body tissues, bones (absorbed bismuth).
Metabolism: Poorly soluble bismuth compounds are mostly converted to insoluble bismuth oxide, hydroxide and oxychloride in acidic pH of the stomach.
Excretion: Faeces (unabsorbed bismuth); urine (absorbed bismuth); 5 days (plasma half-life).
Storage Conditions
Oral: Store below 25°C.
ATC Classification
A02BX05 - bismuth subcitrate ; Belongs to the class of other drugs used in the treatment of peptic ulcer and gastro-oesophageal reflux disease (GERD).
Oral: Store below 25°C.
Available As
  • Bismuth Subcitrate 0.23 gm
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