Colloidal bismuth subcitrate. Bismuth preparations – pharmacological basis of clinical effect. Overdose of bismuth tripotassium dicitrate

LP-004536-131117

Trade name of the drug:

Bismuth tripotassium dicitrate

International nonproprietary name:

bismuth tripotassium dicitrate

Dosage form:

film-coated tablets

Compound:

for 1 tablet:
active substance: bismuth tripotassium dicitrate - 304.6 mg, in terms of bismuth oxide - 120.0 mg.
Excipients: corn starch - 71.1 mg; potassium polyacrylate - 23.6 mg; povidone-K25 - 17.7 mg; macrogol-6000 - 6.0 mg; magnesium stearate - 2.0 mg.
Shell composition: hypromellose - 5.5 mg; titanium dioxide - 3.0 mg; macrogol-4000 - 1.5 mg.

Description:

round, biconvex, film-coated tablets, white or almost white, odorless or with a slight characteristic odor. On a cross section, two layers are visible: the core is white or white with a yellowish tint and the film shell.

Pharmacotherapeutic group:

antiulcer, antiseptic intestinal and astringent.

ATX code:

А02ВХ05

Pharmacological properties

Pharmacodynamics

Gastroprotective and antiulcer agent with bactericidal activity against Helicobacter pylori. It also has anti-inflammatory and astringent effects.
In the acidic environment of the stomach, insoluble bismuth oxychloride and citrate precipitate, and chelate compounds with the protein substrate are formed in the form of a protective film on the surface of ulcers and erosions. Thus, the drug forms a protective layer, which for a long period of time protects the affected areas of the mucous membrane from the influence of aggressive factors. By increasing the synthesis of prostaglandin E, mucus formation and bicarbonate secretion, it stimulates the activity of cytoprotective mechanisms, increases the resistance of the gastrointestinal mucosa to the effects of pepsin, hydrochloric acid, enzymes and bile salts. Leads to the accumulation of epidermal growth factor in the defect area. Reduces the activity of pepsin and pepsinogen.

Pharmacokinetics
Practically not absorbed from the gastrointestinal tract. It is excreted mainly in feces. A small amount of bismuth entering the plasma is excreted from the body by the kidneys.

Indications for use

functional dyspepsia not associated with organic diseases of the gastrointestinal tract;
chronic gastritis and gastroduodenitis in the acute phase, including those associated with Helicobacter pylori;
peptic ulcer of the stomach and duodenum in the acute phase, including those associated with Helicobacter pylori;
irritable bowel syndrome, which occurs predominantly with symptoms of diarrhea.

Contraindications

increased individual sensitivity to the components of the drug;
pregnancy;
breastfeeding period;
taking medications containing bismuth;
chronic renal failure;
children under 4 years of age.

Use during pregnancy and breastfeeding

Bismuth tripotassium dicitrate is contraindicated for use in pregnant women. If it is necessary to use the drug during lactation, breastfeeding should be stopped.

Directions for use and doses

Inside. The duration of the course of treatment and the dose of the drug are determined by the attending physician individually for each patient, depending on the nature of the disease.
Adults and children over 12 years old the drug is prescribed 1 tablet 4 times a day, 30 minutes before meals (breakfast, lunch, dinner) and at night, or 2 tablets 2 times a day 30 minutes before meals (breakfast, dinner).
Children aged 8 to 12 years Prescribe 1 tablet 2 times a day, 30 minutes before meals (breakfast, dinner).
Children aged 4 to 8 years prescribed at a dose of 8 mg/kg/day; Depending on the child’s body weight, 1-2 tablets are prescribed per day (respectively, in 1-2 doses per day).
In this case, the daily dose should be as close as possible to the calculated dose (8 mg/kg/day).
The tablets are taken 30 minutes before meals with a small amount of water. It is recommended to swallow the tablet whole, without chewing or crushing, with a sufficient amount of water. It is not recommended to take the tablets with milk.
The duration of treatment is usually from 4 to 8 weeks. After finishing taking the drug, it is not recommended to take medications containing bismuth (for example, Vikalin, Vikair) for 2 months.
For eradication Helicobacter pylori It is advisable to use bismuth tripotassium dicitrate in combination with antibacterial drugs with anti-Helicobacter activity.
If there is no improvement during treatment, you should consult a doctor. Use the drug only according to the method of use and in the doses indicated in the instructions. If necessary, please consult your doctor before using the medicine.

Side effect

The following adverse events noted with the use of bismuth tripotassium dicitrate are distributed according to the frequency of occurrence in accordance with the following gradation: very often (> 1/10); often (> 1/100,<1/10); нечасто (> 1/1 000, <1/100); редко (> 1/10 000, <1/1 000); очень редко (<1/10 000).
From the gastrointestinal tract: very often - black stool; uncommon - nausea, vomiting, diarrhea or constipation.
Allergic reactions: uncommon - skin rash, itching; very rarely - anaphylactic reactions.
From the nervous system: very rarely - with long-term use in high doses - encephalopathy associated with the accumulation of bismuth in the central nervous system.
Side effects are reversible and disappear quickly after discontinuation of the drug.
If any of the side effects indicated in the instructions get worse, or you notice any other side effects not listed in the instructions, tell your doctor.

Overdose

When using the drug in doses tens of times higher than recommended, or with prolonged use of excessive doses of the drug, bismuth poisoning may develop.
Symptoms: dyspepsia, rash, inflammation of the oral mucosa, characteristic darkening in the form of blue lines on the gums; with long-term use in doses exceeding the recommended ones, renal function may be impaired.
These symptoms are completely reversible when the drug is discontinued.
Treatment: There is no specific antidote. In case of an overdose of the drug, gastric lavage, intake of enterosorbents and symptomatic therapy aimed at maintaining night function are indicated. In case of overdose, the administration of saline laxatives is also indicated. Further treatment should be symptomatic. In case of impaired renal function, accompanied by a high level of bismuth in the blood plasma, complexing agents - dimercaptosuccinic and dimercaptopropanesulfonic acids - can be administered. With the development of severe renal dysfunction, hemodialysis is indicated.

Interaction with other drugs

For half an hour before and half an hour after taking the drug, it is not recommended to take other medications internally, as well as take food and liquids, in particular antacids, milk, fruits and fruit juices. This is due to the fact that when taken orally simultaneously, they can affect the effectiveness of bismuth tripotassium dicitrate.
The drug reduces the absorption of tetracyclines.
The drug is not used simultaneously with other drugs containing bismuth, since the simultaneous use of several bismuth drugs increases the risk of side effects, including the risk of encephalopathy.

special instructions

The drug should not be used for more than 8 weeks. It is not recommended to exceed the established daily doses for adults and children during treatment. During treatment with the drug, you should not use other drugs containing bismuth (see section “Interaction with other drugs”). At the end of a course of treatment with the drug in recommended doses, the concentration of the active substance in the blood plasma does not exceed 3-58 mcg/l, and intoxication is observed only at concentrations above 100 mcg/l.
When using bismuth tripotassium dicitrate, stool may turn dark due to the formation of bismuth sulfide.
Sometimes there is a slight darkening of the tongue.
Alcohol consumption is not recommended during therapy.

Impact on the ability to drive vehicles and machinery

There are no data on the effect of the drug Bismuth tripotassium dicitrate on the ability to drive vehicles and operate machinery.

Release form

Film-coated tablets 120 mg.
7, 10, 14, 28, 30 tablets in blister packs made of polyvinyl chloride film and printed varnished aluminum foil.
7, 10, 14, 20, 28, 30, 50, 56, 60, 100, 112, 160 or 240 tablets in polyethylene terephthalate jars for medicines or polypropylene for medicines, sealed with high-density polyethylene lids with first opening control , or polypropylene lids with a “push-turn” system or low-density polyethylene lids with first-opening control.
One can or 1, 2, 3, 4, 5, 6, 7, 8, 10 or 16 blister packs along with instructions for use are placed in a cardboard package (pack).

Storage conditions

At a temperature not higher than 25°C.
Keep out of the reach of children.

Best before date

3 years. Do not use after expiration date.

Vacation conditions

Available without a prescription.

Manufacturer

Ozon Pharm LLC

Address of the place of production, including for correspondence and receipt of claims:
445143, Russia, Samara region, Stavropol district, village. Podstepki, territory of the SEZ PPT, Highway No. 3, site No. 11, building No. 1.

Bismuth tripotassium dicitrate(lat. bismuthate tripotassium dicitrate) - gastroprotective, antiulcer, antibacterial drug. Other name: colloidal bismuth subcitrate.

Chemical compound: bismuth (III) potassium 2-hydroxy-1,2,3-propanetricarboxylate (salt 1:3:2). The empirical formula is C 12 H 10 BiK 3 O 14.

Bismuth tripotassium dicitrate - international nonproprietary name (INN) of the drug. According to the pharmacological index of bismuth, tripotassium dicitrate belongs to the group “Antacids and adsorbents”. According to ATC - to the group “Antiulcer drugs and drugs for the treatment of gastroesophageal reflux” and has code A02BX05.

Bismuth tripotassium dicitrate (subcitrate) has a pronounced enveloping effect . In the acidic environment of the gastrointestinal tract, bismuth subcitrate forms a protective film on the surface of the damaged mucous membrane of the stomach and duodenum, which promotes scarring of ulcers and protects against the effects of hydrochloric acid and pepsin. In addition, bismuth subcitrate stimulates the synthesis of prostaglandin E 2, which, in turn, stimulates the formation of mucus and the secretion of bicarbonates and leads to the formation and accumulation of epidermal growth factor in the damaged area, which also improves the healing of erosions and ulcers.

Bismuth tripotassium dicitrate can accumulate inside bacteria Helicobacter pylori, resulting in the destruction of the cytoplasmic membranes of the bacterium and its death. That's why bismuth tripotassium dicitrate often used in various HP eradication schemes . At the same time, bismuth tripotassium dicitrate, unlike other drugs containing bismuth, in particular, bismuth subnitrate and bismuth subsalicylate, is able to dissolve in mucus, which allows bismuth to penetrate under the layer of gastric or duodenal mucus, to the location of the maximum number of bacteria Hp. In addition, bismuth prevents the adhesion of Hp to the epithelium of the stomach and duodenum.

Additional inclusion in treatment regimens Helicobacter pylori bismuth tripotassium dicitrate (bismuth subcitrate) increases the frequency of HP eradication without increasing side effects.

Indications for taking medications with bismuth tripotassium dicitrate

How to take bismuth tripotassium dicitrate

Preparations with bismuth tripotassium dicitrate are taken half an hour before breakfast, lunch, dinner and bedtime, 120 mg, washed down with 1-2 sips of water. Duration of treatment is from 4 to 6 weeks. According to indications - up to 8 weeks. After the end of the cycle, a break of 8 weeks is required, during which any medications containing bismuth should be avoided.

Bismuth tripotassium dicitrate and eradication of Helicobacter pylori

The World Health Organization classifies bismuth tripotassium dicitrate as an active drug in relation to Helicobacter pylori, along with several antibacterial agents (Podgorbunskikh E.I., Maev I.V., Isakov V.A.).

The very widespread and incorrect use of common antibacterial agents has led to increased resistance to them Helicobacter pylori. The choice of eradication regimen depends on the presence of individual intolerance by patients to specific drugs, as well as the sensitivity of the strains Helicobacter pylori to these medications. Therefore, as a basic drug for eradication Helicobacter pylori Tripotassium bismuth dicitrate has become increasingly used. In recommendations for eradication Helicobacter pylori set out in the Standards for the diagnosis and treatment of acid-dependent and Helicobacter pylori-associated diseases adopted by the Scientific Society of Gastroenterologists of Russia in 2010, bismuth tripotassium dicitrate is used in both first and second line regimens (the numbering of options is given in accordance with the mentioned Standards):

Line 1. Option 2. One of the standard dosage proton pump inhibitors (PPIs) (omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg, esomeprazole 20 mg, rabeprazole 20 mg twice daily) and amoxicillin (500 mg 4 times daily or 1000 mg twice daily) per day), bismuth tripotassium dicitrate 120 mg 4 times a day or 240 mg 2 times a day in combination with clarithromycin (500 mg 2 times a day), or josamycin (1000 mg 2 times a day), or nifuratel (400 mg 2 times a day) times a day) for 10–14 days.
Line 1. Option 3 (in the presence of atrophy of the gastric mucosa with achlorhydria, confirmed by pH-metry). Amoxicillin (500 mg 4 times a day or 1000 mg 2 times a day) in combination with clarithromycin (500 mg 2 times a day) or josamycin (1000 mg 2 times a day), or nifuratel (400 mg 2 times a day) day), and bismuth tripotassium dicitrate (120 mg 4 times a day or 240 mg 2 times a day) for 10-14 days.

Note. If the ulcer persists according to the results of control endoscopy on days 10–14 from the start of treatment, it is recommended to continue therapy with tripotassium bismuth dicitrate (120 mg 4 times a day or 240 mg 2 times a day) and/or PPI at half the dose for 2– 3 weeks. Prolonged therapy with bismuth tripotassium dicitrate is also indicated in order to improve the quality of the post-ulcer scar and speedy reduction of the inflammatory infiltrate.

Line 1. Option 4 (recommended only for elderly patients in situations in which full-fledged anti-Helicobacter therapy is impossible):

Standard dose PPI in combination with amoxicillin (500 mg 4 times daily or 1000 mg twice daily) and tripotassium bismuth dicitrate (120 mg 4 times daily or 240 mg twice daily) for 14 days
bismuth tripotassium dicitrate 120 mg 4 times a day for 28 days. If there is pain - a short course of PPI. Performed in the absence of eradication Helicobacter pylori after first line therapy.

Line 2(performed in the absence of eradication Helicobacter pylori after first line therapy ). Option 1. One of the PPIs in a standard dosage, bismuth tripotassium dicitrate 120 mg 4 times a day, metronidazole 500 mg 3 times a day, tetracycline 500 mg 4 times a day for 10-14 days.
Line 2. Option 2. One of the standard dosage PPIs, amoxicillin (500 mg 4 times a day or 1000 mg 2 times a day) in combination with a nitrofuran drug: nifuratel (400 mg 2 times a day) or furazolidone (100 mg 4 times a day) and bismuth Tripotassium dicitrate (120 mg 4 times a day or 240 mg 2 times a day) for 10–14 days.
Line 2. Option 3. One of the standard dosage PPIs, amoxicillin (500 mg 4 times a day or 1000 mg 2 times a day), rifaximin (400 mg 2 times a day), bismuth tripotassium dicitrate (120 mg 4 times a day) for 14 days.

Based on comparative studies performed on the use of different HP eradication regimens in pediatrics, data were obtained confirming that the use of bismuth tripotassium dicitrate in these regimens in children is effective, safe and economically justified. The best clinical and economic effectiveness, as follows from the economic examination of various schemes, has the scheme: bismuth tripotassium dicitrate + furazolidone + amoxicillin (Belousova Yu.B. et al.).

It is important that this bactericidal effect of bismuth tripotassium dicitrate, in contrast to the action of most antibacterial agents, manifests itself against both vegetative and coccal forms Helicobacter pylori. The use of bismuth preparations as part of eradication therapy allows one to overcome resistance Helicobacter pylori, to metronidazole and clarithromycin. An important circumstance is the complete absence of strains Helicobacter pylori resistant to bismuth salts. Bismuth tripotassium dicitrate also reduces the activity of pepsin and pepsinogen, probably due to the binding of pepsin, and at acidic pH values it is able to bind bile acids, which is most important in the case of duodenogastroesophageal reflux. In addition, bismuth tripotassium dicitrate significantly increases the secretion of prostaglandins and bicarbonates in the stomach and duodenum, the formation of mucus, stimulates the activity of cytoprotective mechanisms and increases the resistance of the mucous membrane to the effects of aggressive factors, such as: hydrochloric acid, pepsin, enzymes, bile salts (Balukova E.V.).

During eradication Helicobacter pylori monotherapy bismuth preparations are not used . The effect can be achieved only when using bismuth preparations as part of a complex regimen of several drugs. "Maastricht-IV" recommends only four-component regimens with bismuth preparations and, in most cases (not always), as second-line regimens (if the first line fails), alternative, etc. (Isakov V.A.).

Professional medical publications concerning the effects of bismuth tripotassium dicitrate on the gastrointestinal tract

Balukova E.V. Possibilities of bismuth preparations in the treatment of gastroesophageal reflux disease // Therapy. – 2017. - No. 7 (17). pp. 102-108.

Belousova Yu.B., Karpov O.I., Belousov D.Yu., Beketov A.S. Pharmacoeconomics of the use of bismuth tripotassium dicitrate for peptic ulcer disease // Therapeutic archive. - 2007. - No. 2. – T. 79. – p. 1–9.

Khavkin A.I., Zhikhareva N.S., Drozdovskaya N.V. Drug therapy for peptic ulcer in children // Attending physician. - 2006. - No. 1. - With. 26–30.

Grigoriev P.Ya., Yakovenko E.P., Soluyanova I.P., Abdulzhapparova M.L., Talanova E.V., Usankova I.N., Pryanishnikova A.S., Agafonova N.A., Gulyaev P. .V., Yakovenko A.V., Vasiliev I.V., Obukhovsky B.I. Modern methods of therapy for peptic ulcer disease, their effectiveness and cost // Experimental and clinical gastroenterology. - 2003. - No. 3. – p. 21–25.

Standards for the diagnosis and treatment of acid-dependent and Helicobacter pylori-associated diseases (4th Moscow agreement) were adopted by the X Congress of the National Regional State Register on March 5, 2010 // Experimental and clinical gastroenterology. – 2010. – No. 5. – pp. 113–118.

Samsonov A.A., Maev I.V., Ovchinnikova N.I., Shakh Yu.S., Podgorbunskikh E.I. The effectiveness of using colloidal bismuth subcitrate in Helicobacter pylori eradication therapy regimens for duodenal ulcer // RZHGGK. 2004. No. 4. pp. 30–35.

On the website in the “Literature” section there are subsections “Gastroprotectors, cytoprotectors, hepatoprotectors, esophagoprotectors” and “Diseases of the stomach and duodenum (DPC)”, containing articles for healthcare professionals on relevant topics.

Bismuth tripotassium dicitrate is not absorbed into the blood from the gastrointestinal tract. However, during the entire period of treatment, a small amount of bismuth may break off from the colloid and enter the blood. Bismuth that enters the blood is excreted in the urine and its concentration in plasma decreases rapidly after treatment. Bismuth tripotassium dicitrate is excreted primarily in the feces.

Side effects: possible nausea, vomiting, more frequent bowel movements, rarely - skin rash, itching.

During pregnancy and breastfeeding, as well as in cases of impaired renal function, taking bismuth tripotassium dicitrate (bismuth subcitrate) is not recommended.

Special instructions.

Long-term use of large doses of bismuth tripotassium dicitrate can cause reversible encephalopathy.
Half an hour before and half an hour after taking bismuth tripotassium dicitrate, it is not recommended to drink any drinks, milk, eat food or antacids.
Alcoholic drinks are prohibited during therapy with bismuth tripotassium dicitrate.
When treating bismuth with tripotassium dicitrate, the stool may turn black.

In case of overdose Reversible renal failure may develop, symptoms of which may appear after 10 days of taking large doses of bismuth subcitrate and later.

Interaction with other drugs: When used together, bismuth tripotassium dicitrate reduces the absorption of tetracycline. When using bismuth tripotassium dicitrate simultaneously with other drugs containing bismuth, the risk of increasing the concentration of bismuth in the blood increases.

Medicines with bismuth tripotassium dicitrate

Trade names of drugs with active ingredients bismuth tripotassium dicitrate currently* registered in Russia: Vicanol Life, Bismuth tripotassium dicitrate, Vitridinol, De-Nol

Instructions for medical use of the drug Ulcavis

By Order of the Government of the Russian Federation of December 30, 2009 No. 2135-r, bismuth tripotassium dicitrate (coated tablets) is included in List of vital and essential medicines.

Bismuth tripotassium dicitrate has contraindications, side effects and application features; consultation with a specialist is necessary.

Description of Bismuth Tripotassium Dicitrate

Pharmacological group: this drug is an organotropic/gastrointestinal drug/gastroprotector.

Pharmacology

Insoluble bismuth citrate and oxychloride are precipitated in the gastric juice, while chelate compounds are formed with the protein substrate, which, covering the surface of the ulcer, help protect it from acid, pepsin and bile. Bismuth tripotassium dicitrate is able to coagulate protein compounds and destroy Helicobacter pylori.

When taken orally, the drug is practically not absorbed into the gastrointestinal tract and is excreted in the intestines along with feces. Only a small part of bismuth is separated from the colloidal complex and absorbed into the blood, after which it is excreted in the urine by the kidneys.

Bismuth tripotassium dicitrate maintains the integrity and restores the protective function of the barrier of the gastric mucosa, heals peptic ulcers, and helps reduce the frequency of relapses of duodenal ulcers. In addition, this drug is able to have a stimulating effect on the production of prostaglandin E2, which increases the secretion of bicarbonate and mucus formation, improves the production of mucin and the quantitative and qualitative characteristics of gastric mucus. In the area of mucosal defect, bismuth tripotassium dicitrate leads to the accumulation of epidermal growth factor.

Moreover, the drug can reduce the activity of pepsinogen and pepsin. Bismuth tripotassium dicitrate covers the entire surface of the ulcer with a white foamy coating, which persists for several hours; in patients who took the drug three hours before surgery, a thin white layer forms only on the craters of the ulcers. With monotherapy with this drug, Helicobacter pylori disappears only in 30% of cases, when combined with metronidazole or amoxicillin - in 90% of cases.

If the drug is used in large doses for a long time in patients who suffer from impaired renal function, there is a possibility of reversible encephalopathy.

Indications for use of bismuth tripotassium dicitrate

The drug is prescribed to patients suffering from exacerbation of gastric and duodenal ulcers, including a disease that is associated with Helicobacter pylori; exacerbation of chronic gastroduodenitis and gastritis, including those associated with Helicobacter pylori; functional dyspepsia not associated with organic gastrointestinal diseases; irritable bowel syndrome, which occurs with symptoms of diarrhea.

Contraindications bismuth tripotassium dicitrate

The drug is contraindicated for people with hypersensitivity, as well as pregnant women and nursing mothers, and patients with severe impairment of the functional state of the kidneys.

Bismuth tripotassium dicitrate instructions for use

This drug is taken orally. Patients over 12 years of age are prescribed 120 mg 4 times a day 30 minutes before meals and the last time before bedtime, or 240 mg twice a day. Children from 8 to 12 years old should take the drug 120 mg twice a day. Children from 4 to 8 years old are prescribed 8 mg/kg twice a day. The course of treatment lasts from 4 to 8 weeks, and over the next eight weeks you should not take medications that contain bismuth. You can repeat the course of treatment after 2 months.

To remove Helicobacter pylori, you should take orally a combination of bismuth tripotassium dicitrate with metronidazole - 250 mg 4 times a day, and amoxicillin 250 mg 4 times a day for 10 days.

It is not recommended to use large doses of the drug for a long time. You should not take bismuth tripotassium dicitrate for more than 8 weeks. In addition, you should not exceed the daily dose of the drug prescribed by your doctor. During treatment with this drug, it is not allowed to take other drugs containing bismuth. After completion of the course of treatment, the blood plasma contains no more than 3-58 µg/l of the active substance, while intoxication can be observed only if the plasma level of the active substance is more than 100 µg/l.

When using bismuth tripotassium dicitrate, stool may become dark in color due to the formation of bismuth sulfide, and slight darkening of the tongue is also possible. While undergoing treatment with this drug, it is not recommended to drink alcohol. 30 minutes before and after taking the drug, you should refrain from eating solid food, antacids, drinks (juices, milk).

Use during lactation and pregnancy

The drug is contraindicated for use by pregnant women and nursing mothers. If you need to take the drug, you should stop breastfeeding for a while.

Overdose of bismuth tripotassium dicitrate

In case of overdose, renal failure may develop. In this case, it is necessary to do a gastric lavage, take saline laxatives and activated charcoal. Patients with impaired renal function, accompanied by high plasma levels of bismuth, must be administered complexing agents containing SH groups - dimercaptosuccinic and dimercaptopropanesulfonic acids. If the patient suffers from severe renal failure, there is a need for hemodialysis.

Side effects of bismuth tripotassium dicitrate tablets

Side effects include nausea, vomiting, increased bowel movements, and constipation. Allergic reactions often occur - skin rash and itching.

With long-term use of the drug in large doses, the development of encelophalopathy associated with the accumulation of bismuth in the central nervous system is possible.

Drug interactions

This drug reduces the absorption of tetracycline. Medicines containing bismuth can increase the likelihood of developing systemic side effects when used simultaneously with bismuth tripotassium dicitrate. For half an hour before and after taking the drug, it is not recommended to take other drugs orally, as well as liquids and food, especially antacids, milk, fruits, because when taken together they can affect the effectiveness of the drug.

Bismuth tripotassium dicitrate analogues

Among the analogue drugs, the following can be noted: Denol and Novobismol.

Bismuth tripotassium dicitrate price

The cost of this drug ranges from 400 to 735 rubles.

Bismuth tripotassium dicitrate review

More than two years ago I had an intestinal disorder, which was also accompanied by nausea, diarrhea, stomach pain and high fever.

Indigestion and other digestive problems can hardly be considered a rarity, since no one is immune from such disorders, regardless of age and gender. Fortunately, modern medicine offers a lot of medicines, including adsorbents. Bismuth tripotassium dicitrate (pharmacological name of the drug is “De-Nol”) is considered quite good. So what properties does this product have? Is it safe to treat children? What is its cost? These questions are of interest to many readers.

Release form of the medicine

The drug is produced in the form of white oval tablets. The main active substance is bismuth tripotassium dicitrate. The tablets are placed in blisters of 8 pieces. You can purchase a pack of 7 or 14 blisters at the pharmacy.

Of course, the drug also contains some auxiliary components, including povidone, corn starch, magnesium stearate, macrogol 6000.

Pharmacological properties of the drug

The active substance of the drug has pronounced anti-inflammatory and astringent properties. Once in the acidic environment of the stomach, bismuth tripotassium dicitrate is converted to bismuth citrate and bismuth oxychloride. Subsequently, these substances form so-called chelate complexes, which settle on the surface of the damaged mucous membrane, acting as a protective film.

In addition, the drug activates the protective mechanisms of the gastric mucosa and stimulates the secretion of mucus and bicarbonate. Thus, the medicine protects the mucous membrane of the digestive tract from the effects of aggressive acids, enzymes and salts. Moreover, during therapy, there is a decrease in the activity of pepsinogen and pepsin, as well as the accumulation of epidermal growth factor in the area of damage to the mucous membrane, which, in turn, promotes tissue repair processes.

Bismuth dicitrate has a detrimental effect on Helicobacter. This compound accumulates inside the microorganism, which subsequently leads to the destruction of the cytoplasmic membrane of the cell and its death. By the way, the medicine penetrates under the layer of duodenal mucus - this is where the concentration of bacteria is greatest. That is why the drug is more effective than similar products.

The medicine is practically not absorbed by the walls of the digestive system and does not penetrate the bloodstream. It is excreted unchanged from the body along with feces. However, with long-term use, bismuth can accumulate in the central nervous system.

Indications for use

A medicine containing bismuth tripotassium dicitrate is quite often used in medicine. In particular, it is prescribed for irritable bowel syndrome, especially if it is accompanied by bouts of diarrhea. The drug also helps with indigestion, if the cause is not organic damage to the gastrointestinal tract.

Indications for use are also exacerbations of gastroduodenitis and chronic gastritis. This remedy is effective in the treatment of ulcerative lesions of the digestive tract caused by Helicobacter pylori.

The drug "De-Nol" (bismuth tripotassium dicitrate): instructions for use

Of course, first of all, patients are interested in how to take this or that medication correctly. Only a doctor can prescribe a medicine containing bismuth tripotassium dicitrate. The instructions for use contain all the necessary recommendations.

For example, adult patients are usually prescribed to take one tablet four times a day or two tablets twice a day. It is advisable to drink them 30 minutes before meals or before bed. It is better to take the tablets with plenty of water.

For children aged 8 to 12 years, the daily dose is 240 mg of the active substance. Bismuth tripotassium dicitrate should be taken one tablet twice a day. If we are talking about patients 4-8 years old, then the daily dose depends on body weight - 8 mg per kilogram. The full dose should be divided into two doses.

The duration of treatment depends on many factors, but, as a rule, therapy lasts 1-2 months. After stopping treatment, you should not take medications containing bismuth for another 2 months, as this substance accumulates in the body.

Contraindications for use

Many people are interested in whether all categories of patients can take medicine containing bismuth tripotassium dicitrate? The instructions state that there are some contraindications, although there are not many of them. In particular, it is not recommended for pregnant women, as well as new mothers while breastfeeding. Individual hypersensitivity to this substance is also a contraindication. It should also not be used to treat patients suffering from kidney failure.

Are there possible complications during therapy?

So, the doctor prescribed De-Nol for you. What complications can this drug cause? Bismuth tripotassium dicitrate, or rather drugs in which it is the main active substance, extremely rarely lead to the development of side effects. However, some complications are still possible, so it is worth familiarizing yourself with the list of them. During therapy, disorders of the digestive system may occur, including nausea, constipation, diarrhea and vomiting. In some patients, the medicine causes allergic reactions, which are manifested by skin itching, redness, rashes, and swelling.

You should be very careful when taking this drug for a long time, since bismuth tends to accumulate in nerve tissues, which, in turn, can lead to the development of encephalopathy.

Analogs and other drugs with the same properties

Of course, on the modern pharmaceutical market there are many drugs containing bismuth tripotassium dicitrate. Analogues that have the same properties but have a different composition also exist. But only a doctor can select the appropriate remedy, taking into account the characteristics of your body, the form of the disease, etc. If we are talking about drugs containing the same bismuth compound, then their list includes “Bisnol”, “Tribimol”, “Ventrisone” " and "Trimo".

Quite good sorbents are drugs such as Almagel, Enterol and Enterosgel. If we are talking about digestive disorders associated with diseases of the stomach, liver or pancreas, Gastal, Pepsan and Heptaral will be effective, which will help relieve symptoms such as indigestion and nausea. Motilium will help eliminate unpleasant dyspeptic symptoms. Some of these drugs are more expensive, some have a milder effect, in any case, there is a choice, and quite a large one.

How much does the medicine cost?

For many people, cost is low on the list. So how much will the drug “De-Nol”, which contains bismuth tripotassium dicitrate, cost? The price, of course, will depend on the pharmacy whose services you use, place of residence, manufacturer, etc.

The cost of a package of 56 tablets ranges from 390 to 470 rubles. If we are talking about a box of 112 pieces, then its price is about 650-700 rubles. Considering the fact that one package is enough for a full course of treatment, the cost of the drug can be considered quite affordable.