bismuth subnitrate

Action and Spectrum

Actions and Spectrum: 

Action: 

Antidiarrheal: It is commonly used to treat diarrhea because of its ability to create a shield over the inflamed intestinal lining, reducing inflammation and secretions that contribute to diarrhea. 

Antimicrobial: Bismuth subnitrate also possesses some antimicrobial properties, which can help in reducing or inhibiting the growth of certain bacteria in the gastrointestinal tract. 

Spectrum: 

Diarrhea treatment: It helps manage mild to moderate cases of diarrhea, reduces frequency, and improves stool consistency. 

Helicobacter pylori infection: In combination therapy, bismuth subnitrate is utilised to remove Helicobacter pylori, a bacterium that causes peptic ulcers and gastritis. 

Drug Interaction

Adverse Reaction

Frequency not defined  

Blackening of faeces 

Joint toxicity 

Methemoglobinemia 

Vomiting 

Nausea 

Black Box Warning

Black Box Warning:  

None

Contraindication / Caution

Contraindication/Caution:  

Hypersensitivity: Individuals who have previously exhibited hypersensitivity or allergic reactions to bismuth subnitrate or any of its components should avoid its use. 

Renal Impairment: Individuals with kidney disease may need dosage adjustment or avoidance of bismuth subnitrate due to the potential accumulation of the medication. 

Pregnancy and Breastfeeding: There may be limited data on the safety of bismuth subnitrate in pregnant or breastfeeding individuals. Hence, caution should be exercised, and before using it during these times, it is best to take advice from a healthcare provider. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: N/A 

Lactation: Excreted into human milk is unknown 

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology: Bismuth subnitrate is a chemical compound composed of bismuth and nitrate ions used for the treatment of duodenal ulcers and as an anti-diarrheal agent. 

Pharmacodynamics:  

Anti-inflammatory Effect: Bismuth compounds, including bismuth subnitrate, possess mild anti-inflammatory properties. They can help reduce inflammation and irritation in the gastrointestinal tract, which made them useful in managing certain gastrointestinal conditions. 

Mucosal Protection: Bismuth compounds have a mild protective effect on the gastrointestinal mucosa. They can form a protective coating on the mucosal surface, which may help in reducing irritation caused by gastric acid and other irritants.  

Pharmacokinetics: 

Absorption 

Bismuth subnitrate is poorly absorbed in the GI tract. Most of it remains in the gastrointestinal lumen and exerts its effects locally within the gut. Only a minimal amount is absorbed into the systemic circulation. 

Distribution 

Once absorbed, bismuth is distributed throughout the body. It mainly accumulates in the liver, spleen, kidneys, and bone. 

Metabolism 

Bismuth undergoes minimal metabolism in the body. Most of it is eliminated unchanged in the faeces. 

Excretion and Elimination 

The main route of excretion for bismuth subnitrate is via the feces. Some bismuth may also be eliminated through the urine. The plasma half-life is approximately five days. 

Adminstartion

Administration:  

Tablets or Caplets: These are solid forms of the medication that should be swallowed whole with water. As directed by your healthcare provider, adhere to the dose recommendations. 

Liquid/Suspension: Some formulations may come in liquid form. Shake the bottle well before using it to ensure the suspension is mixed correctly. Use an appropriate measuring device to ensure accurate dosage. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: bismuth subnitrate 

Why do we use bismuth subnitrate?  

Bismuth subnitrate is often utilized in antacid formulations and medications for treating various gastrointestinal issues such as indigestion, heartburn, and peptic ulcers. It helps by protecting the stomach lining and reducing acidity. 

It is an active ingredient in some over-the-counter anti-diarrheal medications. Bismuth subnitrate helps alleviate diarrhea symptoms by reducing intestinal inflammation and slowing down bowel movements.