Bismuth Salts
Class: Antidiarrhea Agents
VA Class: GA208
Chemical Name: Bismuth pentapotassium dihydroxide bis(2-hydroxypropane-1,2,3-tricarboxylate hydrate
Molecular Formula: C12H14BiK5O17C7H5BiO6C7H5BiO4
CAS Number: 880149-29-1
Brands: Bismatrol, Devrom, Diotame, Kaopectate, Kao-Tin, Peptic Relief, Pepto-Bismol, Pylera
Introduction
Antidiarrhea agent; antidyspepsia agent; internal deodorant.
Antiulcer agent (as part of multiple-drug regimens for Helicobacter pylori infection).
Uses for Bismuth Salts
Diarrhea
Bismuth subsalicylate used as self-medication in children and adults for symptomatic control of acute nonspecific diarrhea and travelers’ diarrhea.
Bismuth subsalicylate has been used in adults for prevention of travelers’ diarrhea†; however, less effective than anti-infective agents.
Helicobacter pylori Infection and Duodenal Ulcer Disease
Bismuth subsalicylate used for treatment of Helicobacter pylori infection and duodenal ulcer disease (active disease or history of duodenal ulcer); eradication of H. pylori shown to reduce the risk of duodenal ulcer recurrence.
Bismuth subsalicylate used in multiple-drug regimens that also include metronidazole, tetracycline hydrochloride, and a histamine H2-receptor antagonist or proton-pump inhibitor (quadruple therapy); such drug combinations recommended by the American College of Gastroenterology (ACG) as first-line treatment option for eradication of H. pylori infection. ACG recommends consideration of such quadruple-drug regimens in penicillin-allergic patients and those who have previously received a macrolide antibiotic. If the initial 14-day regimen does not eradicate H. pylori, retreat with multiple-drug regimen that does not include metronidazole to avoid possible development of metronidazole resistance.
Multiple-drug regimens including bismuth subsalicylate, metronidazole, tetracycline hydrochloride, and a proton-pump inhibitor (instead of a histamine H2-receptor antagonist) may be more effective against metronidazole-resistant strains of H. pylori; such regimens recommended by ACG as acceptable treatment option for persistent H. pylori infection (“salvage” treatment).
Fixed combination containing bismuth subcitrate potassium, metronidazole, and tetracycline hydrochloride (Pylera) used in conjunction with omeprazole for the treatment of H. pylori infection and duodenal ulcer (active ulcer or history of duodenal ulcer within past 5 years).
Flatulence or Stool Odor
Bismuth subgallate used as self-medication in children and adults for the reduction of flatulence or stool odor from a colostomy or ileostomy.
Bismuth subgallate has been used as self-medication for reduction of odor from fecal incontinence†, irritable bowel syndrome†, or bariatric surgery†.
Bismuth subgallate not expected to be effective for reduction of odor from faulty personal hygiene†.
Dyspepsia (Upset Stomach)
Bismuth subsalicylate used as self-medication in children and adults for symptomatic relief o...
