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Bismuth subcitrate potassium

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IDDRUG-BISMUTH-SUBCITRATE
TipoFármaco
Alegais
Subcitrato de bismutoSubcitrato de bismuto coloidal (CBS)De-NolGastrostatoPylera (component, with metronidazole + tetracycline)Apresentação de um produto químicoUlkavisБісмуту субцитрат калію
Estadorevisto 2026-05-18
DoençasDIS-GASTRIC
FontesSRC-NCCN-BCELL-2025

Fatos sobre as drogas

ClasseSal de bismuto — antimicrobiano/protetor da mucosa (anti-Helicobacter pylori)
MecanismoColloidal bismuth salt that, in the acid gastric milieu, precipitates as bismuth oxychloride and bismuth citrate, which: (i) adhere to ulcer craters and the gastric mucus layer to form a protective barrier; (ii) directly damage Helicobacter pylori cell wall and impair iron and nickel uptake — bactericidal effect; (iii) inhibit H. pylori urease, phospholipase, and proteolytic enzymes; (iv) stimulate prostaglandin E2, bicarbonate, and mucus secretion. Synergistic with metronidazole and tetracycline in quadruple therapy — also overcomes clarithromycin resistance, the primary mode of failure for standard triple therapy.
Dose típicaH. pylori PBMT quadruple therapy (adult): 120 mg (one tablet) PO QID (taken with meals and at bedtime) × 10-14 days, together with omeprazole 20 mg PO BID + metronidazole 500 mg PO TID-QID + tetracycline 500 mg PO QID. Take ≥30 min before meals and at bedtime; avoid co-administration with milk, antacids, or H2 blockers within 30 min (chelation reduces efficacy). Avoid in moderate-severe renal impairment. The combination product Pylera (bismuth subcitrate potassium 140 mg + metronidazole 125 mg + tetracycline 125 mg per capsule, 3 capsules QID × 10 days, with a PPI) is approved in the US/EU as a fixed-dose alternative.
Ucrânia registadaVerdade
NSZU reembolsadoFalso
Ucrânia verificada pela última vez2026-05-18

Notas

STUB — v0.2 prevention-workstream authoring; pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode. Cornerstone of bismuth-based quadruple therapy (PBMT — PPI + bismuth + metronidazole + tetracycline) for H. pylori eradication, increasingly preferred over standard triple therapy in regions with clarithromycin resistance >15% (much of Europe including Ukraine). Overcomes clarithromycin and metronidazole resistance. The black tongue and black stools are the most patient- visible side effects — pre-counseling is essential to avoid panic. Encephalopathy is rare and historically associated with prolonged high- dose use; 10-14 day PBMT courses have a clean safety record. RxNorm has separate codes for "bismuth subcitrate" variants but no single canonical ID for "bismuth subcitrate potassium" was confirmed at draft time — orchestrator should verify. Ukraine: De-Nol is the dominant brand; widely available, out-of-pocket. Two-Co-Lead signoff queued for v0.2-A clinical review.

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