Identification

Name
Bismuth Subcitrate
Accession Number
DB09275
Type
Small Molecule
Groups
Approved
Description

A bismuth compound used for peptic ulcer and gastro-oesophageal reflux disease (GORD).

Structure
Thumb
Synonyms
  • Bismuth tripotassium dicitrate
  • Tripotassium dicitratobismuthate
Product Ingredients
IngredientUNIICASInChI Key
Bismuth subcitrate potassiumBQE6KE1T4H880149-29-1YDDTTXDPCSCLKY-UHFFFAOYSA-H
Bismuth subcitrate potassium monohydrateR3O80H60KXNot AvailableVBVVJMZCAZRTKA-UHFFFAOYSA-H
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
PyleraBismuth subcitrate potassium (140 mg/1) + Metronidazole (125 mg/1) + Tetracycline hydrochloride (125 mg/1)CapsuleOralPhysicians Total Care, Inc.2010-08-18Not applicableUs
PyleraBismuth subcitrate potassium (140 mg/1) + Metronidazole (125 mg/1) + Tetracycline hydrochloride (125 mg/1)CapsuleOralAllergan2013-08-01Not applicableUs
PyleraBismuth subcitrate potassium monohydrate (40 mg) + Metronidazole (125 mg) + Tetracycline hydrochloride (125 mg)CapsuleOralAptalis Pharma Inc.Not applicableNot applicableCanada
Categories
UNII
HS813P8QPX
CAS number
57644-54-9
Weight
Average: 708.503
Monoisotopic: 707.90768
Chemical Formula
C12H14BiK3O14
InChI Key
ZQUAVILLCXTKTF-UHFFFAOYSA-L
InChI
InChI=1S/2C6H8O7.Bi.3K/c2*7-3(8)1-6(13,5(11)12)2-4(9)10;;;;/h2*13H,1-2H2,(H,7,8)(H,9,10)(H,11,12);;;;/q;;+3;3*+1/p-2
IUPAC Name
bismuth(3+) ion tripotassium bis(3,4-dicarboxy-3-hydroxybutanoate)
SMILES
[K+].[K+].[K+].[Bi+3].OC(=O)CC(O)(CC([O-])=O)C(O)=O.OC(=O)CC(O)(CC([O-])=O)C(O)=O

Pharmacology

Indication

For the treatment of peptic ulcer and gastro-oesophageal reflux disease (GORD). Treatment of inflammatory and erosive-ulcerous diseases of gastric and duodenal mucosa: gastritis, ulcer disease of the stomach and duodenum, functional non-ulcerous dyspepsia, erosive duodenitis, post-operative inflammatory and erosive changes – anastomositis, peptic ulcer of anastomosis

Structured Indications
Pharmacodynamics

Bismuth subcitrate is very effective in the treatment of gastroduodenal disorders and appears to act via several mechanisms. It has little acid-neutralizing effect and does not affect acid secretion.

Mechanism of action

Colloidal bismuth subcitrate is very effective in the treatment of gastroduodenal disorders and appears to act via several mechanisms. It has little acid-neutralizing effect and does not affect acid secretion. It is uncertain whether it affects pepsin secretion, but it does inhibit peptic activity. It causes an increase in mucus glycoprotein secretion and may also bind to the gastric mucus layer to act as a diffusion barrier to HCl. It accelerates ulcer healing and causes an accumulation of epidermal growth factor around the ulcer. In addition, it has a cytoprotective effect and increases mucosal secretion of prostaglandins and bicarbonate. It has bactericidal effects against Helicobacter pylori (which is associated with gastritis and peptic ulcers). It also prevents adhesion of H. pylori to epithelial cells and can inhibit enzymes secreted by H. pylori, such as proteases, lipases, glycosidases, and phospholipases.

TargetActionsOrganism
UATP-dependent Clp protease ATP-binding subunit ClpX
antagonist
Helicobacter pylori (strain ATCC 700392 / 26695)
Absorption

The mean peak whole-blood bismuth level after ingestion of colloidal bismuth subcitrate (214 mg bismuth) was more than 50 mg/liter and occurred at 30 minutes. After ingestion of bismuth subnitrate (205 mg bismuth), however, there was no evidence of bismuth absorption into blood, although in three of the volunteers who took bismuth subnitrate a week after colloidal bismuth subcitrate, baseline levels of blood bismuth were still elevated. Forty-five minutes after taking colloidal bismuth subcitrate, mean plasma levels for all five volunteers were also assessed and were 79.76 microg/liter as compared to blood levels of 47.6 microg/liter.

Volume of distribution
Not Available
Protein binding

>90%

Metabolism
Not Available
Route of elimination

Elimination of bismuth is primarily through urinary and biliary routes.

Half life

The elimination half-life of bismuth is approximately 5 days

Clearance

The rate of renal elimination appears to reach steady state 2 weeks after treatment discontinuation with similar rates of elimination at 6 weeks after discontinuation. The average urinary elimination of bismuth is 2.6% per day in the first two weeks after discontinuation (urine drug concentrations 24 to 250 mcg/mL) suggesting tissue accumulation and slow elimination.

Toxicity
Not Available
Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
16-BromoepiandrosteroneThe bioavailability of 16-Bromoepiandrosterone can be decreased when combined with Bismuth Subcitrate.Investigational
19-norandrostenedioneThe bioavailability of 19-norandrostenedione can be decreased when combined with Bismuth Subcitrate.Experimental, Illicit
2,5-Dimethoxy-4-ethylamphetamineBismuth Subcitrate may decrease the excretion rate of 2,5-Dimethoxy-4-ethylamphetamine which could result in a higher serum level.Experimental, Illicit
2,5-Dimethoxy-4-ethylthioamphetamineBismuth Subcitrate may decrease the excretion rate of 2,5-Dimethoxy-4-ethylthioamphetamine which could result in a higher serum level.Experimental
3,4-MethylenedioxyamphetamineBismuth Subcitrate may decrease the excretion rate of 3,4-Methylenedioxyamphetamine which could result in a higher serum level.Experimental, Illicit
4-Bromo-2,5-dimethoxyamphetamineBismuth Subcitrate may decrease the excretion rate of 4-Bromo-2,5-dimethoxyamphetamine which could result in a higher serum level.Experimental, Illicit
5-androstenedioneThe bioavailability of 5-androstenedione can be decreased when combined with Bismuth Subcitrate.Experimental, Illicit
AcepromazineBismuth Subcitrate can cause a decrease in the absorption of Acepromazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Vet Approved
AceprometazineBismuth Subcitrate can cause a decrease in the absorption of Aceprometazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
AlclometasoneThe bioavailability of Alclometasone can be decreased when combined with Bismuth Subcitrate.Approved
AldosteroneThe bioavailability of Aldosterone can be decreased when combined with Bismuth Subcitrate.Experimental, Investigational
Alendronic acidThe serum concentration of Alendronic acid can be decreased when it is combined with Bismuth Subcitrate.Approved
AlimemazineBismuth Subcitrate can cause a decrease in the absorption of Alimemazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Vet Approved
AllopurinolBismuth Subcitrate can cause a decrease in the absorption of Allopurinol resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
AlmasilateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Almasilate.Approved, Experimental
AloglutamolThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Aloglutamol.Experimental
AluminiumThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Aluminium.Approved
Aluminium acetoacetateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Aluminium acetoacetate.Experimental
Aluminium glycinateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Aluminium glycinate.Experimental
Aluminum hydroxideThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Aluminum hydroxide.Approved
AmcinonideThe bioavailability of Amcinonide can be decreased when combined with Bismuth Subcitrate.Approved
AmphetamineBismuth Subcitrate may decrease the excretion rate of Amphetamine which could result in a higher serum level.Approved, Illicit
AndrostenedioneThe bioavailability of Androstenedione can be decreased when combined with Bismuth Subcitrate.Experimental, Illicit
AnecortaveThe bioavailability of Anecortave can be decreased when combined with Bismuth Subcitrate.Investigational
anecortave acetateThe bioavailability of anecortave acetate can be decreased when combined with Bismuth Subcitrate.Investigational
AtamestaneThe bioavailability of Atamestane can be decreased when combined with Bismuth Subcitrate.Investigational
AtazanavirBismuth Subcitrate can cause a decrease in the absorption of Atazanavir resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
AtorvastatinThe serum concentration of Atorvastatin can be decreased when it is combined with Bismuth Subcitrate.Approved
Beclomethasone dipropionateThe bioavailability of Beclomethasone dipropionate can be decreased when combined with Bismuth Subcitrate.Approved, Investigational
BenzphetamineBismuth Subcitrate may decrease the excretion rate of Benzphetamine which could result in a higher serum level.Approved, Illicit
BetamethasoneThe bioavailability of Betamethasone can be decreased when combined with Bismuth Subcitrate.Approved, Vet Approved
BisacodylThe therapeutic efficacy of Bisacodyl can be decreased when used in combination with Bismuth Subcitrate.Approved
Bismuth subnitrateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Bismuth subnitrate.Experimental
BL-1020Bismuth Subcitrate can cause a decrease in the absorption of BL-1020 resulting in a reduced serum concentration and potentially a decrease in efficacy.Investigational
BosutinibThe serum concentration of Bosutinib can be decreased when it is combined with Bismuth Subcitrate.Approved
BudesonideThe bioavailability of Budesonide can be decreased when combined with Bismuth Subcitrate.Approved
Calcium CarbonateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Calcium Carbonate.Approved
Calcium silicateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Calcium silicate.Experimental
CaptoprilThe serum concentration of Captopril can be decreased when it is combined with Bismuth Subcitrate.Approved
CefditorenThe serum concentration of Cefditoren can be decreased when it is combined with Bismuth Subcitrate.Approved
CefpodoximeThe serum concentration of Cefpodoxime can be decreased when it is combined with Bismuth Subcitrate.Approved, Vet Approved
CefuroximeThe serum concentration of Cefuroxime can be decreased when it is combined with Bismuth Subcitrate.Approved
CerivastatinThe serum concentration of Cerivastatin can be decreased when it is combined with Bismuth Subcitrate.Withdrawn
ChloroquineThe serum concentration of Chloroquine can be decreased when it is combined with Bismuth Subcitrate.Approved, Vet Approved
ChlorphentermineBismuth Subcitrate may decrease the excretion rate of Chlorphentermine which could result in a higher serum level.Illicit, Withdrawn
ChlorproethazineBismuth Subcitrate can cause a decrease in the absorption of Chlorproethazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Experimental
ChlorpromazineBismuth Subcitrate can cause a decrease in the absorption of Chlorpromazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Vet Approved
ChlortetracyclineThe serum concentration of Chlortetracycline can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational, Vet Approved
CiclesonideThe bioavailability of Ciclesonide can be decreased when combined with Bismuth Subcitrate.Approved, Investigational
CinoxacinBismuth Subcitrate can cause a decrease in the absorption of Cinoxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational, Withdrawn
ClobetasolThe bioavailability of Clobetasol can be decreased when combined with Bismuth Subcitrate.Investigational
Clobetasol propionateThe bioavailability of Clobetasol propionate can be decreased when combined with Bismuth Subcitrate.Approved
ClobetasoneThe bioavailability of Clobetasone can be decreased when combined with Bismuth Subcitrate.Approved
ClocortoloneThe bioavailability of Clocortolone can be decreased when combined with Bismuth Subcitrate.Approved
Clodronic AcidThe serum concentration of Clodronic Acid can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational, Vet Approved
Cortexolone 17α-propionateThe bioavailability of Cortexolone 17α-propionate can be decreased when combined with Bismuth Subcitrate.Investigational
CorticosteroneThe bioavailability of Corticosterone can be decreased when combined with Bismuth Subcitrate.Experimental
Cortisone acetateThe bioavailability of Cortisone acetate can be decreased when combined with Bismuth Subcitrate.Approved
CysteamineThe therapeutic efficacy of Cysteamine can be decreased when used in combination with Bismuth Subcitrate.Approved, Investigational
Dabigatran etexilateThe serum concentration of Dabigatran etexilate can be decreased when it is combined with Bismuth Subcitrate.Approved
DabrafenibThe serum concentration of Dabrafenib can be decreased when it is combined with Bismuth Subcitrate.Approved
DasatinibBismuth Subcitrate can cause a decrease in the absorption of Dasatinib resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
DeferiproneThe serum concentration of Deferiprone can be decreased when it is combined with Bismuth Subcitrate.Approved
DeflazacortThe bioavailability of Deflazacort can be decreased when combined with Bismuth Subcitrate.Approved, Investigational
DelavirdineThe serum concentration of Delavirdine can be decreased when it is combined with Bismuth Subcitrate.Approved
DemeclocyclineThe serum concentration of Demeclocycline can be decreased when it is combined with Bismuth Subcitrate.Approved
DesonideThe bioavailability of Desonide can be decreased when combined with Bismuth Subcitrate.Approved, Investigational
DesoximetasoneThe bioavailability of Desoximetasone can be decreased when combined with Bismuth Subcitrate.Approved
Desoxycorticosterone acetateThe bioavailability of Desoxycorticosterone acetate can be decreased when combined with Bismuth Subcitrate.Approved
Desoxycorticosterone PivalateThe bioavailability of Desoxycorticosterone Pivalate can be decreased when combined with Bismuth Subcitrate.Experimental, Vet Approved
DexamethasoneThe bioavailability of Dexamethasone can be decreased when combined with Bismuth Subcitrate.Approved, Investigational, Vet Approved
Dexamethasone isonicotinateThe bioavailability of Dexamethasone isonicotinate can be decreased when combined with Bismuth Subcitrate.Vet Approved
DexmethylphenidateBismuth Subcitrate can cause an increase in the absorption of Dexmethylphenidate resulting in an increased serum concentration and potentially a worsening of adverse effects.Approved
DextroamphetamineBismuth Subcitrate may decrease the excretion rate of Dextroamphetamine which could result in a higher serum level.Approved, Illicit
DiethylpropionBismuth Subcitrate may decrease the excretion rate of Diethylpropion which could result in a higher serum level.Approved, Illicit
DiflorasoneThe bioavailability of Diflorasone can be decreased when combined with Bismuth Subcitrate.Approved
DifluocortoloneThe bioavailability of Difluocortolone can be decreased when combined with Bismuth Subcitrate.Approved, Investigational, Withdrawn
DifluprednateThe bioavailability of Difluprednate can be decreased when combined with Bismuth Subcitrate.Approved
Dipotassium phosphateBismuth Subcitrate can cause a decrease in the absorption of Dipotassium phosphate resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
DoxycyclineThe serum concentration of Doxycycline can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational, Vet Approved
ElvitegravirThe serum concentration of Elvitegravir can be decreased when it is combined with Bismuth Subcitrate.Approved
EnoxacinBismuth Subcitrate can cause a decrease in the absorption of Enoxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
EquileninThe bioavailability of Equilenin can be decreased when combined with Bismuth Subcitrate.Experimental
EquilinThe bioavailability of Equilin can be decreased when combined with Bismuth Subcitrate.Approved
ErlotinibThe serum concentration of Erlotinib can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
EstroneThe bioavailability of Estrone can be decreased when combined with Bismuth Subcitrate.Approved
Estrone sulfateThe bioavailability of Estrone sulfate can be decreased when combined with Bismuth Subcitrate.Approved
Etidronic acidThe serum concentration of Etidronic acid can be decreased when it is combined with Bismuth Subcitrate.Approved
FexofenadineThe serum concentration of Fexofenadine can be decreased when it is combined with Bismuth Subcitrate.Approved
FleroxacinBismuth Subcitrate can cause a decrease in the absorption of Fleroxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
FluasteroneThe bioavailability of Fluasterone can be decreased when combined with Bismuth Subcitrate.Investigational
FludrocortisoneThe bioavailability of Fludrocortisone can be decreased when combined with Bismuth Subcitrate.Approved
FlumequineBismuth Subcitrate can cause a decrease in the absorption of Flumequine resulting in a reduced serum concentration and potentially a decrease in efficacy.Withdrawn
FlumethasoneThe bioavailability of Flumethasone can be decreased when combined with Bismuth Subcitrate.Approved, Vet Approved
FlunisolideThe bioavailability of Flunisolide can be decreased when combined with Bismuth Subcitrate.Approved, Investigational
Fluocinolone AcetonideThe bioavailability of Fluocinolone Acetonide can be decreased when combined with Bismuth Subcitrate.Approved, Investigational, Vet Approved
FluocinonideThe bioavailability of Fluocinonide can be decreased when combined with Bismuth Subcitrate.Approved, Investigational
FluocortoloneThe bioavailability of Fluocortolone can be decreased when combined with Bismuth Subcitrate.Approved, Withdrawn
FluorometholoneThe bioavailability of Fluorometholone can be decreased when combined with Bismuth Subcitrate.Approved
FluphenazineBismuth Subcitrate can cause a decrease in the absorption of Fluphenazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
FluprednideneThe bioavailability of Fluprednidene can be decreased when combined with Bismuth Subcitrate.Approved, Withdrawn
FluprednisoloneThe bioavailability of Fluprednisolone can be decreased when combined with Bismuth Subcitrate.Approved
FlurandrenolideThe bioavailability of Flurandrenolide can be decreased when combined with Bismuth Subcitrate.Approved
Fluticasone furoateThe bioavailability of Fluticasone furoate can be decreased when combined with Bismuth Subcitrate.Approved
Fluticasone propionateThe bioavailability of Fluticasone propionate can be decreased when combined with Bismuth Subcitrate.Approved
FluvastatinThe serum concentration of Fluvastatin can be decreased when it is combined with Bismuth Subcitrate.Approved
FormestaneThe bioavailability of Formestane can be decreased when combined with Bismuth Subcitrate.Approved, Investigational, Withdrawn
FosinoprilThe serum concentration of Fosinopril can be decreased when it is combined with Bismuth Subcitrate.Approved
GabapentinThe serum concentration of Gabapentin can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
GarenoxacinBismuth Subcitrate can cause a decrease in the absorption of Garenoxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Investigational
GatifloxacinBismuth Subcitrate can cause a decrease in the absorption of Gatifloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
GefitinibThe serum concentration of Gefitinib can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
GemifloxacinBismuth Subcitrate can cause a decrease in the absorption of Gemifloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
GepefrineBismuth Subcitrate may decrease the excretion rate of Gepefrine which could result in a higher serum level.Experimental
GrepafloxacinBismuth Subcitrate can cause a decrease in the absorption of Grepafloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Investigational, Withdrawn
HalcinonideThe bioavailability of Halcinonide can be decreased when combined with Bismuth Subcitrate.Approved, Investigational, Withdrawn
HE3286The bioavailability of HE3286 can be decreased when combined with Bismuth Subcitrate.Investigational
HydrocortisoneThe bioavailability of Hydrocortisone can be decreased when combined with Bismuth Subcitrate.Approved, Vet Approved
HydrotalciteThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Hydrotalcite.Experimental, Investigational
HydroxyamphetamineBismuth Subcitrate may decrease the excretion rate of Hydroxyamphetamine which could result in a higher serum level.Approved
HyoscyamineThe serum concentration of Hyoscyamine can be decreased when it is combined with Bismuth Subcitrate.Approved
IbandronateThe serum concentration of Ibandronate can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
Iofetamine I-123Bismuth Subcitrate may decrease the excretion rate of Iofetamine I-123 which could result in a higher serum level.Approved
IsoniazidBismuth Subcitrate can cause a decrease in the absorption of Isoniazid resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
IstaroximeThe bioavailability of Istaroxime can be decreased when combined with Bismuth Subcitrate.Investigational
ItraconazoleThe serum concentration of Itraconazole can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
KetoconazoleThe serum concentration of Ketoconazole can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
LedipasvirThe serum concentration of Ledipasvir can be decreased when it is combined with Bismuth Subcitrate.Approved
LevofloxacinBismuth Subcitrate can cause a decrease in the absorption of Levofloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
LisdexamfetamineBismuth Subcitrate may decrease the excretion rate of Lisdexamfetamine which could result in a higher serum level.Approved, Investigational
LoteprednolThe bioavailability of Loteprednol can be decreased when combined with Bismuth Subcitrate.Approved
LovastatinThe serum concentration of Lovastatin can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
MagaldrateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Magaldrate.Approved, Withdrawn
Magnesium HydroxideThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Magnesium Hydroxide.Approved
Magnesium oxideThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Magnesium oxide.Approved
Magnesium peroxideThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Magnesium peroxide.Experimental
Magnesium silicateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Magnesium silicate.Approved, Experimental
Magnesium TrisilicateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Magnesium Trisilicate.Approved
ME-609The bioavailability of ME-609 can be decreased when combined with Bismuth Subcitrate.Investigational
MecamylamineThe serum concentration of Mecamylamine can be increased when it is combined with Bismuth Subcitrate.Approved
MedrysoneThe bioavailability of Medrysone can be decreased when combined with Bismuth Subcitrate.Approved
MelengestrolThe bioavailability of Melengestrol can be decreased when combined with Bismuth Subcitrate.Vet Approved
MemantineThe serum concentration of Memantine can be increased when it is combined with Bismuth Subcitrate.Approved, Investigational
MephedroneBismuth Subcitrate may decrease the excretion rate of Mephedrone which could result in a higher serum level.Investigational
MephentermineBismuth Subcitrate may decrease the excretion rate of Mephentermine which could result in a higher serum level.Approved
MesalazineThe therapeutic efficacy of Mesalazine can be decreased when used in combination with Bismuth Subcitrate.Approved
MesoridazineBismuth Subcitrate can cause a decrease in the absorption of Mesoridazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
MethamphetamineBismuth Subcitrate may decrease the excretion rate of Methamphetamine which could result in a higher serum level.Approved, Illicit
MethenamineThe therapeutic efficacy of Methenamine can be decreased when used in combination with Bismuth Subcitrate.Approved, Vet Approved
MethotrimeprazineBismuth Subcitrate can cause a decrease in the absorption of Methotrimeprazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
MethoxyphenamineBismuth Subcitrate may decrease the excretion rate of Methoxyphenamine which could result in a higher serum level.Experimental
Methylene blueBismuth Subcitrate can cause a decrease in the absorption of Methylene blue resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
MethylphenidateBismuth Subcitrate can cause an increase in the absorption of Methylphenidate resulting in an increased serum concentration and potentially a worsening of adverse effects.Approved, Investigational
MethylprednisoloneThe bioavailability of Methylprednisolone can be decreased when combined with Bismuth Subcitrate.Approved, Vet Approved
MevastatinThe serum concentration of Mevastatin can be decreased when it is combined with Bismuth Subcitrate.Experimental
MidomafetamineBismuth Subcitrate may decrease the excretion rate of Midomafetamine which could result in a higher serum level.Experimental, Illicit, Investigational
MinocyclineThe serum concentration of Minocycline can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
MisoprostolThe risk or severity of adverse effects can be increased when Bismuth Subcitrate is combined with Misoprostol.Approved
MMDABismuth Subcitrate may decrease the excretion rate of MMDA which could result in a higher serum level.Experimental, Illicit
MometasoneThe bioavailability of Mometasone can be decreased when combined with Bismuth Subcitrate.Approved, Vet Approved
MoricizineBismuth Subcitrate can cause a decrease in the absorption of Moricizine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational, Withdrawn
Mycophenolic acidBismuth Subcitrate can cause a decrease in the absorption of Mycophenolic acid resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
Nalidixic AcidBismuth Subcitrate can cause a decrease in the absorption of Nalidixic Acid resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
NCX 1022The bioavailability of NCX 1022 can be decreased when combined with Bismuth Subcitrate.Investigational
NemonoxacinBismuth Subcitrate can cause a decrease in the absorption of Nemonoxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Investigational
NilotinibThe serum concentration of Nilotinib can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
NorfloxacinBismuth Subcitrate can cause a decrease in the absorption of Norfloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
Oleoyl-estroneThe bioavailability of Oleoyl-estrone can be decreased when combined with Bismuth Subcitrate.Investigational
Oxolinic acidBismuth Subcitrate can cause a decrease in the absorption of Oxolinic acid resulting in a reduced serum concentration and potentially a decrease in efficacy.Experimental
PamidronateThe serum concentration of Pamidronate can be decreased when it is combined with Bismuth Subcitrate.Approved
ParamethasoneThe bioavailability of Paramethasone can be decreased when combined with Bismuth Subcitrate.Approved
PazopanibThe serum concentration of Pazopanib can be decreased when it is combined with Bismuth Subcitrate.Approved
PazufloxacinBismuth Subcitrate can cause a decrease in the absorption of Pazufloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Investigational
PefloxacinBismuth Subcitrate can cause a decrease in the absorption of Pefloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
PenicillamineThe serum concentration of Penicillamine can be decreased when it is combined with Bismuth Subcitrate.Approved
PerazineBismuth Subcitrate can cause a decrease in the absorption of Perazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Investigational
PerphenazineBismuth Subcitrate can cause a decrease in the absorption of Perphenazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
PhentermineBismuth Subcitrate may decrease the excretion rate of Phentermine which could result in a higher serum level.Approved, Illicit
Pipemidic acidBismuth Subcitrate can cause a decrease in the absorption of Pipemidic acid resulting in a reduced serum concentration and potentially a decrease in efficacy.Experimental
Piromidic acidBismuth Subcitrate can cause a decrease in the absorption of Piromidic acid resulting in a reduced serum concentration and potentially a decrease in efficacy.Experimental
PitavastatinThe serum concentration of Pitavastatin can be decreased when it is combined with Bismuth Subcitrate.Approved
PrasteroneThe bioavailability of Prasterone can be decreased when combined with Bismuth Subcitrate.Approved, Nutraceutical
Prasterone sulfateThe bioavailability of Prasterone sulfate can be decreased when combined with Bismuth Subcitrate.Investigational
PravastatinThe serum concentration of Pravastatin can be decreased when it is combined with Bismuth Subcitrate.Approved
PrednicarbateThe bioavailability of Prednicarbate can be decreased when combined with Bismuth Subcitrate.Approved
PrednisoloneThe bioavailability of Prednisolone can be decreased when combined with Bismuth Subcitrate.Approved, Vet Approved
PrednisoneThe bioavailability of Prednisone can be decreased when combined with Bismuth Subcitrate.Approved, Vet Approved
PregnenoloneThe bioavailability of Pregnenolone can be decreased when combined with Bismuth Subcitrate.Experimental, Investigational
ProchlorperazineBismuth Subcitrate can cause a decrease in the absorption of Prochlorperazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Vet Approved
PromazineBismuth Subcitrate can cause a decrease in the absorption of Promazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Vet Approved
PromethazineBismuth Subcitrate can cause a decrease in the absorption of Promethazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
PropericiazineBismuth Subcitrate can cause a decrease in the absorption of Propericiazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
PropiopromazineBismuth Subcitrate can cause a decrease in the absorption of Propiopromazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Vet Approved
PrulifloxacinBismuth Subcitrate can cause a decrease in the absorption of Prulifloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Investigational
PseudoephedrineBismuth Subcitrate may decrease the excretion rate of Pseudoephedrine which could result in a higher serum level.Approved
QuinidineBismuth Subcitrate may decrease the excretion rate of Quinidine which could result in a higher serum level.Approved
QuinineThe serum concentration of Quinine can be increased when it is combined with Bismuth Subcitrate.Approved
RimexoloneThe bioavailability of Rimexolone can be decreased when combined with Bismuth Subcitrate.Approved
RiociguatThe serum concentration of Riociguat can be decreased when it is combined with Bismuth Subcitrate.Approved
RisedronateThe serum concentration of Risedronate can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
RitobegronBismuth Subcitrate may decrease the excretion rate of Ritobegron which could result in a higher serum level.Investigational
RosoxacinBismuth Subcitrate can cause a decrease in the absorption of Rosoxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
RosuvastatinThe serum concentration of Rosuvastatin can be decreased when it is combined with Bismuth Subcitrate.Approved
RufloxacinBismuth Subcitrate can cause a decrease in the absorption of Rufloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Experimental
SimvastatinThe serum concentration of Simvastatin can be decreased when it is combined with Bismuth Subcitrate.Approved
SitafloxacinBismuth Subcitrate can cause a decrease in the absorption of Sitafloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Experimental, Investigational
Sodium bicarbonateThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Sodium bicarbonate.Approved
Sodium glycerophosphateBismuth Subcitrate can cause a decrease in the absorption of Sodium glycerophosphate resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
Sodium phosphateBismuth Subcitrate can cause a decrease in the absorption of Sodium phosphate resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
SotalolThe serum concentration of Sotalol can be decreased when it is combined with Bismuth Subcitrate.Approved
SparfloxacinBismuth Subcitrate can cause a decrease in the absorption of Sparfloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational
SulpirideThe serum concentration of Sulpiride can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational
Technetium Tc-99m etidronateThe serum concentration of Technetium Tc-99m etidronate can be decreased when it is combined with Bismuth Subcitrate.Approved
Technetium Tc-99m medronateThe serum concentration of Technetium Tc-99m medronate can be decreased when it is combined with Bismuth Subcitrate.Approved
TemafloxacinBismuth Subcitrate can cause a decrease in the absorption of Temafloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Withdrawn
ThiazinamBismuth Subcitrate can cause a decrease in the absorption of Thiazinam resulting in a reduced serum concentration and potentially a decrease in efficacy.Experimental
ThiethylperazineBismuth Subcitrate can cause a decrease in the absorption of Thiethylperazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Withdrawn
ThioproperazineBismuth Subcitrate can cause a decrease in the absorption of Thioproperazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
ThioridazineBismuth Subcitrate can cause a decrease in the absorption of Thioridazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Withdrawn
Tiludronic acidThe serum concentration of Tiludronic acid can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational, Vet Approved
TixocortolThe bioavailability of Tixocortol can be decreased when combined with Bismuth Subcitrate.Approved, Withdrawn
TolevamerThe risk or severity of adverse effects can be increased when Bismuth Subcitrate is combined with Tolevamer.Approved
TriamcinoloneThe bioavailability of Triamcinolone can be decreased when combined with Bismuth Subcitrate.Approved, Vet Approved
TriethylenetetramineBismuth Subcitrate can cause a decrease in the absorption of Triethylenetetramine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
TrifluoperazineBismuth Subcitrate can cause a decrease in the absorption of Trifluoperazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved
TriflupromazineBismuth Subcitrate can cause a decrease in the absorption of Triflupromazine resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Vet Approved
TromethamineThe therapeutic efficacy of Bismuth Subcitrate can be decreased when used in combination with Tromethamine.Approved
TrovafloxacinBismuth Subcitrate can cause a decrease in the absorption of Trovafloxacin resulting in a reduced serum concentration and potentially a decrease in efficacy.Approved, Investigational, Withdrawn
UbidecarenoneThe serum concentration of Ubidecarenone can be decreased when it is combined with Bismuth Subcitrate.Approved, Investigational, Nutraceutical
UlobetasolThe bioavailability of Ulobetasol can be decreased when combined with Bismuth Subcitrate.Approved
Zoledronic acidThe serum concentration of Zoledronic acid can be decreased when it is combined with Bismuth Subcitrate.Approved
Food Interactions
Not Available

References

General References
  1. Lee SP: The mode of action of colloidal bismuth subcitrate. Scand J Gastroenterol Suppl. 1991;185:1-6. [PubMed:1957120]
  2. Wagstaff AJ, Benfield P, Monk JP: Colloidal bismuth subcitrate. A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic use in peptic ulcer disease. Drugs. 1988 Aug;36(2):132-57. [PubMed:3053124]
  3. Phillips RH, Whitehead MW, Lacey S, Champion M, Thompson RP, Powell JJ: Solubility, absorption, and anti-Helicobacter pylori activity of bismuth subnitrate and colloidal bismuth subcitrate: In vitro data Do not predict In vivo efficacy. Helicobacter. 2000 Sep;5(3):176-82. [PubMed:10971684]
  4. FDA Label [Link]
External Links
PubChem Compound
118987133
PubChem Substance
347827831
ChemSpider
58829660
ATC Codes
A02BD08 — Bismuth subcitrate, tetracycline and metronidazoleA02BX05 — Bismuth subcitrate

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
2CompletedTreatmentFatty Liver / Insulin Resistance / Liver Dysfunction1
3CompletedTreatmentHelicobacter Infections1
3RecruitingTreatmentDuodenal Ulcer1
3WithdrawnTreatmentBacterial Infection Due to Helicobacter Pylori (H. Pylori)1
4RecruitingTreatmentNSAID-induced Gastropathy1
4Unknown StatusTreatmentH. Pylori Infection1
Not AvailableCompletedTreatmentBacterial Infection Due to Helicobacter Pylori (H. Pylori)1
Not AvailableRecruitingTreatmentBacterial Infection Due to Helicobacter Pylori (H. Pylori)3

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
CapsuleOral
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US6350468No1998-12-142018-12-14Us

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility226.0 mg/mLALOGPS
logP-1.3ALOGPS
logP-1.3ChemAxon
logS-0.01ALOGPS
pKa (Strongest Acidic)3.05ChemAxon
pKa (Strongest Basic)-4.2ChemAxon
Physiological Charge-3ChemAxon
Hydrogen Acceptor Count7ChemAxon
Hydrogen Donor Count3ChemAxon
Polar Surface Area134.96 Å2ChemAxon
Rotatable Bond Count10ChemAxon
Refractivity46.46 m3·mol-1ChemAxon
Polarizability15.09 Å3ChemAxon
Number of Rings0ChemAxon
Bioavailability1ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as tricarboxylic acids and derivatives. These are carboxylic acids containing exactly three carboxyl groups.
Kingdom
Organic compounds
Super Class
Organic acids and derivatives
Class
Carboxylic acids and derivatives
Sub Class
Tricarboxylic acids and derivatives
Direct Parent
Tricarboxylic acids and derivatives
Alternative Parents
Alpha hydroxy acids and derivatives / Tertiary alcohols / Carboxylic acid salts / Carboxylic acids / Organic potassium salts / Organic oxides / Hydrocarbon derivatives / Carbonyl compounds / Organic cations
Substituents
Tricarboxylic acid or derivatives / Alpha-hydroxy acid / Hydroxy acid / Tertiary alcohol / Carboxylic acid salt / Organic alkali metal salt / Carboxylic acid / Organic salt / Hydrocarbon derivative / Organooxygen compound
Molecular Framework
Not Available
External Descriptors
Not Available

Targets

Kind
Protein
Organism
Helicobacter pylori (strain ATCC 700392 / 26695)
Pharmacological action
Unknown
Actions
Antagonist
General Function
Zinc ion binding
Specific Function
ATP-dependent specificity component of the Clp protease. It directs the protease to specific substrates. Can perform chaperone functions in the absence of ClpP.
Gene Name
clpX
Uniprot ID
O25926
Uniprot Name
ATP-dependent Clp protease ATP-binding subunit ClpX
Molecular Weight
50352.815 Da
References
  1. Lee SP: The mode of action of colloidal bismuth subcitrate. Scand J Gastroenterol Suppl. 1991;185:1-6. [PubMed:1957120]

Drug created on October 28, 2015 16:23 / Updated on January 21, 2018 04:16