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Bismuth subcitrate

What is it?

Bismuth Subcitrate is a mineral that is used in treating ulcers and upset stomach.

Other names for Bismuth Subcitrate include: CBS, Colloidal Bismuth Subcitrate, and Tripotassium Dicitratobismuthate.

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:

Tell your doctor if you

  • are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement)
  • are allergic to bismuth salts
  • are pregnant or plan to become pregnant while using this medicine
  • are breastfeeding
  • have any other health problems, such as high blood pressure, liver or kidney problems, or heart or blood vessel disease

Dosage:

Talk with your caregiver about how much Bismuth Subcitrate you should take. The amount depends on the strength of the medicine and the reason you are taking Bismuth Subcitrate. If you are using this medicine without instructions from your caregiver, follow the directions on the medicine bottle. Do not take more medicine or take it more often than the directions tell you to.

To store this medicine:

Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.

Drug and Food Interactions:

Do not take Bismuth Subcitrate without talking to your doctor first if you are taking:

  • Antacids (examples: Tums (R), cimetidine (Tagamet(R)), famotidine (Pepcid(R)), ranitidine (Zantac(R)))
  • Bismuth Subcitrate should not be taken with milk or food. Take it 30 minutes before or 2 hours after meals

Warnings:

  • Before taking Bismuth Subcitrate, tell your doctor if you are pregnant or breastfeeding
  • Using too much Bismuth Subcitrate or using it for too long may cause poisoning. Do not take it for longer than 6 weeks (5-9)
  • Large doses may lead to confusion, changes in memory and mood, hallucinations, seizures, and even death (6,10)

Side Effects:

Stop taking your medicine right away and talk to your doctor if you have any of the following side effects. Your medicine may be causing these symptoms which may mean you are allergic to it.

  • Breathing problems or tightness in your throat or chest
  • Chest pain
  • Skin hives, rash, or itchy or swollen skin

Other Side Effects:

You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.

  • Headache and dizziness (3,10)
  • Nausea, diarrhea, and blackening of stool BMs) or the tongue (3,10,11)

References:

1. Kang JY, Tay HH, Wee A et al: Effect of colloidal bismuth subcitrate on symptoms and gastric histology in non-ulcer dyspepsia. A double-blind placebo controlled study. Gut 1990; 31:476-480.

2. Rokkas T & Sladen GE: Bismuth: effects on gastritis and peptic ulcer. Scand J Gastroenterol 1988; 23(suppl 142):82-86.

3. Wagstaff AJ, Benfield P & Monk JP: Colloidal bismuth subcitrate: a review of its pharmcodynamic and pharmcokinetic properties, and its therapeutic use in peptic ulcer disease. Drugs 1988; 36:132-157.

4. Lazzaroni M, Petrillo M & Bianchi Porro G: Comparison of qid and bid administration of De-Nol in the short-term treatment of duodenal ulcer. Br J Clin Pract 1989; 43;151-155.

5. Lauritsen K, Laursen LS & Rask-Madsen J: Clinical pharmcokinetics of drugs used in the treatment of gastrointestinal diseases (part 1). Clin Pharmacokinte 1990;19:11-31.

6. Gorbach SL: Bismuth therapy in gastro-intestinal diseases. Gastorenterolgy 1990; 99:863-875.

7. Gavey CJ, Szeto ML, Mwokolo CU et al: Bismuth accumulates in the body during treatment with tripotassium dicitrato bismuthate. Aliment Pharmacol Ther 1989;3:21-28.

8. Weller M: Neuropsychiatric symptoms following bismuth intoxication. Postgrad Med J 1988; 64:308-310.

9. Lee SP, Lim TH, Pylbus J et al: Tissue distribution of orally administered bismuth in thereat. Clin Exp Pharmacol Physiol 1980: 7:319-324.

10. Bader JP: The safety profile of De-Nol(R). Digestion 1987; 37(suppl 2): 53-59.

11. Rokkas T, Pursey C, Uzoechina E et al: Non-ulcer dydpepsia and short term De-Nol therapy: A placebo controlled trial with particular reference to the role of Campylobacter pylori. Gut 1988; 29:1386-1391.


Last Updated: 11/4/2014

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