Bismuth subcitrate
{{Short description|Pharmaceutical drug}}
{{Infobox drug
| IUPAC_name = Bismuth(3+) potassium 2-olato-1,2,3-propanetricarboxylate (1:5:2)
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| routes_of_administration = Oral
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| CAS_number = 880149-29-1
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = BQE6KE1T4H
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| ATC_prefix = A02
| ATC_suffix = BX05
| PubChem = 124490479
| DrugBank = DB09275
| ChemSpiderID = 32821371
| KEGG = D09739
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| C=12 | H=8 | Bi=1 | K=5 | O=14
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| smiles = C(C(=O)[O-])C(CC(=O)[O-])(C(=O)[O-])[O-].C(C(=O)[O-])C(CC(=O)[O-])(C(=O)[O-])[O-].[K+].[K+].[K+].[K+].[K+].[Bi+3]
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Bismuth subcitrate potassium is a bismuth salt used in combination with antibiotics and a proton pump inhibitor for the treatment of Helicobacter pylori infections.{{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/PIP_decision/WC500005327.pdf|title=P/74/2009: European Medicines Agency decision of 20 April 2009 on the granting of a product specific waiver for Bismuth subcitrate potassium / Metronidazole / Tetracycline hydrochloride (EMEA-000382-PIP01-08) in accordance with Regulation (EC) No 1901/2006 of the European Parliament and of the Council as amended|publisher=European Medicines Agency|date=2009-06-10|access-date=2017-10-24|archive-date=2017-10-24|archive-url=https://web.archive.org/web/20171024205050/http://www.ema.europa.eu/docs/en_GB/document_library/PIP_decision/WC500005327.pdf|url-status=dead}}{{cite journal | vauthors = Urgesi R, Cianci R, Riccioni ME | title = Update on triple therapy for eradication of Helicobacter pylori: current status of the art | journal = Clinical and Experimental Gastroenterology | volume = 5 | pages = 151–7 | year = 2012 | pmid = 23028235 | pmc = 3449761 | doi = 10.2147/CEG.S25416 | doi-access = free }}
A fixed-dose combination with the antibiotics metronidazole and tetracycline is sold under the trade name Pylera.
Contraindications
{{further|Bismuth subcitrate/metronidazole/tetracycline#Contraindications}}{{Empty section|date=August 2022}}
Side effects
{{further|Bismuth subcitrate/metronidazole/tetracycline#Adverse effects}}
A known side effect of bismuth salts is harmless and reversible darkening of tongue and stool by formation of bismuth sulfite. Other side effects of bismuth containing combination therapies are often difficult to assign to a specific component.{{cn|date=May 2021}}
Interactions
Pharmacology
=Mechanism of action=
The mechanism of action of bismuth is not known. It has been reasoned to interfere with the function of the bacterial cell membrane, protein and cell wall synthesis, the enzyme urease, cell adhesion, ATP synthesis, and iron transport mechanisms.
Chemical properties
Bismuth subcitrate potassium is a salt of bismuth (Bi3+), potassium (K+) and citrate ({{chem2|C6H4O7(4-)}}) in a molar ratio of about 1:5:2, with 3 moles of water. It contains about 25.6% (mass percent) bismuth, which is the active moiety, and 22.9% potassium.Drugs.com: {{Drugs.com|pro|pylera}} for Pylera. Accessed 2017-10-27. Other sources give somewhat different ratios of the constituents.
See also
References
{{reflist | 30em}}
{{Drugs for peptic ulcer and GORD}}
{{Bismuth compounds}}