Identification
- Summary
Bismuth subcitrate potassium is a colloid used for the treatment of peptic ulcer and gastro-esophageal reflux disease (GERD).
- Brand Names
- Pylera
- Generic Name
- Bismuth subcitrate potassium
- DrugBank Accession Number
- DB09275
- Background
A bismuth compound used for peptic ulcer and gastro-oesophageal reflux disease (GORD).
- Type
- Small Molecule
- Groups
- Approved, Investigational
- Structure
Structure for Bismuth subcitrate potassium (DB09275)
- Weight
- Average: 780.654
Monoisotopic: 779.79034 - Chemical Formula
- C12H8BiK5O14
- Synonyms
- Bismuth subcitrate potassium anhydrous
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
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- Contraindications & Blackbox Warnings
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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.
Target Actions Organism UATP-dependent Clp protease ATP-binding subunit ClpX antagonistHelicobacter 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.
- Adverse Effects
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Not Available
- Pathways
- Not Available
- Pharmacogenomic Effects/ADRs
- Not Available
Interactions
- Drug Interactions
- This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction Integrate drug-drug
interactions in your softwareAcetophenazine Acetophenazine may increase the neurotoxic activities of Bismuth subcitrate potassium. Alimemazine Alimemazine may increase the neurotoxic activities of Bismuth subcitrate potassium. Amisulpride Amisulpride may increase the neurotoxic activities of Bismuth subcitrate potassium. Amitriptyline Amitriptyline may increase the neurotoxic activities of Bismuth subcitrate potassium. Amitriptylinoxide Bismuth subcitrate potassium may increase the neurotoxic activities of Amitriptylinoxide. Amoxapine Amoxapine may increase the neurotoxic activities of Bismuth subcitrate potassium. Aripiprazole Aripiprazole may increase the neurotoxic activities of Bismuth subcitrate potassium. Aripiprazole lauroxil Bismuth subcitrate potassium may increase the neurotoxic activities of Aripiprazole lauroxil. Asenapine Asenapine may increase the neurotoxic activities of Bismuth subcitrate potassium. Benperidol Bismuth subcitrate potassium may increase the neurotoxic activities of Benperidol. 
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- Avoid alcohol. Avoid ingesting alcohol during therapy with Pylera and for three days after discontinuation as it may cause flushing, nausea, and vomiting.
- Take after a meal. The overall exposure to bismuth subcitrate potassium was not significantly impacted by administration with food when tested in the combination product Pylera.
Products
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Ingredient UNII CAS InChI Key Bismuth subcitrate potassium monohydrate R3O80H60KX Not Available VBVVJMZCAZRTKA-UHFFFAOYSA-H - Active Moieties
Name Kind UNII CAS InChI Key Bismuth cation ionic ZS9CD1I8YE 23713-46-4 JDIBGQFKXXXXPN-UHFFFAOYSA-N - Mixture Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image Bismuth Subcitrate Potassium, Metronidazole and Tetracycline Hydrochloride Bismuth subcitrate potassium monohydrate (140 mg/1) + Metronidazole (125 mg/1) + Tetracycline hydrochloride (125 mg/1) Capsule Oral Par Pharmaceutical, Inc. 2023-03-07 Not applicable US 
KATACOLD 120 MG + 3.75 MG+ l MG /5 ML PEDIYATRIK ŞURUP, 100 ML Bismuth subcitrate potassium (3.75 mg) + Acetaminophen (120 mg) + Chlorpheniramine maleate (1 mg) Syrup Oral BİOFARMA İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey 
Pylera Bismuth subcitrate potassium (40 mg) + Metronidazole (125 mg) + Tetracycline hydrochloride (125 mg) Capsule Oral Laboratoires Juvise Pharmaceuticals Not applicable Not applicable Canada 
Pylera Bismuth subcitrate potassium monohydrate (140 mg/1) + Metronidazole (125 mg/1) + Tetracycline hydrochloride (125 mg/1) Capsule Oral Physicians Total Care, Inc. 2010-08-18 Not applicable US Pylera Bismuth subcitrate potassium monohydrate (140 mg/1) + Metronidazole (125 mg/1) + Tetracycline hydrochloride (125 mg/1) Capsule Oral Allergan, Inc. 2013-08-01 Not applicable US Pylera Bismuth subcitrate potassium monohydrate (140 mg/1) + Metronidazole (125 mg/1) + Tetracycline hydrochloride (125 mg/1) Capsule Oral Axcan Pharma US, Inc. 2007-05-01 2011-06-14 US Pylera 140 mg/125 mg/125 mg Hartkapseln Bismuth subcitrate potassium (140 mg) + Metronidazole (125 mg) + Tetracycline hydrochloride (125 mg) Capsule Oral Laboratoires Juvise Pharmaceuticals 2014-08-12 Not applicable Austria 
Pylera 140 mg/125 mg/125 mg Hartkapseln Bismuth subcitrate potassium (140 mg) + Metronidazole (125 mg) + Tetracycline hydrochloride (125 mg) Capsule Oral Haemato Pharm Gmb H 2018-08-03 Not applicable Austria Pylera 140 mg/125 mg/125 mg Hartkapseln Bismuth subcitrate potassium (140 mg) + Metronidazole (125 mg) + Tetracycline hydrochloride (125 mg) Capsule Oral Eurim Pharm Vertriebs Gmb H & Co Kg 2020-07-15 Not applicable Austria Pylera 140 mg/125 mg/125 mg Hartkapseln Bismuth subcitrate potassium (140 mg) + Metronidazole (125 mg) + Tetracycline hydrochloride (125 mg) Capsule Oral Orifarm Gmb H 2020-01-10 Not applicable Austria
Categories
- ATC Codes
- A02BD08 — Bismuth subcitrate, tetracycline and metronidazole
- A02BD — Combinations for eradication of Helicobacter pylori
- A02B — DRUGS FOR PEPTIC ULCER AND GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD)
- A02 — DRUGS FOR ACID RELATED DISORDERS
- A — ALIMENTARY TRACT AND METABOLISM
- Drug Categories
- Chemical TaxonomyProvided by Classyfire
- 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
- Carboxylic acid salts / Carboxylic acids / Organic potassium salts / Organic oxides / Hydrocarbon derivatives / Carbonyl compounds / Alkoxides / Organic cations
- Substituents
- Aliphatic acyclic compound / Alkoxide / Carbonyl group / Carboxylic acid / Carboxylic acid salt / Hydrocarbon derivative / Organic alkali metal salt / Organic cation / Organic oxide / Organic oxygen compound
- Molecular Framework
- Not Available
- External Descriptors
- Not Available
- Affected organisms
- Humans and other mammals
Chemical Identifiers
- UNII
- BQE6KE1T4H
- CAS number
- 880149-29-1
- InChI Key
- YDDTTXDPCSCLKY-UHFFFAOYSA-H
- InChI
- InChI=1S/2C6H7O7.Bi.5K/c2*7-3(8)1-6(13,5(11)12)2-4(9)10;;;;;;/h2*1-2H2,(H,7,8)(H,9,10)(H,11,12);;;;;;/q2*-1;+3;5*+1/p-6
- IUPAC Name
- bismuth(3+) pentapotassium bis(2-oxidopropane-1,2,3-tricarboxylate)
- SMILES
- [K+].[K+].[K+].[K+].[K+].[Bi+3].[O-]C(=O)CC([O-])(CC([O-])=O)C([O-])=O.[O-]C(=O)CC([O-])(CC([O-])=O)C([O-])=O
References
- General References
- Lee SP: The mode of action of colloidal bismuth subcitrate. Scand J Gastroenterol Suppl. 1991;185:1-6. [Article]
- 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. [Article]
- 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. [Article]
- FDA Label [Link]
- External Links
- PubChem Compound
- 118987133
- PubChem Substance
- 347827831
- ChemSpider
- 34989447
- 47181
- Wikipedia
- Bismuth_subcitrate
Clinical Trials
- Clinical Trials
Phase Status Purpose Conditions Count 4 Completed Treatment Helicobacter Pylori Infection 2 4 Enrolling by Invitation Treatment Dysbiosis / Helicobacter Pylori Infection / Probiotics 1 4 Unknown Status Treatment Helicobacter Pylori 1 4 Unknown Status Treatment Helicobacter Pylori Infection 1 4 Withdrawn Prevention Helicobacter Pylori Infection 1 4 Withdrawn Treatment Treatment of Helicobacter Pylori 1 3 Completed Treatment Helicobacter Infections 1 3 Recruiting Treatment Antibiotic Resistant Infection / Antibiotic Resistant Strain / Helicobacter Pylori Infection 1 3 Withdrawn Treatment Helicobacter Pylori Infection 1 2 Completed Treatment Fatty Liver / Hepatic dysfunction / Resistance, Insulin 1
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage Forms
Form Route Strength Syrup 7.5 mg/5ml Syrup 15 mg/5ml Syrup Syrup 22.5 mg/5ml Tablet, film coated Oral Tablet 300 mg Syrup Oral Tablet, film coated Oral 50 mg Capsule Oral Syrup 1.5 mg/ml Tablet, film coated Oral 120 mg - Prices
- Not Available
- Patents
Patent Number Pediatric Extension Approved Expires (estimated) Region US6350468 No 2002-02-26 2018-12-14 US
Properties
- State
- Solid
- Experimental Properties
- Not Available
- Predicted Properties
Property Value Source Water Solubility 13.8 mg/mL ALOGPS logP 0.79 ALOGPS logP -1.3 Chemaxon logS -1.6 ALOGPS pKa (Strongest Acidic) 3.05 Chemaxon pKa (Strongest Basic) -4.2 Chemaxon Physiological Charge -3 Chemaxon Hydrogen Acceptor Count 7 Chemaxon Hydrogen Donor Count 0 Chemaxon Polar Surface Area 143.45 Å2 Chemaxon Rotatable Bond Count 10 Chemaxon Refractivity 78.69 m3·mol-1 Chemaxon Polarizability 13.97 Å3 Chemaxon Number of Rings 0 Chemaxon Bioavailability 1 Chemaxon Rule of Five No Chemaxon Ghose Filter No Chemaxon Veber's Rule No Chemaxon MDDR-like Rule No Chemaxon - Predicted ADMET Features
- Not Available
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
- 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
- Lee SP: The mode of action of colloidal bismuth subcitrate. Scand J Gastroenterol Suppl. 1991;185:1-6. [Article]
Drug created at October 28, 2015 22:23 / Updated at May 07, 2021 21:40