Bismuth subnitrate

Oral
H. pylori infection

Moderate-severe impairment: Avoid use.

Impaired renal function; pregnancy (3^rd trimester).

Monitor renal function regularly.

Nausea, vomiting, methemoglobinaemia, encephalopathy, bone and joint toxicity, darkening or blackening of faeces.

Overdosage may lead to serious adverse effects such as renal failure, encephalopathy and neurotoxicity. May consider gastric lavage, purgation and hydration. Chelating agents may be useful.

Increased absorption with antisecretory drugs. Reduces absorption of tetracyclines.

Description: Bismuth subnitrate has been used for its supposed antacid and mildly astringent action in various GI disorders. It has also been used topically in the treatment of skin disorders, wounds, burns, haemorrhoids and other anorectal disorders.
Pharmacokinetics:
Absorption: Poor absorption in the GI tract. Increased gastric pH may increase bismuth absorption.
Distribution: Distributed throughout the body tissues, including bone.
Excretion: Unabsorbed bismuth is excreted in the faeces. Plasma half-life: about 5 days.

Antacids, Antireflux Agents & Antiulcerants