Interest in bismuth preparations increased greatly after the discovery of Helicobacter pylori: it turned out that bismuth-based drugs in combination with antibiotics can effectively suppress the activity of the bacterium, leading to the development of peptic ulcers. The “gold standard” in Helicobacter eradication is bismuth subcitrate.
List of bismuth preparations
- "De-Nol";
- "Vicair";
- "Vikalin";
- "Escape";
- "Ulkavis";
- "Vicanol Life";
- "Vitridinol."
"De-Nol"
Manufacturer: Astellas Pharma Europe (Netherlands).
Available in the form of tablets containing 120 mg of bismuth subcitrate. The drug is practically not absorbed into the blood from the gastrointestinal tract. Can be used in the treatment of children from 4 years of age (under medical supervision).
To destroy Helicobacter, it is recommended to use the product in combination with other antibacterial drugs (metronidazole, amoxicillin, clarithromycin).
"Vicair"
, “Valenta”, “Aveksima” (Russia)
It is a combined preparation: in addition to bismuth nitrate (350 mg), it contains antacids (magnesium carbonate and sodium bicarbonate), buckthorn bark powder (25 mg) and calamus rhizomes (25 mg). Available in tablet form. Be sure to read: Breath test for Helicobacter pylori: types of tests, reliability, preparation and conduct
The action of the drug is aimed at the interaction of the main components: bismuth exhibits protective and antibacterial properties, antacids relieve symptoms of increased gastric acidity, and herbal supplements have laxative and antispasmodic effects. This allows you to normalize the functions of the digestive organs.
"Vikalin"
, "Aveksima" and "Avva Rus" (Russia).
The drug is similar in composition to Vikair, but additionally contains rutin (reduces capillary permeability) and kellin (like calamus, relieves spasms of smooth muscles of the gastrointestinal tract).
The product is available in tablet form.
"Escape"
(Russia).
It is an analogue of “De-nol”, contains the same active ingredient - bismuth tripotassium dicitrate in a dosage of 120 mg. Available in the form of film-coated tablets. Its price, compared to the original drug, is 200 rubles lower.
"Ulkavis"
Manufacturer – KRKA (Slovenia).
The medicine also contains bismuth subcitrate (120 mg), so its indications will be the same for other bismuth-containing drugs.
Available in the form of film-coated tablets. Can be used to treat gastrointestinal diseases in children from 4 years of age.
"Vikanol Life"
(Russia).
The composition contains 120 mg of bismuth tripotassium dicitrate. Used as an aid in the treatment of the gastrointestinal tract. The drug does not enter the bloodstream because it is not absorbed by the intestines and is excreted unchanged from the intestines along with feces.
"Vitridinol"
(Russia).
It is another analogue of De-nol with the same composition. Available in the form of film-coated tablets. There are 60 of them in the package. The indications for the product are exactly the same as for other drugs containing bismuth.
Bismuth for gastritis
Bismuth preparations belong to the pharmacotherapeutic group of gastroprotectors and are produced mainly in the form of tablets and capsules in an enteric coating. They show pronounced activity against diseases of the gastrointestinal tract. Bismuth preparations used for gastritis and gastric ulcer (peptic ulcer) exhibit several pronounced effects. Gastroenterology uses drugs from this group as gastrocytoprotective, antiulcer and antibacterial agents.
It is important that bismuth preparations, if used in isolation, inhibit the activity of the Helicobacter microbe, but do not change the properties of gastric juice and do not affect digestion. However, taking bismuth supplements can turn stool black. List of bismuth preparations used to treat diseases of the digestive system - Ulcavis; Vis-Nol; Gastro-Norm; De-Nol; Psorinohel-N; Vikalin; Vikair.
De-nol medicine based on bismuth for the treatment of gastritis
The classic preparation of bismuth is colloidal bismuth subcitrate in combination with potassium.
The classic preparation of bismuth is colloidal bismuth subcitrate in combination with potassium, it is sold under the well-known brand name De-nol
It is sold under the well-known brand De-nol, it is produced in Russia under the control of the Astellas company. This drug is also known as Escape. Adults take De-nol before meals, one tablet four times a day, and at night. Other schemes are also possible.
The drugs should not be taken for more than 2 months, but eradication lasts much shorter. The cost of the drug depends on the dosage, but the average price of a package of 32 tablets of 120 mg each usually does not exceed 300 rubles; In international recommendations you can also find bismuth subsalicylate, a metal compound with salicylic acid.
This compound has pronounced activity against Helicobacter pylori, but it is rarely used in the Russian Federation. The period for taking bismuth compounds in eradication regimens is determined by the doctor.
Bismuth should not be taken during pregnancy and breastfeeding, and should not be used for too long, as it accumulates in the central nervous system with the gradual development of encephalopathy symptoms. Analogues of the drug are Ulcavis; Vikalin; Vikair; Vis-Nol.
Features of the use of bismuth preparations
General recommendations
- Bismuth-containing products should be taken before meals (30 minutes) and washed down with a small amount of liquid. It is preferable to use only water, and it is not advisable to drink it with milk, juices, tea: these drinks change the acidic environment in the stomach, which reduces the effectiveness of bismuth salts.
- For the same purpose (see above), they refuse to take antacids before using the medicine.
- It is not recommended to combine bismuth preparations: this can lead to an overdose.
- Bismuth should not be used with other medications simultaneously, but at 2-3 hour intervals, unless a different regimen is prescribed.
Be sure to read:
Antihistamines: list of medications and features of their use
The standard course of treatment for gastritis and peptic ulcers is from 4 to 8 weeks. The dosage is selected by the doctor individually.
Destruction of Helicobacter
There are several schemes with which you can achieve positive results:
- First line (triple therapy) – clarithromycin + PPI + amoxicillin/metronidazole. The course is set individually, usually from 7 to 14 days.
- The second line is PPI + tripotassium bismuth dicitrate + metronidazole + tetracycline. The duration of the course is determined by the doctor.
The effectiveness of treatment is checked using instrumental tests (for Helicobacter antigens and antibodies to it), FEGDS and/or biopsy.
How to take bismuth for gastritis
Bismuth preparations are indicated for erosive and ulcerative lesions of the mucous membranes of the intestines and stomach during an exacerbation. Effective against ulcerative pathologies caused by Helicobacter. Prescribed to eliminate inflammatory processes in the gastrointestinal tract during an exacerbation, with symptoms of dyspeptic disorder: diarrhea, flatulence, bloating, vomiting. Effective for digestive disorders not associated with organic diseases of the gastrointestinal tract.
Tablets and suspensions are taken orally. Typically, bismuth preparations are approved for use in children over eight years of age in reduced dosages. Adults and children over 12 years of age are prescribed the same dosage by a gastroenterologist. The frequency of administration is from two to four times a day and is determined by the attending physician. Medicines should be taken with non-carbonated water, swallowing whole. Do not drink milk or any other drinks. Do not take products with bismuth for another 8 weeks after completing the course.
Contraindications for taking bismuth for gastritis
Bismuth preparations are not prescribed to patients who have a medical history of episodes of intolerance to bismuth and its preparations. Prohibited for severe pathologies of the kidneys and urinary system, during pregnancy and breastfeeding. Do not take the drug for longer than 8 weeks. Darkening of the tongue or gums may occur. It is not recommended to combine with alcoholic drinks.
During treatment with bismuth preparations, you should stop breastfeeding. It has not been established what effect bismuth preparations have on the fetus of a pregnant woman and her body. The combination of several medications containing bismuth is contraindicated. Not used in the treatment of gastrointestinal pathologies in children under four years of age.
Sources:
- https://prokishechnik.info/preparaty/vismuta.html
- https://schelkovo-bolnica1.ru/preparaty/preparaty-vismuta-dlya-zheludka-spisok-sredstv-i-osobennosti-ih-primeneniya/
- https://health-ua.com/article/4472-ot-vismuta-do-denola—sovremennye-strategii-i-perspektivy
- https://expertology.ru/13-sovremennykh-preparatov-dlya-lecheniya-khelikobakternoy-infektsii-khelikobakter-pilori/
- https://dzrmuzshkola2.ru/gastrit/pri-gastrite-samye-effektivnye-sredstva-sxema-lechenie-medikamentami-chto-prinimat-pri-yazve-zheludka.html#i-83
Alternative to bismuth preparations
Despite the fact that bismuth salts have proven themselves in the treatment of gastrointestinal disorders, not all groups of patients tolerate these drugs well.
For replacement, herbal medicines are used, as well as synthetic drugs based on sucralfate, omeprazole, and pirenzepine. These medications include:
- "Venter";
- "Gastrocepin";
- "Omeprazole";
- "Domstal-O";
- "Omez DSR" and others.
The properties of these drugs make it possible to achieve effects similar to those of bismuth salts. Thus, sucralfate forms a protective coating on the mucous membranes and reduces the activity of digestive enzymes; omeprazole and pirenzepine reduce the production of gastric juice, and herbal remedies in combination with synthetic drugs enhance the regenerative abilities of the body and gently normalize the functioning of the digestive organs.
In continuation of the topic, be sure to read:
- Diagnosis of Helicobacter pylori: antibodies, breath test and biopsy
- What medications should I use for increased gas formation?
- Heartburn medications: review of tablets and features of their use
- Treatment tables (diets) No. 1-15 according to Pevzner: food tables and diet
- Irritable bowel syndrome: symptoms and treatments
- Symbiotics: concept, list of drugs and products
- Duodenal ulcer: how is the pathology manifested and treated?
- Gastroprotectors: names of drugs and their use in gastroenterology
- List of intestinal antiseptics and their use
- Antiulcer drugs for the stomach and duodenum
Be sure to read:
pH-metry of the stomach: preparation, implementation and interpretation of diagnostic results
Are there possible complications during therapy?
So, the doctor prescribed De-Nol for you. What complications can this drug cause? Bismuth tripotassium dicitrate, or rather drugs in which it is the main active substance, extremely rarely lead to the development of side effects. However, some complications are still possible, so it is worth familiarizing yourself with the list of them. During therapy, disorders of the digestive system may occur, including nausea, constipation, diarrhea and vomiting. In some patients, the medicine causes allergic reactions, which are manifested by skin itching, redness, rashes, and swelling.
You should be very careful when taking this drug for a long time, since bismuth tends to accumulate in nerve tissues, which, in turn, can lead to the development of encephalopathy.
Pharmacodynamics
Now it’s worth discussing how bismuth tripotassium dicitrate affects the body. It is a hepatoprotective and antiulcer substance that is effective against Helicobacter pylori. In addition, it has anti-inflammatory and astringent effects.
After the tablet is ingested, its insoluble acids are precipitated - all due to the acidic environment of the stomach. Then chelate compounds are formed with the protein substrate, which look like a protective film. It protects the gastrointestinal tract from aggressive factors for a long time.
Plus, “Bismuth tripotassium dicitrate” (120 mg and other dosages), increasing the synthesis of prostaglandin E, mucus formation and bicarbonate secretion, stimulates the activity of cytoprotective mechanisms, increases the resistance of the gastrointestinal mucosa to the effects of pepsin, hydrochloric acid, bile salts acids and enzymes, reduces the activity of pepsinogen and pepsin, leading to the accumulation of epidermal factor in the defect area.
"Bismuth tripotassium dicitrate" is almost not absorbed from the gastrointestinal tract. And it is excreted from the body mainly with feces. Only a small amount of this substance enters the plasma, and it is excreted by the kidneys.
Antisecretory agents
These pills reduce the amount of gastric juice because they block histamine receptors. The most common medications from this group are Ranitidine, Gastrocepin, Cimetidine.
This category includes proton pump inhibitors, which reduce acid secretion. Most often from this group, patients are prescribed Omeprazole, Pariet.
Ranitidine
Helps reduce the production of hydrochloric acid, improves blood microcirculation. It can be prescribed for treatment and prevention if a person has a predisposition to the disease. Ranitidine is usually taken twice a day.
Gastrocepin
This is an M1-cholinergic receptor blocker, the action is aimed at suppressing the production of gastric juice, as well as protecting the mucous membrane from an aggressive alkaline environment. Gastrocepin is prescribed for high acidity to reduce the amount of gastric juice secreted. You need to take the tablets 2 times a day.
Cimetidine
This drug reduces acidity levels and makes acid production less intense. You can take the tablets right before meals for 6 weeks.
Omeprazole
A proton pump inhibitor that is used to reduce acid production. The last stage of acid formation is suppressed due to the composition of the tablet. Therefore, the level of secretion decreases regardless of the origin of the stimulus. This drug has a rapid effect that lasts throughout the day. Contraindications for use include pregnancy and lactation.
Pariet
A proton pump inhibitor, the action of which is aimed at reducing acidity. The drug has a whole list of side effects, so you should not take it without a doctor. Otherwise, headaches, rashes, diarrhea or constipation may occur.
