Bismuth biskalcitrate

Bismuth compounds Bismuth biskalcitrate. Bismuth salicylate. Bismuth subnitrate. Tripotassium dicitratobismuthate... 

Omeprazole markedly increases the absorption and bioavailability of bismuth from tripotassium dicitratobismuthate and bismuth biskalcitrate. Other proton pump inhibitors are expected to interact similarly. However, this is probably unlikely to be clinically relevant. 

Thirty-four healthy subjects were randomised to receive a triple therapy capsule Helizide (containing bismuth biskalcitrate 140 mg, metronidazole 125 mg, and tetracycline 125 mg) at a dose of three capsules four times daily with or without omeprazole 20 mg twice daily for 6 days. Omeprazole increased the maximum serum levels and AUC of bismuth by about threefold. However, the maximum serum level achieved was 25.5 micrograms/L, which was still well below 50 micrograms/L, a level reported to be highly unlikely to cause toxicity. The authors also state that in clinical trials of Helizide with omeprazole for 10 days in several hundred patients, no patient showed signs of encephalopathy, a notable toxic adverse effect of bismuth. ... 

O Morain C, Borody T, Farley A, De Boer WA, DaUaire C, Schuman R, Piotrowski J, Fallone CA, T3dgat G, Megraud F, Spenard J. Efflcacy and safety of single-triple capsules of bismuth biskalcitrate, metronidazole and tetracycline, given with omeprazole, for the eradication of Helicobacter pylori an international multicentre study. Aliment Pharmacol Ther (2003) 17,... 

Spenard J, Aumais C, Massicotte J, Tremblay C, Lefebvre M. Influence of omeprazole on bioavailability of bismuth following administration of a triple capsule of bismutii biskalcitrate, metronidazole, and tetracycline. J Clin Pharmacol (2004) 44, 640-5. 

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