Ranitidine Bismuth salicylate

RANITIDINE TRIPOTASSIUM DICITRATOBISMUTHATE t adverse effects of tripotassium dicitratobismuthate t absorption Do not use together for more than 16 weeks. Bismuth salicylate and subnitrate do not interact... 

Bismuth salts are still in use. Tripotassium dicitrato-bismuthate and bicitropeptide (a bismuth-peptide complex) are used in the eradication of Helicobacter pylori in combination with antibiotics (SEDA-21,233) (1 ), and ranitidine bismuth citrate is used to treat peptic ulcer (5). Bismuth salicylates are used in other intestinal diseases, such as microscopic colitis (6,7) and collagenous colitis (8). Bismuth subnitrate plus iodoform is used to pack surgical cavities. Bismuth oxide and bismuth subgallate are found in some topical formulations that are used for treating hemorrhoids. Bismuth is also used topically as a bacteriostatic. 

Ranitidine possibly causes an increase in the absorption of bismuth from tripotassium dicitratobismuthate, but not bismuth salicylate or bismuth subnitrate. Any increase is considered unlikely to be clinically relevant with recommended short courses for H. pylori eradication. Other H2-receptor antagonists would be expected to interact similarly. 

The AUC of a single 240-mg dose of tripotassium dicitratobismuthate (TDB, De Noltabs), was increased fourfold in 12 healthy subjects given two 300-mg doses of ranitidine (one the night before and one 2 hours before the bismuth compound). The maximum serum levels were approximately doubled. The same regimen of ranitidine had no significant effect on the absorption of bismuth from bismuth salicylate (Pepto-Bismol) or bismuth subnitrate (Roter tablets) ... 

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