Interacting drugs- summary

Bismuth subsalicylates +

Aspirin

 If taken with aspririn and ringing in ears occurs, discontinue use

Tetracyclines                                                                                                                    decrease GI absorption and bioavailability of tetracyclines 

Indigestion

None reported

None reported

Special precautions:

Impaction- may occur in infants and debilated patients

Radiologic examinations- May interfere with radiologic examinations of GI tract. Bismuth is radiopaque.

Indications:

For digestion without causing constipation, nausea, control of diarrhea, including travellers diarrhea, within 24 hours. Also relieves abdominal cramps.

Dosage-

Adults- 2 tablets or 30ml

Children- 9 to 12 years- 2/3 rd tablet or 10ml 3 to 6 years- 1/3 rd tablet or 5ml; bleow 3 years- Consult physician

Bismuth sub salicylate-

1. Allergy- Tell your doctor if you ever had and unusual or allegic reaction to bismuth subsalicylate or other salicylates such as aspirin, including oil of winter green.

2. Diet- Tell your doctor if you are on any special diet, such a low-sodium or low sugar diet.

3. Pregnancy- Occassional use of bismuth salicylate is not likely to cause problems in the fetus or in the newborn. Salicylates have not shown to cause birth defects in humans. Use of salicyltes may cause unwanted effects on the heart or blood flow in the new born infant. Use of salicylates during the last 2 weeks of pregnancy may cause bleeding problems in the fetus before or during delivery or in the new born infant.

4. Breast feeding- Salicylates pass into breast milk. Although they have not been shown to cause problems in nursing babies it is possible that problems may occur if large amounts of salicylates are taken regularly.

5.Children- FluId loss caued by diarrhea may result in a severe conditon. Medicine for diarrrhea must not be given to children ( under 3 years of age) without checking with the doctor. In older children suffering from diarrhea medicine for diarrhea may be used , but it is important that a sufficient amount of liquids be given to replace the fluid lost by the body.

6. Other medicines- when taking bismuth subsalicylates, tell you doctor if you are taking any of the following-                                                                                             Anticoagulants -heparin- salicylates in the medicine may increase the chance                  of bleeding.                                                                                                                   Antidiabetics- oral,- this medicine may make the levels of sugar in the blood                  too low.                                                                                                                              Medicine for pain- and inflammation- (except narcotics) - if these medicines             contains salicylates , use of bismuth salicylates may lead to increased side effects of overdose.                                                                                                                     Probenecid or sulfinpyrazone - bismuth sub salicylate may make these medicines   less effective for treating gout Tetracycline by mouth (medicine for infection ) tablet         form of bismuth subsalicylate should be taken at least 1 to 3 hrs before or after           tetracycline , otherwise it may decrease the effect of tertacycline.

7.Other medical problem s- presence of other medical problems may affect the           use of bismuth subsalicylate.                                                                                         Dysentry- condition may become worse- a different kind of treatment is reqd.            Gout- salicylate may worsen the gout and make the medicine used for gout                   less effective                                                                                                          Hemophilia- or other bleeding problems  - salicylate may increase the chance                     of bleeding                                                                                                                          Kidney disease- greater chance  of side effects because body may be unable                  to get rid of bismuth subsalicyltate                                                                                        Stomach ulcer- use of this medicine may make the condition worse.

8. Missed dose- Take the medicine as directed by the doctor. If you miss a dose,              take it as soon as you remember. however, If it almost time for the next dose                    go back to the regular schedule dosing schedule. Do not double doses.

Pharmacology:

Bismuth subsalicylate(BSS) appears to have antimicrobial effects in vitro and may have anti-inflammatory effects. The salicylate moiety provides the antisecretory effect, while the bismuth moiety may exert direct antimicrobial effects against bacterial and viral enteropathogens

Pharmacokinetics:

BSS undergoes chemical dissociation in the GI tract. Following ingestion, salcylate is absorbed with more than 90% recovered in the urine; plasma levels are simil

Refer Bismuth salts