Peringatan Keamanan

Depending on the level of severity of a patient's renal impairment, administration of bismuth compounds may not be appropriate as the reduced renal clearance can lead to undesirably elevated blood levels of bismuth A32571. Similarly, because of the biliary excretion of bismuth, severe liver disease may theoretically result in accumulation of bismuth as well A32571.

Bismuth toxicity seemingly develops only from excessive dosage (perhaps from ingestion of bismuth over a prolonged time or intramuscular injections) and is characterized by nephrotoxicity, osteoarthropathy, encephalopathy, hepatotoxicity, stomatitis, and gingivitis A32571. However, the insoluble inorganic bismuth compounds are reported to be mainly associated with reversible encephalopathy A32571. In fact a number of studies have discussed how patients may experience a syndrome of subacute, progressive encephalopathy involving potential aphasia, myoclonous, and/or gait instability after taking bismuth subgallate in large quantities well over the usual recommended dosages A32586, A32587. This kind of encephalopathy is usually reversible with the discontinuation of the bismuth subgallate usage however A32586, A32587.

Bismuth subgallate

DB13909

small molecule approved

Deskripsi

Bismuth subgallate is a yellow colored substance that presents as an odorless powder that undergoes discoloration when exposed to sunlight. It is a heavy metal salt of gallic acid that is highly insoluble and poorly absorbed. Possessing protective effects on the gastric mucosa, strong astringent effects, and not as yet elucidated antimicrobial and hemostatic actions, bismuth subgallate is most commonly available as an over-the-counter internal deodorant where it is often employed as the primary active ingredient.

Struktur Molekul 2D

Berat 394.091
Wujud solid

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) The bismuth component of bismuth subgallate is known to have a terminal half-life of 21-72 days [L2330].
Volume Distribusi In general, oral administration is one of the most common routes of administration for non-prescription bismuth subgallate products and gastrointestinal and systemic absorption is usually very low.
Klirens (Clearance) On average, the blood clearance of the bismuth component of a bismuth salt like bismuth subgallate is within the range of 50 to 95 ml/min [A32583].

Absorpsi

Bismuth subgallate is only slightly, if at all, absorbed after oral ingestion L2314. The general human oral bioavailability of bismuth subgallate has been reported as low as 0.04% L2314. Any absorption that does occur is likely to happen from the upper small intestine A32571. The gastrointestinal absorption of bismuth from bismuth compounds demonstrates a large interindividual variation L2314. Factors affecting the absorption involve the formulation of the bismuth subgallate compound as well as the dietary factors of the individuals themselves A32571. Nevertheless, absorption can be enhanced with the concomitant intake of citrate and sulfhydryl-group-containing compounds L2314. Conversely, the simultaneous administration of antacids or a diet that is high in thiol content can lower absorption of bismuth subgallate A32571.

Metabolisme

No specific metabolism of bismuth is known L2314. In the kidney it induces the de novo synthesis of a bismuth-metal-binding protein, which is a kind of methallothionein L2314.

Rute Eliminasi

Ingested bismuth is primarily eliminated unabsorbed by way of the faeces L2314. Any absorbed bismuth is eliminated from the body by both the urinary and faecal (including bile) routes L2314. Excretion of absorbed bismuth in the urine is rapid, with most of the metal excreted within 24 hours A32571. About 10% of the absorbed bismuth is detected in faeces, presumably owing to biliary secretion A32571.

Interaksi Obat

847 Data
Bismuth subsalicylate Bismuth subsalicylate may increase the neurotoxic activities of Bismuth subgallate.
Bismuth subcitrate potassium Bismuth subcitrate potassium may increase the neurotoxic activities of Bismuth subgallate.
Bismuth subcarbonate Bismuth subcarbonate may increase the neurotoxic activities of Bismuth subgallate.
Bismuth subnitrate Bismuth subnitrate may increase the neurotoxic activities of Bismuth subgallate.
Valproate bismuth Bismuth subgallate may increase the neurotoxic activities of Valproate bismuth.
Cyclosporine Cyclosporine may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Icosapent Icosapent may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefotiam Cefotiam may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Mesalazine Mesalazine may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefmenoxime Cefmenoxime may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefmetazole Cefmetazole may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Pamidronic acid Pamidronic acid may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Tenofovir disoproxil Tenofovir disoproxil may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Indomethacin Indomethacin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cidofovir Cidofovir may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefpiramide Cefpiramide may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Ceftazidime Ceftazidime may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Loracarbef Loracarbef may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefalotin Cefalotin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Nabumetone Nabumetone may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Ketorolac Ketorolac may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Tenoxicam Tenoxicam may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Celecoxib Celecoxib may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefotaxime Cefotaxime may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Tolmetin Tolmetin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Foscarnet Foscarnet may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Rofecoxib Rofecoxib may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Piroxicam Piroxicam may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Methotrexate Methotrexate may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cephalexin Cephalexin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Fenoprofen Fenoprofen may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Valaciclovir Valaciclovir may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Valdecoxib Valdecoxib may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Diclofenac Diclofenac may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Sulindac Sulindac may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Bacitracin Bacitracin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Amphotericin B Amphotericin B may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cephaloglycin Cephaloglycin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Flurbiprofen Flurbiprofen may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Adefovir dipivoxil Adefovir dipivoxil may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Pentamidine Pentamidine may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Etodolac Etodolac may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Mefenamic acid Mefenamic acid may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Acyclovir Acyclovir may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Naproxen Naproxen may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Sulfasalazine Sulfasalazine may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Phenylbutazone Phenylbutazone may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Meloxicam Meloxicam may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Carprofen Carprofen may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefaclor Cefaclor may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Diflunisal Diflunisal may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Tacrolimus Tacrolimus may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Ceforanide Ceforanide may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Salicylic acid Salicylic acid may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Meclofenamic acid Meclofenamic acid may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Acetylsalicylic acid Acetylsalicylic acid may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Carboplatin Carboplatin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Oxaprozin Oxaprozin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Ketoprofen Ketoprofen may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Balsalazide Balsalazide may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Ibuprofen Ibuprofen may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefditoren Cefditoren may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Atazanavir Atazanavir may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Colistimethate Colistimethate may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefuroxime Cefuroxime may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefapirin Cefapirin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefadroxil Cefadroxil may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefprozil Cefprozil may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Ceftriaxone Ceftriaxone may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Olsalazine Olsalazine may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Lumiracoxib Lumiracoxib may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefamandole Cefamandole may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefazolin Cefazolin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefonicid Cefonicid may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefoperazone Cefoperazone may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefotetan Cefotetan may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefoxitin Cefoxitin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Ceftizoxime Ceftizoxime may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefradine Cefradine may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Magnesium salicylate Magnesium salicylate may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Salsalate Salsalate may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Choline magnesium trisalicylate Choline magnesium trisalicylate may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefepime Cefepime may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefacetrile Cefacetrile may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Ceftibuten Ceftibuten may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cefpodoxime Cefpodoxime may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Antrafenine Antrafenine may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Aminophenazone Aminophenazone may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Antipyrine Antipyrine may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Tiaprofenic acid Tiaprofenic acid may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Lopinavir Lopinavir may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Etoricoxib Etoricoxib may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Hydrolyzed Cephalothin Hydrolyzed Cephalothin may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Cephalothin Group Cephalothin Group may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Oxyphenbutazone Oxyphenbutazone may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Latamoxef Latamoxef may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Nimesulide Nimesulide may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Benoxaprofen Benoxaprofen may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Metamizole Metamizole may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.
Zomepirac Zomepirac may decrease the excretion rate of Bismuth subgallate which could result in a higher serum level.

Referensi & Sumber

Artikel (PubMed)
  • PMID: 4813513
    Sparberg M: Correspondence: Bismuth subgallate as an effective means for the control of ileostomy odor: a double blind study. Gastroenterology. 1974 Mar;66(3):476.
  • PMID: 11870955
    Tramontina VA, Machado MA, Nogueira Filho Gda R, Kim SH, Vizzioli MR, Toledo Sd: Effect of bismuth subgallate (local hemostatic agent) on wound healing in rats. Histological and histometric findings. Braz Dent J. 2002;13(1):11-6.
  • PMID: 19375279
    Puia SA, Renou SJ, Rey EA, Guglielmotti MB, Bozzini CE: Effect of bismuth subgallate (a hemostatic agent) on bone repair; a histologic, radiographic and histomorphometric study in rats. Int J Oral Maxillofac Surg. 2009 Jul;38(7):785-9. doi: 10.1016/j.ijom.2009.03.003. Epub 2009 Apr 16.
  • PMID: 26614041
    Couto EV, Ballin CR, Sampaio CP, Maeda CA, Ballin CH, Dassi CS, Miura LY: Experimental study on the effects of bismuth subgallate on the inflammatory process and angiogenesis of the oral mucosa. Braz J Otorhinolaryngol. 2016 Jan-Feb;82(1):17-25. doi: 10.1016/j.bjorl.2014.12.009. Epub 2015 Oct 27.
  • PMID: 12895572
    Mai LM, Lin CY, Chen CY, Tsai YC: Synergistic effect of bismuth subgallate and borneol, the major components of Sulbogin, on the healing of skin wound. Biomaterials. 2003 Aug;24(18):3005-12.
  • PMID: 9146788
    Lambert JR, Midolo P: The actions of bismuth in the treatment of Helicobacter pylori infection. Aliment Pharmacol Ther. 1997 Apr;11 Suppl 1:27-33.
  • PMID: 23120195
    Agrawal SR, Jain AK, Marathe D, Agrawal R: The effect of bismuth subgallate as haemostatic agent in tonsillectomy. Indian J Otolaryngol Head Neck Surg. 2005 Oct;57(4):287-9. doi: 10.1007/BF02907688.
  • PMID: 27429283
    Vyas KS, Vasconez HC: Wound Healing: Biologics, Skin Substitutes, Biomembranes and Scaffolds. Healthcare (Basel). 2014 Sep 10;2(3):356-400. doi: 10.3390/healthcare2030356.
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