BISMUTH SUBGALLATE

Absorption

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

Toxicity

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 . Similarly, because of the biliary excretion of bismuth, severe liver disease may theoretically result in accumulation of bismuth as well .
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 . However, the insoluble inorganic bismuth compounds are reported to be mainly associated with reversible encephalopathy . 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 . This kind of encephalopathy is usually reversible with the discontinuation of the bismuth subgallate usage however .

Chemical properties

bright yellow powder

The Uses of BISMUTH SUBGALLATE

Bismuth Subgallate is pharmaceutical abuse deterrent compound constructed in more than one strengths.

The Uses of BISMUTH SUBGALLATE

Investigations of:

• Pharmacological activity, specifically NO and PGE2 production by macrophages
• Treatment of Helicobacter pylori infections

Indications

The most common medical purpose for which bismuth subgallate is currently and formally indicated for is the use as a non-prescription internal deodorant product for the purpose of deodorizing flatulence and stools .
Additionally, there are also various non-prescription (over the counter) bismuth subgallate based wound healing products as well as ongoing studies into whether or not the substance can be utilized as a legitimate hemostatic agent - usually for soft tissue surgery in otorhinolaryngology and/or dermatologic settings .
Moreover, in the past bismuth subgallate may have seen some use as a treatment for Helicobacter pylori infection . In contrast, contemporary first-line therapies generally involve proton pump inhibitor and antibiotic combination therapies that generally achieve high rates of pathogen eradication, ease of administration, and patient compliance.

Background

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.

What are the applications of Application

Bismuth(III) gallate basic is an inhibitor of production of nitric oxide synthase

Definition

ChEBI: Bismuth subgallate is a bismuth coordination entity. It has a role as an astringent.

Pharmacokinetics

Bismuth subgallate is a heavy metal salt that is relatively insoluble and poorly absorbed . As a result, systemic absorption is not necessary or possibly even desired when the agent is administered orally or onto specific otorhinolaryngology and/or dermatologic wound sites where it can execute its pharmacologic action directly within the gastrointestinal lumen to deodorize flatulence and stools or potentially elicit a hemostatic effect on wounds .
Additionally, like other bismuth agents, one of the most common side effects associated with bismuth subgallate is its propensity to cause a black discoloration of the tongue and stools when the agent combines with trace amounts of sulfur in the saliva and/or gastrointestinal tract . This discoloration is temporary and harmless, gradually dissipating over a number of days and eventually disappearing after the discontinuation of the bismuth agent .

Metabolism

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