Drug/Small Molecule:
bismuth subsalicylate

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This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?
2D structure from PubChem
provided by PubChem

Overview

Generic Names
  • Bismuth oxide salicylate
  • Bismuth oxysalicylate
  • Bismuth(III) subsalicylate
  • Bismuthi subsalicylas
  • Bismutum subsalicylicum
  • bismuth
Trade Names
  • Bismatrol
  • Bismed
  • Bismuth caplets
  • Bismuth chewables
  • Extra strength bismuth
  • Extra-strength bismuth
  • Maalox multi action
  • PMS-bismuth subsalicylate
  • Pepto-bismol
  • Spiromak forte
  • Stabisol
  • Vismut
  • Wismutsubsalicylat
Brand Mixture Names
  • Bismuth + Antacid [Chewable Tablets] (Bismuth Subsalicylate + Calcium Carbonate)
  • Pepto-Bismol Chewables (Bismuth Subsalicylate + Calcium Carbonate)
  • Watkins Settelz (Bismuth Subsalicylate + Pectin + Phenyl Salicylate)

PharmGKB Accession Id:
PA164774805

Description

Bismuth subsalicylate is the active ingredient in the popular medication Pepto-Bismol that is used to treat nausea, heartburn, indigestion, upset stomach, diarrhea, and other temporary discomforts of the stomach and gastrointestinal tract. It is also the main ingredient of Kaopectate. It displays anti-inflammatory action (due to salicylic acid) and also acts as an antacid and mild antibiotic.

Source: Drug Bank

Indication

Used to treat nausea, heartburn, indigestion, upset stomach, diarrhea, and other temporary discomforts of the stomach and gastrointestinal tract.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

As an antidiarrheal, the exact mechanism has not been determined. Bismuth subsalicylate may exert its antidiarrheal action not only by stimulating absorption of fluid and electrolytes across the intestinal wall (antisecretory action) but also, when hydrolyzed to salicylic acid, by inhibiting synthesis of a prostaglandin responsible for intestinal inflammation and hypermotility. In addition, bismuth subsalicylate binds toxins produced by Escherichia coli. Both bismuth subsalicylate and the intestinal reaction products, bismuth oxychloride and bismuth hydroxide, are believed to have bactericidal action. As an antacid, bismuth has weak antacid properties.

Source: Drug Bank

Pharmacology

Bismuth subsalicylate displays anti-inflammatory action (due to salicylic acid) and also acts as an antacid and mild antibiotic. It can also cause a black tongue and black stools in some users of the drug, when it combines with trace amounts of sulfur in their saliva and gastrointestinal tract. This discoloration is temporary and harmless.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Based on in vitro dissociation data and in vivo animal data, bismuth subsalicylate is believed to be largely hydrolyzed in the stomach to bismuth oxychloride and salicylic acid. In the small intestine, nondissociated bismuth subsalicylate reacts with other anions (bicarbonate and phosphate) to form insoluble bismuth salts. In the colon, nondissociated bismuth subsalicylate and other bismuth salts react with hydrogen sulfide to produce bismuth sulfide, a highly insoluble black salt responsible for the darkening of the stools.

Source: Drug Bank

Absorption

Following oral administration, absorption of the salicylate component from the small intestine is generally rapid and complete (>90%).

Source: Drug Bank

Chemical Properties

Chemical Formula

C7H5BiO4

Source: Drug Bank

Isomeric SMILES

C1=CC=C2C(=C1)C(=O)O[Bi]O2.O

Source: Drug Bank

O[Bi]1OC(=O)C2=C(O1)C=CC=C2

Source: Drug Bank

Canonical SMILES

O[Bi]1OC(=O)C2=CC=CC=C2O1

Source: Drug Bank

Average Molecular Weight

362.0926

Source: Drug Bank

Monoisotopic Molecular Weight

361.999166889

Source: Drug Bank

LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB01294
ChEBI:
261649
KEGG Compound:
C07870
KEGG Drug:
D00728
PubChem Compound:
16682734
PubChem Substance:
46507128
7847793
Drugs Product Database (DPD):
2262363
ChemSpider:
17615374

Clinical Trials

These are trials that mention bismuth subsalicylate and are related to either pharmacogenetics or pharmacogenomics.

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.