Ranitidine bismuth citrate

Chemical name

N-[2-[[[5-[(Диметиламино)м��тил]-2-фуранил]метил]т��о]этил]-N'-метил-2-нитро -1,1- etendiamina bismuth citrate

Characteristics

Contains ranitidine (authority), trivalent bismuth citrate and in the weight ratio of 81:64:55. White or no white amorphous powder. Easily soluble in water.

Of drugs

The drugs-protivoyazvennoe. Is ulzerogenny combined effects : ranitidine blocks gistaminove H_2-retseptora obkladochnykh stomach cells, the basal ingibiruet and stimulirovannuyu use of the day and night the secretion of hydrochloric acid, bismuth citrate is protective (agent) influence on the mucous membrane of the stomach and bakteritiden against Helicobacter Pylori.v stomach dissociation for the individual components. Speed and the intake ranitidine proportional to the dose (up to 1600 mg), C_max achieved through normal hours, with an average of 455 ng / J Absorption variabelna bismuth, it is reduced by 50% (speed) and 25% (complete), with the admission 30 minutes before the food and rises with (above 6) vnutrijeluderngo pH. C_max (3.3 ng / ml) is defined through 15-60 minutes, there was no change in the range of doses of 400-800 mg and disproportionate increases at doses above 800 mg. Hardly koumouliruet : even in the appointment of 800 mg twice a day for 28 days C_max less than 20 ng / J The distribution of ranitidine - 1.7 l / kg, linking a plasma protein-15%, in the liver demetiliruetsa (1% of dose) and oxidized to N-oksida (4%) and S-oksida (1%), T_1/2 2,8-3,1-hour general and kidney Cl-760 and 530 l / min, with the urine through tubularna secreta displayed 30% dose. T_1/2 bismuth - 11-28 days, the relationship with the squirrels-98%, with urine output less than 1% of dose in feces-28% for 6 days. Eliminations both components of the kidney function and is not dependent on the liver.

Indications

Ulcers disease stomach and duodenal ulcers, eradikation Helicobacter pylori, treatment and prevention of the recurrence of Helicobacter pylori (in combination with klaritromitinom or amoksicillinom).

Contraindications

Hypersensitivity, the violation of kidney severe kidney failure, porphyria (incl. history), pregnancy and breast-feeding (at the end of treatment), children's age (up to 14 years).

Side-Effects

Tremor, dizziness, headaches, sleep disorders and taste, sputannosti consciousness, depression, hallucinations (mainly the very heavy older patients), zagrudinne pain gastralgia, constipation, nausea and vomiting, diarrhoea, tranzithornoe increased liver enzymes artralgia, mialgia, anaemia, lakopenia, thrombocytopenia, agranulozitos, pancitopenia, giperplazia aplasia or bone marrow transplantation, breast swelling glands in men skin itching, rash, anaphylacticskie reaction.

Specific guidance

Under the influence of bismuth is temporary and harmless dark language and blackening faeces.

Patient interaction

Penicillin III generation (amoxicillin), and makrolida (klaritromicin) increase (each) bakteritidnyi effect bismuth (for gelikobakter). Klaritromicin increases absorption ranitidine.

Overdosing

Side effects from the overdose of ranitidine reversible, not specific and did not Opasna.simptoma : a neiro- or nefrotoksicnosti Vismuta.lechenie : removal neabsorbirovannah amounts of blood, symptomatic therapy. Ranitidine bismuth and removed from the blood haemodialysis.

Precautions

Before treatment to verify in the absence of malignant processes in the digestive tract.

Dosing and Administration

During the first two weeks, 400 mg twice a day in combination with klaritromitinom (500 mg twice a day), the following two weeks, ranitidine bismuth citrate 400 mg twice a day regardless of the meal.

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