Ranitidine bismuth citrate - drug, which has antisecretory and bactericidal action.
Group affiliation: H2-histamine receptor blocker.
Shape
Physical
Pills. The film-coated tablet contains ranitidine bismuth citrate 400 mg; in a blister 14 pcs., in a box 1, 2 or 4 blisters.
Chemical
N- / 2 - /// 5 - / (Dimethylamino) methyl / -2-furanyl / methyl / thio / ethyl / -N'-methyl-2-nitro-1,1-ethenediamine bismuth citrate.
Pharmacological properties
Antiulcer, which is mediated by two active ingredients. Ranitidine - a blocker of H2-histamine receptors, suppresses basal and stimulated, day and night gastric acid secretion, reducing both the volume of its secretion and the concentration hydrochloric acid and pepsin are secreted. Bismuth citrate in vitro has a bactericidal effect on Helicobacter pylori, a protective effect on the gastric mucosa.
Indications
Stomach ulcer and duodenal ulcer, including those associated with Helicobacter pylori (in combination with amoxicillin or clarithromycin ohm).
Prospects for repurposing
Ranitidine bismuth citrate may also be effective against coronavirus and SARS-CoV-2, since it exhibits low cytotoxicity and is able to protect cells from infection with the SARS-CoV-2 virus, with a selectivity index of several times higher than that of remdesivir a. This is due to the fact that it inhibits the activity required for viral replication helicase Nsp13 SARS-CoV-2 due to irreversible displacement of zinc (II) ions from enzyme and bismuth ions ( III)
Contraindications
Hypersensitivity, acute porphyria, chronic renal failure (CC less than 25 ml / min), childhood (up to 14 years), pregnancy, lactation.
Side effects
From the digestive system: gastralgia, diarrhea or constipation, increased activity of "hepatic" transaminases, hepatitis (hepatocellular, cholestatic or mixed, with or without jaundice, usually reversible), acute pancreatitis. From the side of the cardiovascular system: decrease BP, bradycardia, AV block, chest pain, asystole (with injection). On the part of the hematopoietic organs: anemia, leukopenia, thrombocytopenia, agranulocytosis, pancytopenia, aplasia bone marrow. From the nervous system and sensory organs: headache, dizziness, depression, hallucinations, in severe and elderly patients - impaired visual perception (associated with a violation of accommodation); violation of taste; tremor, confusion. From the side of the musculoskeletal system: arthralgia, myalgia. Allergic reactions: pruritus, urticaria, angioedema, bronchospasm, anaphylactic shock, anaphylactoid reactions. Others: gynecomastia in men.
Overdose. Symptoms: neuro- and nephrotoxicity. Treatment: gastric lavage, symptomatic therapy. Ranitidine and bismuth can be removed from the bloodstream by hemodialysis a.
Method of administration and dosage
Inside, regardless of food intake, 2 times a day (morning and evening). In the treatment and prevention of benign gastric and duodenal ulcers, as well as for the eradication of Helicobacter pylori and the relief of concomitant symptoms of dyspepsia, the following combination therapy regimens are used. Within 7 days - 3 drugs: Scheme 1. 2 times a day - ranitidine bismuth citrate 400 mg, clarithromycin 500 mg, metronidazole 400 mg or amoxicillin 1 g. Scheme 2. 2 times a day - ranitidine bismuth citrate 400 mg, clarithromycin 250 mg, metronidazole 400 or 500 mg or tinidazole 500 mg. Scheme 3. Ranitidine bismuth citrate 400 mg 2 times a day, metronidazole 500 mg 3 times a day, tetracycline 500 mg 4 times a day. Scheme 4. 2 times a day - ranitidine bismuth citrate 400 mg, tinidazole 500 mg, amoxicillin 1 g. Within 14 days - 2 drugs: Scheme 5. Ranitidine bismuth citrate 400 mg 2 times a day and clarithromycin 500 mg 2 or 3 times a day. Scheme 6. Ranitidine bismuth citrate 400 mg 2 times a day and amoxicillin 500 mg 4 times a day. To stimulate regeneration processes in ulcerative diseases of the stomach and duodenal ulcer - 800 mg / day (for 2 doses) for 28 days. For the treatment of duodenal ulcers - 800 mg / day (for 2 doses) for 4 weeks (can be extended up to 8 weeks if necessary); with a stomach ulcer - 8 weeks.