Mode of action:
De-Nol anti-ulcer drug that contains the active ingredient - bismuth subcitrate. De-Nol belongs to the binding of drugs, however, has a multi-faceted action, affecting various parts of the pathogenesis of peptic ulcer disease. The main pharmacological effects of the drug include astringent, antibacterial and gastrotsitoprotektornoe action.
The mechanism of binding activities of bismuth subcitrate is based on its ability to precipitate proteins by forming chelates with them. Thus, the mucosal surface of the stomach and duodenum formed protective film. It is noted that the formation of a protective film takes place entirely in areas with erosive and ulcerative lesions, which contributes to their early scarring by eliminating the negative impact of the acidic environment of the stomach. In reaction chelating bismuth subcitrate protein plays an important role acidic environment of the stomach, which acts as a catalyst in the reaction.
Drug De-Nol has bactericidal activity against Helicobacter pylori. The antimicrobial effect of bismuth subcitrate is based on its ability to inhibit the enzymatic activity in a cell of a microorganism, which leads to a change in the flow of vital reactions and, consequently, the destruction of bacteria. Furthermore, the drug permeability and gives the microstructure of the cell membrane which not only reduces the viability of cells, but also leads to a loss of adhesiveness Helicobacter pylori. Noted a reduction of virulence and motility of micro-organisms under the influence of bismuth subcitrate. In contrast to other antimicrobial agents used for the treatment of diseases associated with Helicobacter pylori, active currently not identified strains resistant to the action of bismuth subcitrate. Bismuth subcitrate, characterized by a high degree of solubility, whereby the drug is able to penetrate deep into the mucus layer, inactivating microorganisms under the mucosa. Thus, when using the drug De-Nol reduces the risk of recurrence of peptic ulcer.
De-Nol gastrotsitoprotektivnym has a pronounced effect, which is based on such mechanisms of action:
- Stimulation of the biosynthesis of prostaglandin E2, under the influence of which increases the formation of mucin production and bicarbonate ions, which form a protective mucous-bicarbonate barrier.
- Improvement of the microcirculation in the antral part of the stomach and duodenum, which contributes to the improvement of metabolism at the cellular level, which leads to acceleration of regeneration of cells and helps to restore the microstructure of the mucous membranes.
- Reducing the amount of hydrochloric acid by reducing its secretion fundic cells of the stomach, which leads to decrease the acidity of gastric juice.
- Due to the formation of complex compounds of pepsin with bismuth subcitrate inactivation of pepsin, which results in a decreased peptic activity of gastric juice.
After oral administration absorbed into the systemic circulation, only a small part of the bismuth subcitrate. The concentration of drug in the blood increases with prolonged use. The drug is excreted in the feces.
Indications for use:
The drug is used for various diseases of the stomach and duodenum, which are accompanied by mucosal lesions, including:
- Gastric ulcer and duodenal ulcers caused by Helicobacter pylori, including peptic ulcer of the stomach and duodenum;
- Acute and chronic gastritis and gastro, including associated with Helicobacter pylori;
- Destruction of the gastric mucosa, resulting from treatment with nonsteroidal anti-inflammatory drugs;
- Functional dyspepsia is not related to organic disease of the gastrointestinal tract;
- The drug is also used to treat patients suffering from irritable bowel syndrome, which is accompanied by a violation of the chair.
How to use:
The drug used for the treatment of adults and children over the age of 14 years. The duration of treatment and the dose determined by the attending physician for each patient, depending on the nature of the disease.
Usually administered 4 tablets of the drug per day. The daily dose is recommended to divide into 2 or 4 parts.
According to the first scheme of the drug by taking 1 tablet per 30 minutes before a meal (with meals thrice) and 1 tablet before bedtime.
An alternative regimen take 2 tablets of the preparation per 30 minutes before meals 2 times per day (morning and evening).
The tablet is recommended to swallow whole without chewing or crushing, drinking plenty of water. It is not recommended to wash down pills milk. Duration of treatment is usually from 4 to 8 weeks. After taking the drug should not take medicines containing bismuth, for 2 months.
If the results of microbiological tests show the presence of Helicobacter pylori, is recommended to perform the treatment on one of the following schemes:
De-Nol - 1 tablet per 30 minutes before meals 2 times per day;
Clarithromycin - 500 mg 2 times a day;
Amoxicillin - 1000 mg 2 times a day.
The duration of treatment 1-2 weeks.
De-Nol - 1 tablet 30 minutes before a meal two times a day;
Tetracycline - at 500mg 4 times a day;
Metronidazole - at 500mg 3 times a day;
Preparations of proton pump inhibitors (omeprazole, lansoprazole, etc.) in the standard dosage.
The duration of treatment 1-2 weeks.
After the completion of the combination therapy may continue treatment with De-Nol to accelerate regeneration of the mucous membrane of the stomach and duodenum. In this case, drug taking by the standard procedure. Please note that the total duration of therapy with De-Nol should not exceed 8 weeks.
The drug is usually well tolerated, but some patients had such side effects when using the drug De-Nol:
The gastro-intestinal tract: nausea, vomiting, stool disorders (development as constipation and diarrhea), a slight darkening of the tongue, staining stool in black.
Allergic reactions: itching, rash, urticaria. Very rarely noted the development of anaphylactic reactions.
With long-term use of the drug or taking high doses, patients have a buildup of bismuth in the tissues of the central nervous system that can cause encephalopathy.
Side effects are reversible and transient after discontinuation of the drug.
- Hypersensitivity to the drug;
- Administration of drugs containing bismuth;
- During pregnancy and lactation;
- Severe renal dysfunction;
- The drug is not indicated for children under the age of 14 years.
The drug is contraindicated in pregnancy.
If necessary, use during lactation should decide on the termination of breastfeeding.
Interactions with other drugs:
Milk, food and antacids reduce the effectiveness of the drug De-Nol. Recommended observe interval of at least 30 minutes between doses of bismuth subcitrate and antacids. It is recommended to take the drug at least 30 minutes before eating.
The drug is not used concurrently with other medicinal preparations containing bismuth, since simultaneous use of several drugs bismuth increases the risk of side effects, including the risk of encephalopathy.
Using the drug in doses many times higher than recommended, or with prolonged use of excessive doses of the drug may develop bismuth poisoning. Symptoms of poisoning are the development of reversible renal failure and increase the level of bismuth in the blood.
No specific antidote. If overdose is shown gastric lavage, enterosorbents and symptomatic therapy aimed at maintaining renal function. In case of overdose, also shows the assignment of saline laxatives. With the development of severe renal impairment shown hemodialysis.
Tablets of 8 pieces, at 7 or 14 blisters per carton.
The drug should be stored in a dry place away from direct sunlight at temperatures between 15 and 25 degrees Celsius.
Shelf life - 4 years.
Gastro rules Bismofalk.
1 tablet of the drug De-Nol contains:
Colloidal bismuth subcitrate - 120 mg;