bismuth-subsalicylate and Vomiting

The influence of a typical 60-mL dose of subsalicylate bismuth (Pepto-Bismol) on the absorption of 200 mg of orally administered doxycycline hyclate was studied. Bioavailability of doxycycline was significantly reduced by 37% and 51%, respectively, when subsalicylate bismuth was given simultaneously and as a multiple-dose regimen before doxycycline. Peak serum concentrations of doxycycline were significantly decreased when subsalicylate bismuth was given two hours before doxycycline but not when given two hours after doxycycline. Subsalicylate bismuth should not be taken when doxycycline is used for therapeutic purposes, and we suggest travelers should not take the agents together in an effort to prevent diarrhea.

Topics: Adult; Biological Availability; Bismuth; Clinical Trials as Topic; Double-Blind Method; Doxycycline; Drug Interactions; Humans; Male; Organometallic Compounds; Random Allocation; Salicylates; Vomiting

Renal pigmentation due to the administration of exogenous compounds is an uncommon finding in most species. This report describes renal pigmentation and intranuclear inclusions of the proximal convoluted tubules due to chronic bismuth administration in a rhesus macaque. An 11-year-old Indian-origin rhesus macaque with a medical history of chronic intermittent vomiting had been treated with bismuth subsalicylate, famotidine, and omeprazole singly or in combination over the course of 8 years. At necropsy, the renal cortices were diffusely dark green to black. Light and electron microscopy revealed intranuclear inclusions within the majority of renal proximal tubular epithelial cells. These inclusions appeared magenta to brown when stained with hematoxylin and eosin and were negative by the Ziehl-Neelsen acid-fast stain. Elemental analysis performed on frozen kidney measured bismuth levels to be markedly elevated at 110.6 ppm, approximately 500 to 1000 times acceptable limits. To our knowledge, this is the first report of renal bismuth deposition in a rhesus macaque resulting in renal pigmentation and intranuclear inclusions.

Topics: Animals; Antiemetics; Bismuth; Kidney; Kidney Diseases; Macaca mulatta; Male; Monkey Diseases; Organometallic Compounds; Pigmentation; Pigmentation Disorders; Salicylates; Vomiting

Topics: Animals; Bismuth; Chelating Agents; Dog Diseases; Dogs; Female; Foreign Bodies; Organometallic Compounds; Radiography, Abdominal; Salicylates; Tablets; Treatment Outcome; Vomiting