Twice daily tripotassium dicitrato bismuthate in the treatment of duodenal ulceration

Abstract

Summary:Fifty three patients with endoscopically proven duodenal ulceration have cooperated in a clinical trial to compare the ulcer healing effect of tripotassium dicitrato bismuthate (TDB) at standard dosage adminitered either twice or four times daily. No statistically significant difference has been found to exist between ulcer healing in the two groups at 4 weeks (72% and 67%, P = 0.944) or at 8 weeks (92% and 81%, P = 0.504) and it is concluded that twice daily TDB maintains the effectiveness of the drug and has advantages for patient compliance.

Comparison of qid and bd administration of De‐Nol in the short term treatment of duodenal ulcer

“…A further prolongation of therapy to eight weeks permitted us to achieve an almost equal percentage healing rate for both Groups A and 8. These results are to an extent in agreement with those of Hollanders 4 , who, at eight weeks, cited a percentage healing of 92 per cent with bd dosing and 81 per cent with the qid regimen.…”

“…CBS's action giving ‘physical protection’ to the ulcer lesion, as well as its ability to induce the synthesis of endogenous gastric prostaglandins, is of short duration 12 , 13 ; this would support, if anything, a more frequent daily administration of the drug. In agreement with Hollanders 4 , we believe that it is possible to suggest a positive role for CBS in affecting the qualitative composition of mucus, in increasing gastric bicarbonates (as a barrier) and in the regeneration of duodenal mucosal microvilli, the latter probably favoured by the accumulation of the drug within the lysosomes of the duodenal enterocytes 14 . This last action, in our opinion, could constitute the rationale for the twice‐daily administration of the drug.…”

“…Both pharmacological and clinical observations 1–3 have clearly demonstrated that the administration of antisecretory drugs, either twice daily (morning and evening) or in a single night‐time dose, produces a clinical response which is virtually identical to that obtained with multidose treatment. This aspect of clinical experience with drugs with a complex mechanism of action such as colloidal bismuth sub‐citrate (CBS, De‐Nol) is still rather limited 4 .…”

Mucosal Protecting Agents: First Choice in Uncomplicated Ulcer Disease?

“…Scand J Gastroenterol 1988, 23(Suppl 153), [71][72][73][74][75][76][77][78][79][80] The clinical value of the mucosal protecting agents sucralfate and colloidal bismuth is compared with that of the acid inhibitors ranitidine and omeprazole. The efficacy of both protecting agents is comparable to that of ranitidine, but they are all surpassed by omeprazole.…”