A bismuth chelate that protects stomach ulcers
Tripotassium dicitratobismuthate
A bismuth chelate that coats and protects stomach ulcers and is used in some Helicobacter pylori treatment regimens, taken as short courses.
What is Tripotassium dicitratobismuthate?
Tripotassium dicitratobismuthate is a bismuth-based medicine used to help heal stomach and duodenal ulcers by forming a protective coat over the ulcer, and it is also used as part of some treatment combinations to clear Helicobacter pylori, the bacterium behind many ulcers. A very common and harmless effect is that it blackens the tongue and turns the stools dark or black. It is taken as short courses, kept apart from food, milk and antacids, which can stop it working. It is not for long-term continuous use.
Education and reference only. This is a plain-language guide to Tripotassium dicitratobismuthate — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Tripotassium dicitratobismuthate is a medicine that contains bismuth and is used for stomach and duodenal (upper gut) ulcers. It works by forming a protective layer over the ulcer so it can heal, and it also has some activity against Helicobacter pylori, a bacterium that causes many ulcers, which is why it is included in certain treatment combinations to clear that infection. It is taken by mouth as short courses rather than continuously. A well-known feature is that it commonly darkens the tongue and the stools.
How it works
When tripotassium dicitratobismuthate reaches the acidic stomach, it forms a coating that sticks to the base of an ulcer, shielding it from acid and digestive juices so the lining can heal. It also helps protect the stomach lining more generally and has a direct effect against Helicobacter pylori, weakening the bacteria, which is why it is used alongside antibiotics in some regimens to clear that infection. Because food, milk and antacids reduce the acidity it needs to form its coat, it is taken apart from these so it can work properly. It is used in short courses to allow ulcers to heal.
Company & origin
Originated / developed by: Generic and branded manufacturers.
A bismuth-based medicine used in the UK to coat and protect stomach ulcers and as part of some treatment combinations for Helicobacter pylori infection.
What it treats
Conditions Tripotassium dicitratobismuthate is used for
Practical use
How to take Tripotassium dicitratobismuthate
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as directed, kept apart from food, milk and antacids, which can stop it working.
- Expect your tongue to darken and your stools to turn black; this is harmless with this medicine.
- Complete the full short course, and if it is part of a Helicobacter pylori regimen, take the antibiotics exactly as directed.
- Do not take it continuously for long periods, as bismuth can build up.
- Tell your prescriber about other medicines and any kidney problems before starting.
Weighing it up
Advantages & disadvantages of Tripotassium dicitratobismuthate
Advantages
- Helps heal stomach and duodenal ulcers by forming a protective coat over them.
- Has direct activity against Helicobacter pylori, so it is useful in combination regimens to clear the infection.
- Taken as short courses rather than as a long-term medicine.
Disadvantages
- Commonly blackens the tongue and turns the stools dark, which can be alarming if unexpected.
- Must be kept apart from food, milk and antacids, which takes a little planning.
- Not suitable for long-term continuous use, as bismuth can build up.
Practical use
Good to know
The most striking but completely harmless effect is that this medicine often blackens the tongue and turns the stools dark or black; this is expected and is not a sign of bleeding, though black stools from other causes can be serious, so mention them if you are unsure. To work, it relies on the stomach being acidic, so it is taken apart from food, milk and antacids, which would otherwise stop it forming its protective coat. It is used in short courses, not as a long-term continuous medicine, partly because bismuth can build up with prolonged use. It is often part of a Helicobacter pylori treatment combination, so it is important to complete the whole course and take any antibiotics as directed. Tell your prescriber about other medicines and any kidney problems.
Who should not take it / use with caution
- People who have had a serious allergic reaction to bismuth or to the medicine should not take it.
- It should not be used by people with significant kidney problems, because bismuth can build up.
- It is used with care, and on medical advice, in pregnancy and breastfeeding, and is not for long-term continuous use.
Monitoring
- Checking that ulcer symptoms improve and, where relevant, that Helicobacter pylori is cleared.
- Keeping courses short and avoiding prolonged continuous use.
- Reviewing kidney function where there are concerns about bismuth build-up.
Side effects
- A harmless blackening of the tongue and dark or black stools.
- Nausea or stomach upset in some people.
- Rarely, with prolonged or excessive use, build-up of bismuth affecting the nervous system.
Key interactions
- Food, milk and antacids reduce how well it works, so keep them apart.
- It can affect the absorption of some other medicines, including certain antibiotics, so spacing may be advised.
- Tell your prescriber about all your medicines, especially other ulcer or acid treatments.
Available as: Tablets or liquid taken by mouth.
Answers
Tripotassium dicitratobismuthate: frequently asked questions
What is tripotassium dicitratobismuthate used for?
It is used to help heal stomach and duodenal ulcers by coating them, and as part of some treatment combinations to clear Helicobacter pylori infection.
Why has my tongue and stool gone black?
A black tongue and dark or black stools are a very common, harmless effect of this bismuth medicine; it is not a sign of bleeding when caused by the medicine.
Why must I keep it away from food and milk?
It needs an acidic stomach to form its protective coat, and food, milk and antacids reduce that acidity and stop it working properly.
Can I take it long term?
No. It is used in short courses, because bismuth can build up with prolonged continuous use.
Do I still need antibiotics?
If it is part of a Helicobacter pylori regimen, yes; complete the whole course and take the antibiotics exactly as directed to clear the infection.
Authoritative sources
- BNF
- NICE CKS
Building a medicines information resource?
We create evidence-led, dose-free drug and formulary references for teams.