With the modern pace of life, when it becomes difficult to keep track of your diet and you have to snack on anything on the run, there is a risk of developing diseases of the gastrointestinal tract. In this case, you have to think about how to protect yourself from possible problems without restructuring your normal lifestyle. There are many drugs that can suppress unpleasant symptoms, but Escape, an antiulcer and antiseptic agent based on bismuth tripotassium dicitrate, can remove the symptoms and at the same time cure the cause of the disease or carry out effective prevention of the disease.
Escape is a modern, highly effective drug for the treatment and prevention of gastrointestinal diseases, which compares favorably with foreign analogues due to its affordable price, combined with the high quality of the raw materials from which it is made. Next, we will tell you in more detail about the drug Escape; instructions for use will also be discussed in the article.
Release form and composition
The drug is produced in the form of film-coated tablets: biconvex, round, with a faint ammonia odor; shell and core in cross section - from almost white to white (10 or 14 pieces in blisters, 4 or 8 blisters in a cardboard pack and instructions for using Escape).
Composition per 1 tablet:
- active ingredient: bismuth tripotassium dicitrate – 300 mg (corresponds to the content of bismuth oxide – 120 mg);
- auxiliary components: corn starch – 54.22 mg; povidone – 42 mg; polacrilin – 20 mg; magnesium stearate – 3.78 mg;
- film coating: AquaPolish P white 019.49 MS [hydroxypropyl methylcellulose (E464), hydroxypropylcellulose (E463), stearic acid (E570), talc (E553b), polyethylene glycol, titanium dioxide (E171)] – 13 mg.
Pharmacological properties
Pharmacodynamics
Escape is a gastroprotective and antiulcer drug that exhibits bactericidal activity against Helicobacter pylori, with an astringent and anti-inflammatory effect.
The active substance of Escape, bismuth tripotassium dicitrate, is precipitated in the acidic environment of the stomach in the form of insoluble bismuth compounds - oxychloride and citrate, which form chelates with a protein substrate, representing a protective film on ulcerative and erosive surfaces. A protective layer is formed that protects the affected mucous membrane from the effects of aggressive factors for a long time.
Bismuth tripotassium dicitrate increases the synthesis of prostaglandin E, improves mucus secretion and the formation of bicarbonate, potentiates the activity of cytoprotective mechanisms, increases the resistance of the gastrointestinal mucosa to pepsin, hydrochloric acid, enzymes and bile salts. In the area of ulceration it leads to the accumulation of epidermal growth factor. Inhibits the activity of pepsin and pepsinogens.
Pharmacokinetics
Bismuth tripotassium dicitrate is almost not absorbed from the gastrointestinal tract.
Bismuth is excreted mainly in feces; a small amount of the substance entering the plasma is eliminated by the kidneys.
Escape: instructions for use (dosage and method)
Escape film-coated tablets are taken orally 30 minutes before meals and washed down with a sufficient amount of water. They should be swallowed whole, without crushing or chewing. It is not recommended to take tablets with milk.
The duration of the course of therapy and dose are determined individually by the attending physician, depending on the nature and clinical course of the disease.
Standard dosage of Escape - depending on the age of the patient, tablets are taken as follows:
- children over 12 years old and adults: 1 pc. 4 times a day, before breakfast, lunch, dinner (30 minutes before meals) and before bed, or 2 pcs. 2 times/day 30 minutes before breakfast and dinner;
- children from 8 to 12 years old: 1 pc. 2 times/day 30 minutes before breakfast and dinner;
- children from 4 to 8 years: at a dose of 8 mg/kg per day, which, depending on the child’s body weight, is 1 or 2 pieces. (respectively, in 1 or 2 doses). The daily dose should be closest to the calculated one.
As a rule, the therapeutic course lasts from 4 to 8 weeks. After completion of treatment, it is not recommended to take products containing bismuth (Vicair, Vikalin, etc.) for 2 months.
To eradicate Helicobacter pylori, bismuth tripotassium dicitrate is used in combination with antibiotics that have anti-Helicobacter activity.
Instructions
Registration number: Trade name of the drug: Escape® International nonproprietary name or generic name : bismuth tripotassium dicitrate Dosage form: film-coated tablets
Composition per tablet:
Active substance: bismuth tripotassium dicitrate – 300.00 mg, in terms of bismuth oxide – 120.00 mg. Excipients: corn starch - 54.22 mg, povidone (medium molecular weight polyvinylpyrrolidone, povidone K 25) - 42.00 mg, polacrilin (potassium polacrilin) - 20.00 mg, magnesium stearate - 3.78 mg. Shell: AquaPolish® P white 019.49 MS [Hydroxypropyl methylcellulose (E 464) – 7.80 mg; hydroxypropylcellulose (E 463) – 1.30 mg; stearic acid (E 570) – 0.91 mg; talc (E 553b) – 1.30 mg; polyethylene glycol – 0.39 mg; titanium dioxide (E171) – 1.30 mg] – 13.00 mg.
Description
Round, biconvex, film-coated tablets of white or almost white color, with a faint odor of ammonia, white or almost white on the break. Pharmacotherapeutic group: Antiulcer, antiseptic intestinal and astringent. ATX code: [A02ВХ05]
Pharmacological properties
Pharmacodynamics
Gastroprotective and antiulcer agent with bactericidal activity against Helicobacter pylori. It also has anti-inflammatory and astringent effects.
In the acidic environment of the stomach, insoluble bismuth oxychloride and citrate are precipitated, and chelate compounds are formed with the protein substrate in the form of a protective film on the surface of ulcers and erosions. Thus, the drug forms a protective layer, which for a long period of time protects the affected areas of the mucous membrane from the influence of aggressive factors. By increasing the synthesis of prostaglandin E, mucus formation and bicarbonate secretion, it stimulates the activity of cytoprotective mechanisms, increases the resistance of the gastrointestinal mucosa to the effects of pepsin, hydrochloric acid, enzymes and bile salts. Leads to the accumulation of epidermal growth factor in the defect area. Reduces the activity of pepsin and pepsinogen.
Pharmacokinetics
Practically not absorbed from the gastrointestinal tract. It is excreted mainly in feces. A small amount of bismuth entering the plasma is excreted from the body by the kidneys.
Indications for use
- functional dyspepsia not associated with organic diseases of the gastrointestinal tract;
- chronic gastritis and gastroduodenitis in the acute phase, including those associated with Helicobacter pylori;
- peptic ulcer of the stomach and duodenum in the acute phase, including those associated with Helicobacter pylori;
- irritable bowel syndrome, which occurs predominantly with symptoms of diarrhea.
Contraindications
- increased individual sensitivity to the components of the drug;
- pregnancy;
- breastfeeding period;
- taking medications containing bismuth;
- chronic renal failure;
- children under 4 years of age.
Use during pregnancy and breastfeeding
Bismuth tripotassium dicitrate is contraindicated for use in pregnant women. If it is necessary to use the drug during lactation, breastfeeding should be stopped.
Directions for use and doses
Inside. The duration of the course of treatment and the dose of the drug are determined by the attending physician individually for each patient, depending on the nature of the disease.
For adults and children over 12 years of age, the drug is prescribed 1 tablet 4 times a day, 30 minutes before meals (breakfast, lunch, dinner) and at night, or 2 tablets 2 times a day 30 minutes before meals (breakfast, dinner).
Children aged 8 to 12 years are prescribed 1 tablet 2 times a day 30 minutes before meals (breakfast, dinner).
Children aged 4 to 8 years are prescribed a dose of 8 mg/kg/day; Depending on the child’s body weight, 1-2 tablets are prescribed per day (respectively, in 1-2 doses per day). In this case, the daily dose should be as close as possible to the calculated dose (8 mg/kg/day).
The tablets are taken 30 minutes before meals with a small amount of water.
It is recommended to swallow the tablet whole, without chewing or crushing, with a sufficient amount of water. It is not recommended to take the tablets with milk. The duration of treatment is usually from 4 to 8 weeks. After finishing taking the drug, it is not recommended to take medications containing bismuth (for example, Vikalin, Vikair) for 2 months.
To eradicate Helicobacter pylori, it is advisable to use Bismuth tripotassium dicitrate in combination with antibacterial drugs that have anti-Helicobacter activity.
Side effects
The following adverse events noted with the use of bismuth tripotassium dicitrate are distributed according to the frequency of occurrence in accordance with the following gradation: very often (≥ 1/10); often (≥ 1/100, < 1/10); uncommon (≥ 1/1000, < 1/100); rare (≥ 1/10,000, < 1/1,000); very rare (<1/10,000).
From the gastrointestinal tract: very often - black stool; uncommon – nausea, vomiting, diarrhea or constipation.
Allergic reactions: infrequently - skin rash, itching; very rarely - anaphylactic reactions.
From the nervous system: very rarely - with prolonged use in high doses
- encephalopathy associated with the accumulation of bismuth in the central nervous system.
Side effects are reversible and disappear quickly after discontinuation of the drug.
Overdose
When using the drug in doses tens of times higher than recommended, or with prolonged use of excessive doses of the drug, bismuth poisoning may develop.
Symptoms: dyspepsia, rash, inflammation of the oral mucosa, characteristic darkening in the form of blue lines on the gums; with long-term use in doses exceeding the recommended ones, renal function may be impaired.
These symptoms are completely reversible when the drug is discontinued.
Treatment: there is no specific antidote. In case of an overdose of the drug, gastric lavage, intake of enterosorbents and symptomatic therapy aimed at maintaining kidney function are indicated. In case of overdose, the administration of saline laxatives is also indicated. Further treatment should be symptomatic. In case of impaired renal function, accompanied by a high level of bismuth in the blood plasma, complexing agents – dimercaptosuccinic and dimercaptopropanesulfonic acids – can be administered. With the development of severe renal dysfunction, hemodialysis is indicated.
Interaction with other drugs
For half an hour before and half an hour after taking the drug, it is not recommended to take other medications internally, as well as take food and liquids, in particular antacids, milk, fruits and fruit juices. This is due to the fact that when taken orally simultaneously, they can affect the effectiveness of bismuth tripotassium dicitrate.
The drug reduces the absorption of tetracyclines.
The drug is not used simultaneously with other drugs containing bismuth, since the simultaneous use of several bismuth drugs increases the risk of side effects, including the risk of encephalopathy.
special instructions
The drug should not be used for more than 8 weeks. It is not recommended to exceed the established daily doses for adults and children during treatment. During treatment with the drug, you should not use other drugs containing bismuth (see section “Interaction with other drugs”). At the end of a course of treatment with the drug in recommended doses, the concentration of the active substance in the blood plasma does not exceed 3 - 58 mcg/l, and intoxication is observed only at concentrations above 100 mcg/l.
When using bismuth tripotassium dicitrate, stool may turn dark due to the formation of bismuth sulfide.
Sometimes there is a slight darkening of the tongue. Alcohol consumption is not recommended during therapy.
Effect on the ability to drive vehicles and machines There is no data on the effect of Escape® film-coated tablets on the ability to drive vehicles and machines.
Release form
Film-coated tablets, 120 mg.
10 or 14 tablets in a blister pack made of polyvinyl chloride film and printed varnished aluminum foil.
4 or 8 blister packs along with instructions for use are placed in a cardboard pack.
Storage conditions
Store at a temperature not exceeding 25 °C. Keep out of the reach of children.
Best before date
3 years. Do not use after the expiration date stated on the packaging.
Vacation conditions
Over the counter.
Marketing authorization holder/organization receiving consumer complaints
PJSC OTCPharm, Russia, 123317, Moscow, st. Testovskaya, 10 Tel.: +7 (800) 775-98-19 Fax www.otcpharm.ru
, 305022, Russia, Kursk, st. 2nd Aggregatnaya, 1a/18, tel./fax www.pharmstd.ru
Side effects
While taking Escape, the following side effects may develop (mostly reversible and quickly disappear after discontinuation of the drug):
- Gastrointestinal tract: very often – black stool; uncommon – nausea/vomiting, diarrhea or constipation;
- immune system: uncommon – itching, skin rash; extremely rarely - anaphylaxis;
- CNS (central nervous system): extremely rarely (with long-term use of high doses) - encephalopathy caused by the accumulation of bismuth in the central nervous system.
Overdose
The use of Escape in doses tens of times higher than recommended, or prolonged use of excessive doses, can lead to bismuth poisoning.
Symptoms of an overdose of bismuth tripotassium dicitrate are rash, dyspepsia, inflammation of the oral mucosa, and specific (in the form of blue lines) darkening of the gums. As a result of long-term use in doses exceeding the recommended ones, renal dysfunction may develop. Symptoms go away on their own after discontinuation of the drug.
If bismuth intoxication is established, the patient needs to rinse the stomach, give enterosorbents, and, if necessary, carry out symptomatic treatment aimed at maintaining kidney function. In case of overdose, it is also recommended to take saline laxatives. For the treatment of impaired renal function, accompanied by high plasma concentrations of bismuth, complexing agents are prescribed - dimercaptopropanesulfonic and dimercaptosuccinic acids. In case of severe renal impairment, hemodialysis is prescribed. The specific antidote for bismuth tripotassium dicitrate is currently unknown.
ESCAPE (tablets)
After the polyps were removed from my esophagus, I started having bouts of nausea, especially in the morning.
It didn’t matter whether I was full or hungry, just the smell of food made me sick. Perhaps something happened in the stomach during the operation, since the polyps were in the lower third. The polypectomy operation itself was difficult, with bleeding. Saw Motilak, Mezim, Gaviscon. And so on for a couple of months. When I finally managed to pour water or broth into myself, I was tormented by a feeling of heaviness and fullness in my stomach. Sometimes there was pain. Gradually, the feeling of joy from delicious food disappeared, the quality of life fell every day. I couldn’t go to a cafe with my friends because I felt sick. I couldn’t cook for my family because I was sick. Every day I felt sick. I tried cerucal - but my head was spinning, my heart was pounding, my blood pressure was jumping. I decided to endure it myself. br>After a couple of weeks, when I miraculously did not vomit right into my husband’s scrambled eggs, I decided to go to the doctor. I don’t know why I realized it so late, probably the polypectomy discouraged me from visiting doctors. The gastroenterologist diagnosed acute gastritis. To do this, I had to undergo a gastroscopy, but it is necessary, so it is necessary.
The doctor prescribed medications - Mezim, Omeprazole, No-Shpa. I continued to feel nauseous. My stomach hurt. I returned to my doctor, he decided to change the therapy, adding Escape. This is a drug based on bismuth tripotassium dicitrate, it should help with gastritis both with and without Helicobacter pylori. It supposedly forms a film on the surface of the stomach)
The instructions stated that it not only removes the symptoms, but also eliminates the cause of the disease, protects the stomach and restores damage to its mucosa. I really hoped that the new treatment plan would finally bring results and I was not mistaken: the attacks of nausea began to come less and less often, morning sickness disappeared completely, and I was finally able to cook food calmly.
I took Escape 2 times a day, 2 tablets at a time, about half an hour before meals. The instructions also have an alternative option to take 1 tablet 4 times a day, but it was inconvenient for me, I didn’t eat that many times a day. The tablets are small, swallow without problems, and have no unpleasant odor. The drug suited me, it is definitely good and the benefits from it are obvious.
During gastroscopy after the Escape course, a decrease in inflammation of the gastric mucosa was noted, which may be due to the fact that the nausea has gone away. Escape has few contraindications, so I recommend it for such problems, but it is still advisable to first be examined by a doctor.
special instructions
The duration of Escape should not exceed 8 weeks.
During therapy, it is not recommended to exceed the established daily doses for children and adults.
You should not use other medications containing bismuth during treatment with Escape. Upon completion of the therapeutic course (if taken in recommended doses), the concentration of bismuth in the blood plasma varies from 3 to 58 mcg/l. However, intoxication is observed when the level of bismuth in plasma is 100 µg/l and above.
Taking bismuth tripotassium dicitrate may turn stool dark due to the formation of bismuth sulfide. Some patients experience slight darkening of the tongue.
Drinking alcoholic beverages during therapy is not recommended.
Impact on the ability to drive vehicles and complex mechanisms
No data.
Drug interactions
Any other oral medications, as well as food and liquids (including antacids, milk, fruit and fruit juices) are not recommended to be taken within half an hour before or after Escape, as they may affect the Escape if taken concomitantly with Tripotassium Bismuth Dicitrate. efficiency.
Bismuth reduces the absorption of tetracyclines.
It is important to avoid using Escape concomitantly with other medicines containing bismuth. This is due to the fact that taking several bismuth preparations at the same time increases the risk of developing negative side reactions, including encephalopathy.
Interaction with other drugs
Due to the fact that Escape forms a protective film in the stomach, it is not recommended for half an hour before and half an hour after taking this drug to take other medications, as well as food and liquid, especially antacids: milk, fruits and fruit juices. These substances, when taken simultaneously with Escape, may affect its effectiveness.
Escape also reduces the absorption of tetracyclines. The drug should not be used simultaneously with other medications that contain bismuth, because in this case the dose of this substance increases many times and the risk of side effects increases.
Reviews about Escape
According to reviews, Escape is an excellent remedy for exacerbations of chronic gastritis, enteritis, and colitis. It quickly and effectively relieves stomach pain, nausea and heartburn. Relief occurs almost after the first dose. Patients note the adequate cost of the drug and its availability in pharmacies.
In rare cases, they complain about the lack of the expected effect, which, according to users, turns out to be weaker than some analogues. They also consider the dosing regimen inconvenient, since the tablets have to be taken 4 times a day.
Reviews from doctors
Doctors note the high quality of the drug and its ease of tolerance by patients. As well as positive dynamics in recovery from diseases such as gastritis, gastroduodenitis, and ulcers. Doctors also prescribe Escape for preventive purposes and at the first symptoms of exacerbation of chronic diseases.
Escape is a modern tool, affordable and made from high-quality European raw materials, no different from foreign analogues. Escape has almost no contraindications, is easily tolerated and easy to use, it helps not only with serious chronic and acute gastrointestinal diseases, but also with minor problems associated with heartburn or dyspepsia. However, you should remember that you can use it as a course for 4 to 8 weeks, then take a break. In general, the drug has proven its effectiveness and safety.
