uses
What is bismuth/metronidazole/tetracycline used for?Bismuth/metronidazole/tetracycline is commonly used to treat Helicobacter pylori (H. pylori) infections in people who have or have had certain types of ulcers. Infection with H. pylori can lead to ulcers and other problems.Bismuth/metronidazole/tetracycline work together to fight a specific type of bacteria, H. pylori, that infects the stomach. Some bacteria may have developed resistance to metronidazole and tetracycline, which are antibiotics. This may make the antibiotics not work as well. These antibiotics will not work for infections caused by viruses, such as the common cold, the flu, or coronavirus. They also will not work for any other infections that are not caused by bacteria. Taking any antibiotic when it is not needed may cause the antibiotic to not work for bacterial infections in the future.Bismuth/metronidazole/tetracycline may also be used for other conditions as determined by your health care provider.How does bismuth/metronidazole/tetracycline work (mechanism of action)?Helicobacter pylori (H. pylori) is a type of bacteria that grows well in acidic places, like the stomach. Bismuth/metronidazole/tetracycline contains three different medicines (bismuth, metronidazole, and tetracycline) that are used together to help get rid of an H. pylori infection. They each work in different ways. Bismuth may help disrupt H. pylori and increase the effects of antibiotics. Metronidazole is an antibiotic that kills H. pylori by damaging its DNA. Tetracycline is an antibiotic that stops H. pylori from making proteins that it needs to grow and multiply. Bismuth/metronidazole/tetracycline is usually taken along with a fourth medicine called a proton pump inhibitor (PPI), such as omeprazole, that reduces the amount of acid in the stomach.How is bismuth/metronidazole/tetracycline supplied (dosage forms)?Brands and other namesPyleraDosage forms and strengths140 mg/125 mg/125 mg oral capsulesHow should I store bismuth/metronidazole/tetracycline?Bismuth/metronidazole/tetracycline should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). Store in a cool, dry place.
how to use
capsule that is swallowed
drug interactions
Does bismuth/metronidazole/tetracycline interact with foods or drinks?Foods and drinks that are high in calcium may decrease the amount of tetracycline that your body absorbs. You should not eat or drink dairy products, like milk and yogurt, or calcium-fortified products at the same time or near the time that you take bismuth/metronidazole/tetracycline. Do not drink alcohol or eat or drink anything that has propylene glycol in it while taking metronidazole and for at least three days afterwards. Drinking alcohol or propylene glycol while taking bismuth/metronidazole/tetracycline may increase your risk for nausea or vomiting, headache, flushing, and stomach cramps. Also, heavy drinking can make it harder for your body to fight infection and increase your risk of developing ulcers.Does bismuth/metronidazole/tetracycline interact with other medicines (drug interactions)?Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.In particular, make sure that you discuss if you are using any of the following before taking bismuth/metronidazole/tetracycline.A birth control pillA blood thinner, which is a medicine used to treat or prevent blood clotsA medicine for seizures, such as phenobarbital or phenytoinAn antacid containing aluminum, calcium, or magnesiumCimetidine (Tagamet HB), which is a medicine used for heartburnSodium bicarbonate, which is a medicine used for heartburn and stomach ulcers and is in some over-the-counter (OTC) and prescription medicines, such as Alka-Seltzer, Zegerid, and Zegerid OTCAny multivitamin, supplement, or other product that contains aluminum, calcium, iron, magnesium, or zincDisulfiram within the past two weeks, which is a medicine commonly used to help treat alcohol use disorderLithium, which is a medicine for certain mental health conditionsBusulfan, which is a medicine to treat certain cancersMedicines that can cause QT prolongation, which is a potentially dangerous heart rhythm problemMany other medicines may alter the blood levels of bismuth/metronidazole/tetracycline. Tell your health care provider about all medicines that you take or have recently taken.This may not be a complete list of medicines that can interact with bismuth/metronidazole/tetracycline. Always check with your health care provider.
side effects
What are the most common side effects of bismuth/metronidazole/tetracycline?The most common side effects of bismuth/metronidazole/tetracycline are listed below. Tell your health care provider if you have any of these side effects that bother you.Dark-colored or black stools (poop)DiarrheaNauseaHeadacheThere may be other side effects of bismuth/metronidazole/tetracycline that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.What are the serious side effects of bismuth/metronidazole/tetracycline?While less common, the most serious side effects of bismuth/metronidazole/tetracycline are described below, along with what to do if they happen.Severe Allergic Reactions. Bismuth/metronidazole/tetracycline may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of this serious allergic reaction.Breathing problems or wheezingRacing heartFever or general ill feelingSwollen lymph nodesSwelling of the face, lips, mouth, tongue, or throatTrouble swallowing or throat tightnessItching, skin rash, or pale red bumps on the skin called hivesNausea or vomitingDizziness, feeling lightheaded, or faintingStomach crampsJoint painDark-colored peeYour skin or the whites of your eyes turning yellowish in color (also called jaundice)Severe Skin Reactions. Metronidazole may cause severe skin reactions, called Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP). These can lead to death if not treated. If you develop a rash or pus-filled pimples, stop taking metronidazole and immediately call your health care provider. Get emergency help right away if you have any of the following symptoms of a severe skin reaction.Painful red or purple skin that looks burnt and peels offFlat red rash or blisters on your skin, mouth, nose, and genitalsRed, painful, watery eyesAntibiotic-Associated Diarrhea. An overgrowth of germs called Clostridioides difficile, or “C. diff,†can happen in your gut with many types of antibiotics. This can cause a condition known as antibiotic-associated diarrhea and can happen even up to two months after stopping the antibiotic. Call your health care provider right away if you have any of the following symptoms of this condition.Watery diarrheaDiarrhea that does not go awayBlood in your stool (poop)Severe stomach crampsFever that starts after you start or finish the medicineNerve Problems. Nerves are the fibers that carry sensations from your body to the brain. Damage to these nerves, called peripheral neuropathy (including nerves in your eyes), may happen in people who are taking metronidazole. Stop taking this medicine and call your health care provider if you develop pain, burning, tingling, numbness, or weakness in your arms, hands, legs, or feet or if you have blurred or reduced vision or pain in your eyes.Brain or Central Nervous System (CNS) Effects. Bismuth/metronidazole/tetracycline may rarely cause effects on the brain or central nervous system (CNS). These problems include meningitis (inflammation of the protective membranes around the brain and spinal cord), encephalopathy (a rare but potentially serious condition that affects the brain), and pseudotumor cerebri (a serious condition where the pressure around the brain increases). Stop taking this medicine and get help right away if you have any of the following symptoms.Trouble with balance or coordinationDizzinessNausea or vomitingSlurred or slow speechConfusion, memory problems, or difficulty concentratingSevere headacheStiff neckVision changesFeverSeizures. Some people who have taken metronidazole have reported having seizures. There are many different types of seizures and some of them are not easy to recognize. Stop taking this medicine and call your health care provider if you have any of the following signs that a seizure is happening or could happen.Muscle twitching, jerking, spasms, tremors, or other uncontrolled movementsStiffening of your arms and legsFeeling anxious, nervous, confused, or a sense of dreadFeeling dizzy or lightheadedFalling or losing consciousnessHeart Rhythm Changes. Metronidazole may cause a rare dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk for this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium, or who take some medicines for other heart rhythm problems. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipped heartbeat.Sensitivity to Sunlight. Your skin may be very sensitive to light from the sun and devices that give off similar light, such as sunlamps and tanning beds, while you are taking certain medicines, including tetracycline. This is called photosensitivity. Exposing your skin to this kind of light, even for a short time, can cause your skin to be severely sunburned, blistered, or swollen. Stop taking this medicine and tell your health care provider right away if you have any of these symptoms. Avoid being in the sun or using sunlamps while taking this medicine. Use sunscreen and wear a hat and clothes that cover your skin if you must be in the sunlight.Another Infection. Taking bismuth/metronidazole/tetracycline may lead to an infection with other types of germs, such as fungi. Call your health care provider if your infection does not get better or gets worse. Permanent Teeth Discoloration. Tetracycline can cause a permanent change in tooth color to yellow, gray, or brown. It may also affect the growth of tooth enamel (also called enamel hypoplasia). These side effects can happen during tooth development when this medicine is taken in the last half of pregnancy and in children up to age eight years. Tell your health care provider if you are or plan to become pregnant. If your child is taking tetracycline and is less than eight years old, call your health care provider right away.
overdose and misseddose
What should I do if I accidentally use too much bismuth/metronidazole/tetracycline?If you or someone else has used too much bismuth/metronidazole/tetracycline, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.What should I do if I miss a dose of bismuth/metronidazole/tetracycline?If you miss a dose, skip the missed dose and take the next dose at the usual scheduled time. Do not take double or extra doses. If you miss more than four doses of bismuth/metronidazole/tetracycline, contact your health care provider.It is important to complete your prescribed course of bismuth/metronidazole/tetracycline, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to these or other similar medicines.
warnings and Precautions
Who should not use bismuth/metronidazole/tetracycline?Allergies to Ingredients. People who are allergic to any of the following should not take bismuth/metronidazole/tetracycline.BismuthMetronidazolePyleraTetracyclineAny other medicine known as a nitroimidazoleAny of the ingredients in the specific product dispensedYour pharmacist can tell you all of the ingredients in the specific bismuth/metronidazole/tetracycline products they stock.Drug Interactions. Bismuth/metronidazole/tetracycline should not be taken while you are using certain other medicines. Before taking bismuth/metronidazole/tetracycline, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.Alcohol. Potentially serious side effects can occur if metronidazole is taken with foods or drinks that contain alcohol. Do not drink alcohol or eat foods that contain a type of alcohol called propylene glycol while taking metronidazole. See the Interactions section for more details.Pregnancy. Do not take bismuth/metronidazole/tetracycline if you are pregnant. If you become pregnant, contact your health care provider right away. See the Pregnancy section for more details.Severe Kidney Problems. Tetracycline should not be taken if you have severe kidney problems. If there is a concern about the health of your kidneys, your health care provider may do tests to determine if they are working well enough to take this medicine.Cockayne Syndrome. Metronidazole should not be taken if you have Cockayne syndrome, which is a rare genetic disorder that affects growth and development.What should I know about bismuth/metronidazole/tetracycline before using it?Do not take bismuth/metronidazole/tetracycline unless it has been prescribed to you by a health care provider. Your health care provider may tell you to take another medicine, called a proton pump inhibitor (PPI), while you are taking bismuth/metronidazole/tetracycline. It is important to take all medicines exactly as prescribed.Do not share bismuth/metronidazole/tetracycline with other people, even if they have the same condition as you. It may harm them.Keep bismuth/metronidazole/tetracycline out of the reach of children.Take bismuth/metronidazole/tetracycline capsules whole with a full glass (eight ounces) of water, especially when taking a dose before bed. This medicine can irritate your throat. Drinking enough water to completely swallow the medicine may help lower the risk of throat irritation.Each dose of bismuth/metronidazole/tetracycline comes in a “daily blister card.†Follow the instructions on the card and ask your pharmacist or other health care provider if you have any questions. The medicine should be taken four times every day, after meals and before bedtime. At the end of each day, after all doses have been taken, the empty card may be thrown away.Bismuth can cause your stools (poop) to become dark or black in color. It can also darken the color of your tongue. These are harmless reactions that usually go away within a few days after finishing treatment. People who are less than eight years old can be at greater risk for some side effects from tetracycline. Talk to your health care provider about the risks if your child is in this age group.Bismuth/metronidazole/tetracycline may affect the results of X-rays or certain lab tests. Tell all of your health care providers that you are taking this medicine before any procedures or bloodwork. What should I tell my health care provider before using bismuth/metronidazole/tetracycline?Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if bismuth/metronidazole/tetracycline is right for you.In particular, make sure that you discuss any of the following.Current and Past Health Conditions. Tell your health care provider if you have any of the following.Heart rhythm problemsKidney problemsLiver problemsBlood disorders, including high or low levels of red blood cells, white blood cells, or plateletsNervous system problems, such as peripheral neuropathyPregnancy. Tetracycline may cause harm to an unborn baby. It is not known if or how bismuth or metronidazole could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant. If you become pregnant, contact your health care provider right away.Breastfeeding. Metronidazole and tetracycline pass into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. You and your health care provider may decide that you should pump your breastmilk and throw it away while you are taking this medicine and for two days after you finish taking it. During this time, you may feed your baby with previously stored breastmilk or infant formula.
about
Bismuth/metronidazole/tetracycline is used to treat an infection in the stomach caused by bacteria called Helicobacter pylori (H. pylori). It contains three different medicines that work together to kill this bacteria. It is usually taken along with a fourth medicine that reduces the amount of acid in the stomach. Common side effects include diarrhea, nausea, dark-colored stools (poop), and headache. Serious side effects are rare but may include allergic reactions and severe diarrhea. This medicine may also make your skin more sensitive to light from the sun, sunlamps, and tanning beds.