Bismuth subcitrate/metronidazole/tetracycline (By mouth)

Introduction

Bismuth Subcitrate Potassium (BIZ-muth sub-SIT-rate poe-TAS-ee-um), Metronidazole (met-roe-NYE-da-zole), Tetracycline Hydrochloride (tet-ra-SYE-kleen hye-droe-KLOR-ide)

Treats a stomach infection (H. pylori) that causes ulcers. This medicine is used together with omeprazole.

Brand Name(s)

Pylera

When This Medicine Should Not Be Used

How to Use This Medicine

Capsule

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• It is best to take this medicine after meals and at bedtime.
• Swallow the capsules whole and with a full glass (8 ounces) of water. Do not crush, break, or chew the capsules.
• Drink extra fluids to help prevent irritation or ulcers in the esophagus (the tube between the throat and stomach).
• Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
• If you miss more than four doses of this medicine, check with your doctor.

Warnings While Using This Medicine

• Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
• Make sure your doctor knows if you have nerve problems, a history of blood problems (such as leukopenia), or a fungal infection (such as candidiasis).
• Stop using this medicine and call your doctor right away if you have a seizure or numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• This medicine may cause your tongue to become a darker color or even black. It may also make your stools (bowel movements) black. This is only temporary and will not hurt you. Your tongue and stools will go back to normal when you stop using this medicine. Ask your doctor about this if you have any concerns.
• This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
• If your symptoms do not improve or if they get worse, call your doctor.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate.
• Chest pain.
• Convulsions (seizures).
• Fast, irregular, or pounding heartbeat.
• Fever, chills, cough, sore throat, and body aches.
• Headache, dizziness, or blurred vision.
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet.
• Unusual tiredness or weakness.
• Vaginal discharge, itching, or pain.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Dark, black tongue, or black stools.
• Diarrhea, nausea, stomach upset or pain, or change in taste.
• Skin rash.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are using lithium (Lithane?, Lithobid®, or Eskalith®), cimetidine (Tagamet®), phenytoin (Dilantin®), phenobarbital, or penicillin. Tell your doctor if you are also using a blood thinner such as warfarin (Coumadin®), antacids containing aluminum, calcium, or magnesium (such as Maalox®, Mylanta®, or Tums®), or supplements containing iron, zinc, or sodium bicarbonate.
• Avoid milk or dairy products while taking this medicine.
• Birth control pills may not work while you are using this medicine. To keep from getting pregnant, use another form of birth control along with your birth control pills. Other forms include condoms, a diaphragm, or a contraceptive foam or jelly.
• Do not drink alcohol while you are using this medicine and for at least one day after you stop taking it. Tell your doctor if you are also using disulfiram (Antabuse®) or have taken any in the last two weeks.