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Bismuth subsalicylate/metronidazole/tetracycline (By mouth)

Treats a stomach infection (H pylori) that causes ulcers. This medicine contains a combination of antibiotics.

Brand Name(s):

Helidac Therapy

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to bismuth subcitrate potassium, metronidazole or similar medicines (such as tinidazole), tetracycline, or aspirin or other salicylates. Do not use this medicine if you have also used disulfiram (Antabuse®) within the last 2 weeks or if you have recently been or will soon be treated with methoxyflurane (Penthrane®). Do not use this medicine if you are pregnant or breastfeeding or have severe kidney disease. Do not drink alcohol while you are using this medicine.

How to Use This Medicine:

Chewable Tablet, Tablet, Capsule

  • Take your medicine as directed.
  • The medicine for each day is packaged on a blister card that contains 8 chewable tablets of bismuth subsalicylate, 4 tablets of metronidazole, and 4 capsules of tetracycline.
  • Pay attention to how to take each medicine. Completely chew and swallow 2 bismuth tablets. Swallow the metronidazole tablet and the tetracycline capsule whole with a full glass (8 ounces) of water. This will help prevent irritation of the esophagus (tube between the throat and stomach). Do not chew, crush, or break the metronidazole tablet and the tetracycline capsule.
  • Take 1 dose (all 4 pills) 4 times a day, after meals and at bedtime.
  • Take all of the medicine in your prescription to clear up your infection, even if you feel better after the first few doses.
  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. Call your doctor if you missed more than 4 doses of this combination of medicines.

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  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.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 out of the reach of children. 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 also use aspirin, cimetidine (Tagamet®), lithium (Eskalith®, Lithobid®), penicillin, phenobarbital (Luminal®), phenytoin (Dilantin®), probenecid (Benemid®), sulfinpyrazone (Anturan®), diabetes medicine that you take by mouth (such as glimepiride, glyburide, metformin, Actos®, Janumet®, Januvia®), or a blood thinner (such as warfarin, Coumadin®, Jantoven®). Tell your doctor if you also take antacids that contain aluminum, calcium, or magnesium (such as Maalox®, Tums®), supplements that contain iron, zinc, or sodium bicarbonate).
  • Do not drink alcoholic beverages or other products that have propylene glycol while you are using this medicine and for 3 days after you stop.
  • Avoid taking this medicine with milk or other dairy products.

Warnings While Using This Medicine:

  • It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
  • Make sure your doctor knows if you have kidney disease, liver disease, nerve problems, seizures, or a history of blood disorders.
  • This medicine may make you dizzy or have trouble seeing clearly. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you.
  • This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
  • This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Avoid people who are ill, and wash your hands often. Brush and floss your teeth gently, do not play rough sports, and be careful with sharp objects.
  • This medicine should not be given to children, especially if they have or are recovering from the chicken pox or flu. Children can develop a rare but serious condition called Reye syndrome if given this medicine.
  • Birth control pills may not work well while you are using this combination of medicines. To avoid pregnancy, use another form of birth control.
  • Tell any doctor or dentist who treats you that you are using this medicine. You may need to stop using this medicine several days before you have surgery or medical tests.
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
  • Call your doctor if your symptoms do not improve or if they get worse.

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
  • Blistering, peeling, red skin rash
  • Changes in vision
  • Decrease in how much or how often you urinate, difficult or painful urination
  • Fever, chills, cough, sore throat, and body aches
  • Headache, stiff neck, nausea, vomiting
  • Numbness, tingling, or burning pain in your hands, arms, legs, or feet
  • Seizures or tremors
  • Sudden and severe stomach pain, nausea, vomiting, fever, and lightheadedness
  • Unusual bleeding, bruising, weakness
  • Warmth or redness in your face, neck, arms, or upper chest

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

  • Black stools, dark-colored tongue
  • Diarrhea, stomach pain, mild nausea
  • Discoloration of the teeth
  • Dizziness
  • Mild skin rash
  • White patches in your mouth or tongue

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

Last Updated: 4/4/2014

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