Bismuth, Metronidazole, and Tetracycline : Uses, Side Effects, Interactions & More
Metronidazole can cause cancer in laboratory animals. However, it can be useful when taken to heal ulcers. Talk to your doctor about the risks and benefits of using this combination containing metronidazole to treat your ulcers.
Why is this medication prescribed?
Bismuth, metronidazole, and tetracycline are used together with other ulcer medications to treat duodenal ulcers. It belongs to a class of drugs called antibacterial agents. It works by preventing the growth and spread of Helicobacter pylori bacteria, which often occurs with ulcers. Treating this infection keeps the ulcers from coming back.
How should this medicine be used?
Bismuth, metronidazole, and tetracycline (Helidac) come in two chewable bismuth tablets, a metronidazole tablet, and a tetracycline capsule to take together by mouth. Bismuth, metronidazole, and tetracycline (Pylera) come as capsules to take by mouth. It is usually taken four times a day, with meals and before bed for 10 days (Pylera) or 14 days (Helidac). Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any parts you don’t understand. Take this medicine exactly as directed. Do not take more or less, or take it more often than prescribed by your doctor.
If you are taking bismuth, metronidazole, and tetracycline (Helidac), chew and swallow the bismuth tablets. Swallow the metronidazole tablet and tetracycline capsule whole with a full glass of water (8 ounces [240 milliliters]). If you are taking bismuth, metronidazole, and tetracycline (Pylera), swallow the capsules whole with a full glass of water (8 ounces [240 milliliters]). It is especially important to take the dose at bedtime with plenty of fluids to avoid irritation of the throat and stomach.
Take bismuth, metronidazole, and tetracycline at least 1 hour before or 2 hours after eating or drinking foods that contain calcium, such as dairy products and juices, and foods fortified with calcium.
Keep taking this medicine even if you feel fine. Do not stop taking it without consulting your doctor. If you stop taking this medicine too soon or miss doses, your infection may not be fully treated and the bacteria may become resistant to antibiotics.
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking bismuth, metronidazole, and tetracycline,
- Tell your doctor and pharmacist if you are allergic to bismuth, metronidazole (Flagyl), aspirin or salicylates, doxycycline (Doryx, Vibramycin), minocycline (Dynacin, Minocin), tetracycline (Sumycin), tinidazole (Tindamax), any other medications, or any of the ingredients in the combination of bismuth, metronidazole and tetracycline. Ask your pharmacist for a list of the ingredients.
- Tell your doctor if you are taking or have taken disulfiram (Antabuse). Your doctor may tell you not to take bismuth, metronidazole, and tetracycline if you are taking disulfiram (Antabuse) or have taken it in the past two weeks.
- Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antibiotics such as penicillin, anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven), aspirin or aspirin-containing products, astemizole (Hismanal) (not available in the US) , Cimetidine (Tagamet), lithium (Eskalith, Lithobid), diabetes medications, omeprazole (Prilosec, Zegerid), oral contraceptives, phenobarbital (Luminal), phenytoin (Dilantin, Phenytek), probenecid (in Col-probenecid, Probalan), sulfinpyrazone (Anturane)) and terfenadine (Seldane) (not available in the US). Your doctor may need to change the doses of your medications or monitor you closely for side effects.
- If you are taking antacids that contain aluminum, calcium, magnesium, or sodium bicarbonate, or zinc supplements, take them 1 to 2 hours before or 1 to 2 hours after bismuth, metronidazole, and tetracycline. If you are taking iron supplements, take them 3 hours before or 2 hours after bismuth, metronidazole, and tetracycline.
- Tell your doctor if you have kidney or liver disease. Your doctor may tell you not to take this medicine.
- Tell your doctor if you have an infection or if you have or have ever had blood problems, Crohn’s disease, or central nervous system conditions.
- Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking this medicine, call your doctor. Tetracycline can cause birth defects and harm nursing babies.
- You should know that this medicine can decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, implants, injections and intrauterine devices). Use another method of birth control while taking this medicine. Talk to your doctor about the types of birth control that will work for you during and after your treatment with bismuth, metronidazole, and tetracycline.
- Remember not to drink alcoholic beverages or take products with alcohol or propylene glycol while taking this medicine and for at least 3 days after treatment ends. Alcohol and propylene glycol can cause nausea, vomiting, stomach cramps, headache, sweating, and flushing (flushing of the face) when taken during treatment with metronidazole.
- Plan to avoid unnecessary or prolonged exposure to sunlight or ultraviolet light (tanning beds and sunlamps) and wear protective clothing, sunglasses, and sunscreen. This medicine can make your skin sensitive to sunlight.
- You should know that when tetracycline is taken during pregnancy or by infants or children up to the age of 8, it can cause teeth to become permanently stained and not form properly. It can also prevent bones from developing properly. Children under 8 years old should not take tetracycline.
What should I do if I forget a dose?
Skip the missed dose and continue your regular dosing schedule until all of the medicine is gone. Do not take a double dose to make up for the one you forgot. If you miss more than four doses, call your doctor.
What side effects can this medication cause?
Bismuth, metronidazole, and tetracycline may cause side effects. Darkening of the tongue and stool is temporary and harmless. Tell your doctor if any of these symptoms are severe or do not go away:
- dark urine
- loss of appetite
- stomach pain
- metallic taste in the mouth
- dry or sore mouth
If you have any of the following symptoms, stop taking this medication and call your doctor immediately:
- numbness, pain, burning, or tingling in your hands or feet
- blurred vision
- difficulty speaking
- problems with coordination
- confusion or agitation
- ringing in the ears
- vaginal itching and/or discharge
- fever, cough, sore throat, chills, or other signs of infection
- bloody or tarry stools
If you experience a serious side effect, you or your doctor can submit a report online to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medicine in the container it came in, tightly closed, and out of the reach of children. Store at room temperature and away from excess heat and moisture (not in the bathroom).
Unnecessary medications must be disposed of in special ways to ensure that pets, children, and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. Check out the FDA drug safe disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
It is important to keep all medicines out of the sight and reach of children, as many containers (such as those containing weekly pills and those for eye drops, creams, patches and inhalers) are not child-resistant and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach. http://www.upandaway.org
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, has trouble breathing, or cannot wake up, immediately call 911 for emergency services.
Symptoms of overdose may include:
- ringing in the ears
- high fever
- lack of energy
- fast heart rate
- shortness of breath
- fast breathing
- problems with coordination
- pain, burning, or tingling in the hands or feet
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor may order some laboratory tests to check your response to this medicine.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking this medicine.
Do not let anyone else take your medicine. Your prescription probably can’t be refilled. If you still have symptoms of an ulcer after finishing this medicine, call your doctor.
It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you every time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.
Disclaimer: DrLinex has made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.