bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride at a glance
Medicine class
Bismuth-based combination containing the antibiotics metronidazole and tetracycline.
Usual role
Eradication of H. pylori in people with an active or previous associated ulcer, alongside omeprazole.
Administration
Swallow capsules whole after food while seated, with a full glass of water; do not lie down immediately afterwards.
Alcohol
Avoid alcohol during treatment and for at least 24 hours afterwards.
What is bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride used for?
The selected UK product is licensed for use with omeprazole.
Eradication of Helicobacter pylori.
Prevention of relapse of peptic ulcers in people with active or previous H. pylori-associated ulcers.
How does bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride work?
Bismuth disrupts processes H. pylori needs to survive and attach to the stomach lining. Metronidazole damages bacterial DNA, while tetracycline blocks bacterial protein production. Omeprazole reduces stomach acid and forms part of the combined treatment.
bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride preparations and strengths
Capsule
Route: Oral
Strengths: 140 mg + 125 mg + 125 mg
How to take bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride
Follow the dispensing label and take it with the prescribed omeprazole. Take the capsules after food, swallow them whole while seated with a full glass of water, and do not open or chew them.
Do not lie down immediately afterwards because tetracycline can irritate or ulcerate the oesophagus.
Do not take dairy products, antacids, iron, zinc or sodium bicarbonate at the same time because they can reduce tetracycline absorption.
Avoid alcohol during treatment and for at least 24 hours afterwards.
Limit direct sunlight and ultraviolet exposure because tetracycline can cause an exaggerated sunburn reaction.
bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride side effects
Common or expected effects
- Black or otherwise altered stools
- Diarrhoea
- Nausea or vomiting
- Metallic or unpleasant taste
- Abdominal discomfort, constipation or wind
- Dry mouth
- Headache, dizziness, sleepiness or tiredness
- Dark urine
- Reduced appetite
- Rash
- Oral or vaginal thrush
Get urgent medical advice
- Allergic swelling, breathing difficulty or widespread hives
- Blistering, peeling or otherwise severe skin reactions
- Confusion, hallucinations, fits or other signs of encephalopathy
- New numbness, tingling, pain or weakness suggesting peripheral neuropathy
- Problems coordinating movement, walking or speech
- Severe or persistent diarrhoea suggesting antibiotic-associated colitis
- Severe headache with visual disturbance or stiff neck
- Jaundice or other symptoms of significant liver injury
bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride in pregnancy
The selected UK product is contraindicated during pregnancy. Tetracycline can affect developing teeth and bones. Anyone who is pregnant, may be pregnant or becomes pregnant during treatment should contact the prescriber promptly.
bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride while breastfeeding
Do not breastfeed while taking this combination because the selected UK product is contraindicated during breastfeeding. Discuss alternatives with the prescriber.
bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride interactions
A full medicines review is important because each component has clinically relevant interactions.
Alcohol and alcohol-containing products
Can cause nausea, vomiting, abdominal cramps, flushing and headache; avoid during treatment and for at least 24 hours afterwards.
Warfarin and other coumarin anticoagulants
Anticoagulant effects may increase, so clotting tests and treatment may need closer review.
Lithium
Metronidazole can precipitate lithium toxicity; lithium concentrations require close monitoring if combined.
Common questions about bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride
Answers are fully visible for fast scanning and source review.
What is this combination used for?
It is used with omeprazole to eradicate H. pylori and help prevent recurrence of associated peptic ulcers.
Is this combination the same as Pylera?
Pylera is the brand name of the selected UK capsule containing these three active ingredients.
Why is it taken with omeprazole?
Omeprazole reduces stomach acid and is an essential part of the licensed combined treatment for H. pylori.
Can the capsules be opened or chewed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.