Learn more about usage, cautions, and possible side effects .
Chemical Name: BISMUTH (BIS-muth sub-sa-LIS-a-late), METRONIDAZOLE (me-troe-NI-da-zole), and TETRACYCLINE (te-tra-SYE-kleen)
This medicine is an antimicrobial combination used with a histamine blocker (such as ranitidine) to treat Helicobacter pylori (H. pylori) infection associated with ulcers.
THIS MEDICINE SHOULD ONLY BE USED TO TREAT ULCERS OF THE SMALL INTESTINES (duodenal ulcers) associated with Helicobacter pylori infection. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE if you are also taking acitretin, busulfan, ergot alkaloids(such as ergotamine), an HIV protease oral solution (such as amprenavir), isotretinoin, methoxyflurane, penicillin antibiotics (such as amoxicillin), ranolazine, disulfiram, or if you have taken disulfiram within the past 14 days. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking amiodarone, angiotensin converting enzyme inhibitors (such as enalapril), anticoagulants (such as warfarin), atovaquone, barbiturates (such as phenobarbital), cimetidine, cyclosporine, digoxin, hormonal contraceptives (such as birth control pills, patches), hydantoins (such as phenytoin), lithium, macrolide immunosuppressants (such as sirolimus), methotrexate, salicylates (such as aspirin), sulfinpyrazone, urinary alkalinizers (such as sodium bicarbonate), valproic acid, or medicines for diabetes (such as glipizide). DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including a history of blood problems (such as anemia, low white blood cells, or unusual bleeding or bruising), a seizure disorder (such as epilepsy), other central nervous system problems, a viral infection (such as flu, shingles), stomach or bowel problems (such as inflammation, peptic ulcers, Crohn disease), dehydration problems, lupus, allergies, pregnancy, or breast-feeding. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have kidney problems, liver problems, or bleeding or blood clotting problems (such as hemophilia, von Willebrand disease). USE OF THIS MEDICINE in a child or teenager who has a viral infection (such as chickenpox or flu) is not recommended. USE OF THIS MEDICINE IN CHILDREN under 8 years old is not recommended. Discuss with your doctor the risks and benefits of giving this medicine to your child. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine.
Follow the directions for using this medicine provided by your doctor. AN ADDITIONAL PATIENT INFORMATION LEAFLET is available with this medicine. Read it carefully. Ask your doctor, nurse, or pharmacist any questions that you may have about this medicine. EACH DOSE OF THIS MEDICINE is made up of 2 pink chewable tablets, one white tablet, and one orange and white capsule. Each blister card contains 4 doses (enough doses for 1 day). TAKE A DOSE OF THIS MEDICINE four times a day, at mealtimes and at bedtime, unless your doctor tells you otherwise. To take a dose of this medicine, thoroughly chew 2 pink tablets and swallow. Afterwards, take 1 white tablet and 1 orange and white capsule with a full glass of water (8 oz/240 mL). SWALLOW THE TABLET AND CAPSULE WHOLE. Do not break, crush, or chew before swallowing. DRINKING EXTRA FLUIDS while you are taking this medicine is recommended. Be sure to do this especially with the bedtime dose. Check with your doctor for instructions. DO NOT TAKE AN ANTACID that has aluminum, calcium, magnesium or any product that has iron or zinc in it within 2 hours of this medicine. DO NOT EAT OR DRINK DAIRY PRODUCTS within 2 hours of this medicine. STORE THIS MEDICINE at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), away from heat and light. TO CLEAR UP YOUR INFECTION COMPLETELY, continue using this medicine for the full course of treatment even if you feel better in a few days. Do not miss any doses. IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you miss more than 4 doses of this medicine, contact your doctor.
DO NOT TAKE THIS MEDICINE if you have had an allergic reaction to it, to any ingredient in this product, to salicylates (such as aspirin), or to non-steroidal anti-inflammatory medicines (such as ibuprofen). A severe reaction includes a severe rash, hives, breathing difficulties, or dizziness. If you have a question about whether you are allergic to this medicine, contact your doctor or pharmacist. IF YOU EXPERIENCE difficulty breathing; tightness of chest; swelling of eyelids, face, or lips; or if you develop a rash or hives, tell your doctor immediately. Do not take any more of this medicine unless your doctor tells you to do so. THIS MEDICINE COMBINATION SHOULD ONLY BE USED to treat H. Pylori infection associated with ulcers. It is not effective for treating viral infections (such as the common cold). Be sure to use this medicine for the full course of treatment. If you do not, the medicine may not clear up your infection completely. This could cause your ulcer to recur. THIS MEDICINE MAY AFFECT CERTAIN LAB TEST RESULTS, including x-rays, blood, liver function, and triglycerides. Make sure laboratory personnel and your doctors know you use this medicine. DO NOT DRINK ALCOHOL while you are using this medicine and for at least 1 day after you have stopped taking this medicine. Stomach cramps, nausea, vomiting, headaches, and flushing may occur. This medicine may cause dizziness. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to this medicine. Using this medicine alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. THIS MEDICINE MAY CAUSE increased sensitivity to the sun. Avoid exposure to the sun, sunlamps, or tanning booths until you know how you react to this medicine. Use a sunscreen or protective clothing if you must be outside for a prolonged period. THIS MEDICINE MAY TEMPORARILY DISCOLOR or darken the tongue or stools. This is normal and not a cause for concern. This medicine has an aspirin-like medicine in it. Aspirin has been linked to a serious illness called Reye syndrome. DO NOT USE THIS MEDICINE TO TREAT NAUSEA OR VOMITING IN A CHILD OR TEENAGER who has recently had chickenpox or flu. Nausea or vomiting may be a sign of Reye syndrome. Contact your doctor with any questions or concerns. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. This includes non-steroidal anti-inflammatory medicines (such as ibuprofen) and other products containing aspirin or bismuth. IF YOU ARE TAKING ASPIRIN for some other condition as directed by your doctor, and you develop ringing in the ears, contact your doctor. DO NOT RECEIVE A LIVE VACCINE (such as typhoid) while you are taking this medicine. Talk with your doctor before you receive any vaccine. FOR WOMEN USING HORMONAL BIRTH CONTROL (such as birth control pills): This medicine may decrease the effectiveness of your birth control pill. To prevent pregnancy, use an additional form of birth control. FOR WOMEN: THIS MEDICINE HAS BEEN SHOWN TO CAUSE HARM to the human fetus. Do not use this medicine if you are pregnant. Avoid becoming pregnant while you take this medicine. IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using this medicine during pregnancy. THIS MEDICINE IS EXCRETED IN BREAST MILK. Do not breast-feed while taking this medicine.
SIDE EFFECTS that may occur while taking this medicine include constipation; darkening of the tongue or stools; diarrhea; dizziness; headache; indigestion; loss of appetite; metallic taste; nausea; stomach pain; or vomiting. If they continue or are bothersome, check with your doctor. CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience blurred vision, signs of infection (such as fever, chills, or persistent sore throat), sore mouth, vaginal odor or discharge, or white patches in the mouth or on the tongue. CONTACT YOUR DOCTOR IMMEDIATELY if you experience bloody stools; depression; black, hairy, or sore tongue; dark urine; loss of coordination; numbness or tingling in the hands or feet; pale stools; red or blistered skin; seizures; severe or persistent headache or stomach pain; unusual bruising or bleeding; or yellowing of the eyes or skin. An allergic reaction to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Use our drug interaction checker to find out if your medicines interact with each other. Check drug interactions
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include rapid breathing, nausea, vomiting, ringing in the ears, fever, sluggishness, fast pulse, and confusion.
If your symptoms do not improve or if they become worse, check with your doctor. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS MEDICINE out of the reach of children.
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