bismuth subsalicylate, metronidazole, and tetracycline

Pronunciation:	bizz MUTH sub sah LIH sah late, me troe NI da zole, and tet ra SYE kleen
Brand:	Helidac

What is the most important information I should know about bismuth subsalicylate, metronidazole, and tetracycline?

Take all of the bismuth subsalicylate, metronidazole, and tetracycline that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated.

Bismuth subsalicylate, metronidazole, and tetracycline is not approved for use by children. Children younger than 8 years of age should not use tetracycline because of its unfavorable effects on tooth and bone formation.

Avoid taking dairy products, multivitamins, iron supplements, antacids, and laxatives within 2 hours of taking tetracycline. These products decrease the effectiveness of tetracycline.

Tetracycline may decrease the effectiveness of birth control pills. Use a second method of birth control while taking this medication to be sure you are protected from pregnancy.

Avoid prolonged exposure to sunlight. Tetracycline may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Do not drink alcohol or take alcohol-containing products while taking this medication and for 1 day after stopping therapy, unless approved by your doctor. Alcohol and metronidazole may cause nausea, vomiting, abdominal cramps, headache, and flushing.

What is bismuth subsalicylate, metronidazole, and tetracycline?

Bismuth subsalicylate is a mild antibiotic.

Likewise, metronidazole and tetracycline are also antibiotics. They fight bacteria in your body.

Together, bismuth subsalicylate, metronidazole, and tetracycline are used to treat Helicobacter pylori, a bacterial infection involved in causing stomach ulcers.

Bismuth subsalicylate, metronidazole, and tetracycline may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking bismuth subsalicylate, metronidazole, and tetracycline?

Before taking this medication, tell your doctor if you have

kidney disease;
liver disease;
epilepsy or another seizure disorder; or
an allergy to aspirin.

You may not be able to take bismuth subsalicylate, metronidazole, and tetracycline or you may require a lower dose or special monitoring if you have any of the conditions listed above.

Bismuth subsalicylate, metronidazole, and tetracycline is in the FDA pregnancy category D. This means that it is known to harm an unborn baby. Tetracycline may affect bone and tooth development. Do not take this medication without first talking to your doctor if you are pregnant.

Tetracycline and metronidazole pass into breast milk. Tetracycline may affect bone and tooth development in a nursing infant. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

Children younger than 8 years of age should not receive tetracycline. It can cause permanent tooth discoloration, and it can affect growth.

How should I take bismuth subsalicylate, metronidazole, and tetracycline?

Take bismuth subsalicylate, metronidazole, and tetracycline exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Chew and swallow the bismuth subsalicylate tablets.

Swallow (don't chew) one each of the metronidazole and tetracycline pills.

To prevent heartburn and damage to the esophagus, be sure to take each dose (especially the bedtime dose) with a full glass of water (8 ounces).

Take all 4 pills four times daily with meals and at bedtime.

Do not take dairy products, iron supplements, multivitamins, calcium supplements, antacids, or laxatives within 2 hours of taking tetracycline. These products reduce the effectiveness of tetracycline.

Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

Skip the missed dose and take your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor. If more than 4 doses in a row have been missed, contact your doctor.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of a bismuth subsalicylate, metronidazole, and tetracycline overdose include nausea, vomiting, diarrhea, slow breathing, ringing in the ears, fever, a fast heartbeat, confusion, numbness or tingling, and seizures.

What should I avoid while taking bismuth subsalicylate, metronidazole, and tetracycline?

Avoid taking dairy products, multivitamins, iron supplements, antacids, and laxatives within 2 hours of taking tetracycline. These products decrease the effectiveness of tetracycline.

Avoid prolonged exposure to sunlight. Tetracycline may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

What are the possible side effects of bismuth subsalicylate, metronidazole, and tetracycline?

If you experience any of the following serious side effects, stop taking bismuth subsalicylate, metronidazole, and tetracycline and seek emergency medical attention:

an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
a severe headache;
vision changes;
confusion;
liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue);
blood problems (fever, fatigue, easy bruising or bleeding);
severe diarrhea; or
seizures.

If you experience any of the following less serious side effects, continue to take your medication and talk your doctor.

nausea, vomiting, or diarrhea;
metallic taste in mouth;
sensitivity to the sun;
dark "furry"; tongue, black tongue, or swollen tongue;
vaginal yeast infection;
numbness or tingling;
dizziness or decreased co-ordination;
decreased appetite; or
dark stools.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect bismuth subsalicylate, metronidazole, and tetracycline?

Do not take the following drugs within 2 hours of taking bismuth subsalicylate, metronidazole, and tetracycline because they will decrease the effectiveness of tetracycline:

cholestyramine (Questran) or colestipol (Colestid);
antacids containing aluminum or magnesium such as Tums and Rolaids;
minerals such as iron, zinc, calcium, and magnesium, which are found in dairy products (milk, cheese, etc.) and over-the-counter vitamin and mineral supplements.

Before taking bismuth subsalicylate, metronidazole, and tetracycline tell your doctor if you are taking any of the following medicines

anticoagulants such as warfarin (Coumadin). This medicine may have an increased effect when taken with bismuth subsalicylate, metronidazole, and tetracycline, and bleeding could result.
penicillin and cephalosporin antibiotics. These may have a decreased effect and an infection could worsen.
birth control pills. Their effectiveness may be decreased, resulting in pregnancy.
disulfiram (Antabuse). A two week period should elapse between therapy with disulfiram and metronidazole.
cimetidine (Tagamet, Tagamet HB). This medication may increase the effects of metronidazole leading to side effects.
lithium (Lithobid, Eskalith, others). Metronidazole may increase the effects of lithium leading to side effects.
phenytoin (Dilantin) or phenobarbital (Luminal, Solfoton). These medications may make metronidazole ineffective.
diabetes medicines, aspirin, probenecid (Benemid), and sulfinpyrazone. These medicines may be affected by bismuth subsalicylate.

Drugs other than those listed here may also interact with bismuth subsalicylate, metronidazole, and tetracycline. Talk to your doctor before taking any prescription or over-the-counter medicine.

Where can I get more information?

Your pharmacist has additional information about bismuth subsalicylate, metronidazole, and tetracycline written for health professionals that you may read.

What does my medication look like?

Bismuth subsalicylate, metronidazole, and tetracycline is available with a prescription under the brand name Helidac. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Helidac-14 blister cards each containing 8 round, pink bismuth subsalicylate tablets, 4 white, round 250 mg metronidazole tablets, and 4 orange and white 500 mg tetracycline tablets

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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