Bismuth subsalicylate, Metronidazole, Tetracycline hydrochloride

Brand names: Helidac Therapy

Why is Bismuth subsalicylate, Metronidazole, Tetracycline hydrochloride prescribed?

Helidac is a drug combination that cures the infection responsible for most stomach ulcers. Although ulcers used to be blamed on stress and spicy food, doctors now know that a germ called Helicobacter pylori is the actual culprit in a majority of cases.

Most important fact about Bismuth subsalicylate, Metronidazole, Tetracycline hydrochloride

You need to take all of the Helidac pills 4 times each day for 14 days. (You should also be taking an acid blocker such as cimetidine, famotidine, or ranitidine.) If you fail to stick to this regimen, the infection may not be cured.

How should you take Bismuth subsalicylate, Metronidazole, Tetracycline hydrochloride?

There are four pills in each dose of Helidac. The two pink tablets (bismuth subsalicylate) should be chewed and swallowed. The white tablet (metronidazole) and the orange and white capsule (tetracycline) should be swallowed whole. Be sure to drink at least 8 ounces of fluid with each dose—and especially at bedtime—to prevent irritation.

• If you miss a dose...Take the next dose at the appointed time and continue with your regular schedule until the medication is used up. Do not try to "catch up" by doubling a dose. If you miss more than four doses, contact your physician.

• Storage instructions...Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Helidac.

• Side effects may include:Abdominal pain, diarrhea, nausea

Why should Bismuth subsalicylate, Metronidazole, Tetracycline hydrochloride not be prescribed?

Do not take Helidac if you have ever had an allergic reaction to any of the following medications:

AspirinBismuth subsalicylateDoxycyclineMetronidazoleTetracycline

Helidac is not for use by children and pregnant or nursing women. The tetracycline part of the therapy can harm a developing baby, stunt a child's growth, and interfere with tooth development.

You should also avoid Helidac if you have kidney or liver disease.

Special warnings about Bismuth subsalicylate, Metronidazole, Tetracycline hydrochloride

Don't be alarmed if your tongue and/or bowel movements turn black while you are taking Helidac. This is a harmless side effect of the bismuth subsalicylate part of the therapy.

The tetracycline part of Helidac therapy increases the risk of getting a bad sunburn. Limit your exposure to the sun. If you notice a reddening of your skin, stop taking Helidac and call your doctor.

If you develop a headache and blurred vision, numbness and tingling in the arms and legs, or seizures, stop taking Helidac and call your doctor immediately. Also report any infection that develops and be sure your doctor is aware of any infection or blood disorder you already have.

Possible food and drug interactions when taking Bismuth subsalicylate, Metronidazole, Tetracycline hydrochloride

Combining aspirin with Helidac sometimes causes ringing in the ears. If this happens, check with your doctor. You may need to temporarily stop taking aspirin.

During Helidac therapy, alcoholic beverages can cause abdominal cramps, nausea, vomiting, headache, and flushing. Avoid alcohol until at least 1 day after finishing Helidac.

For 1 hour before and 2 hours after each dose of Helidac, avoid eating dairy products. They can interfere with the medication's absorption.

Since Helidac can interfere with oral contraceptives, you should use an additional form of birth control during Helidac therapy.

Do not start Helidac therapy if you have taken the anti-alcohol drug disulfiram within the past 2 weeks.

Certain other drugs may also interact. Check with your doctor before combining Helidac with any of the following:

Antacids containing aluminum, calcium, or magnesiumBlood-thinning drugs such as warfarinCimetidineDiabetes medications such as insulin and glyburideIron (including vitamins that contain iron)LithiumPenicillinPhenobarbitalPhenytoinProbenecidSodium bicarbonate (baking soda)SulfinpyrazoneZinc (including vitamins that contain zinc)

Special information if you are pregnant or breastfeeding

Do not undertake Helidac therapy during this period.

Recommended dosage for Bismuth subsalicylate, Metronidazole, Tetracycline hydrochloride

ADULTS

Take all 4 Helidac pills 4 times daily, with each meal and at bedtime.

Overdosage

An overdose of the bismuth subsalicylate part of Helidac can be fatal. The other components can have serious consequences as well.

• Symptoms of Helidac overdose may include:Confusion, coma, convulsions, coordination problems, diarrhea, fast heartbeat, high fever, lethargy, nausea, numbness or pain in the arms and legs, rapid breathing, ringing in the ears, severe heart and lung problems, vomiting

If you suspect an overdose, seek medical attention immediately.