Trade Names:Helidac- Carton containing blister cards that, in total, contain 112 bismuth subsalicylate 262.4 mg chewable tablets, 56 metronidazole 250 mg tablets, 56 tetracycline hydrochloride 500 mg capsules
Trade Names:Pylera- Capsules bismuth subcitrate potassium 140 mg, metronidazole 125 mg, tetracycline 125 mg
Each of the ingredients is individually active in vitro against most strains of H. pylori . The relative contribution of systemic versus local antimicrobial activity for H. pylori eradication is not established.
Treatment of patients with H. pylori infection and duodenal ulcer.Helidac
Take in combination with an H 2 antagonist.Pylera
Take in combination with omeprazole.
Pregnant or breast-feeding women; children; renal or hepatic function impairment; hypersensitivity to aspirin, salicylates, bismuth subsalicylate, metronidazole or other nitroimidazole derivatives, or any of the tetracyclines.
PO 2 bismuth subsalicylate chewable tablets (262.4 mg/tablet), 1 metronidazole 250 mg tablet, and 1 tetracycline 500 mg capsule taken together 4 times daily for 14 days.Pylera
3 capsules 4 times daily, after meals and at bedtime for 10 days. Each capsule contains bismuth subcitrate potassium 140 mg, metronidazole 125 mg, or tetracycline 125 mg.
Store between 68° and 77°F.
Avoid during metronidazole use and for at least 24 h after administration.Aluminum-, calcium-, and magnesium-containing antacids
May decrease absorption of tetracycline.Anticoagulants
Possible increased anticoagulant effect and risk of bleeding.Antidiabetic agents
Possible increased antidiabetic effect.Bactericidal antibiotics (eg, penicillins)
Tetracycline may reduce effectiveness.Busulfan
Busulfan trough levels may be elevated, increasing the risk of toxicity (eg, hemorrhagic cystitis, veno-occlusive disease).Contraceptives, hormonal
Tetracycline may reduce effectiveness.Disulfiram
Metronidazole has been reported to cause psychosis.Drugs that decrease microsomal liver enzyme activity (eg, cimetidine)
May decrease metronidazole Cl.Drugs that induce microsomal hepatic activity (eg, barbiturates [eg, phenobarbital], phenytoin)
May reduce metronidazole plasma levels, decreasing the efficacy.Iron, sodium bicarbonate, or zinc
May decrease absorption of tetracycline.Lithium
Metronidazole may increase lithium blood levels.Methoxyflurane
Tetracycline has caused fatal renal toxicity.Phenytoin
May reduce elimination of tetracycline.Retinoids (eg, acitretin, isotretinoin)
Coadministration with tetracycline may increase the risk of benign intracranial hypertension.Urinary alkalinizers
Tetracycline excretion may be increased.
Metronidazole may interfere with AST, ALT, LDH, trigylcerides, and nevu Kinase glucose.X-ray procedures
Bismuth absorbs x-rays and may interfere with GI diagnostic procedures.
Palpitation (1%); MI.
Headache (8%); asthenia (4%); dizziness (3%); anxiety, insomnia, paresthesia (1%); benign intracranial hypertension.
Maculopapular rash, rash (1%).
Abnormal stool (16%); nausea (12%); abdominal pain, diarrhea, dyspepsia (9%); taste perversion (5%); melena (3%); anorexia, constipation, tongue discoloration, vomiting (2%); anal discomfort, dry mouth, duodenal ulcer, flatulence, gastritis, gastroenteritis, GI hemorrhage (1%).
Vaginitis (4%); urinary abnormality (2%).
Lab test abnormalities (3%); increased ALT (2%); increased AST (1%).
Back pain (2%).
Upper respiratory infection (2%); cough, rhinitis, sinusitis (1%).
Flu syndrome (5%); infection, pain (2%); chest pain (1%).
Metronidazole has been shown to be carcinogenic in mice and rats. Avoid unnecessary use of the drug.
Category D . Contraindicated during pregnancy.
Secreted into breast milk.
Safety and effectiveness not established. Contraindicated in children.
Prolonged use may result in bacterial or fungal overgrowth.
Use with caution.
Convulsive seizures and peripheral neuropathy have been reported with metronidazole.
Bismuth subsalicylate may cause a harmless darkening of the tongue and stools.
Do not use because of the risk nephrotoxicity.
Consider in a patient in whom diarrhea develops.
Has been reported.
Tetracycline may increase susceptibility to sunburn.
Coma, confusion, convulsions, CV collapse, death, hyperpnea, hyperpyrexia, lethargy, nausea, pulmonary or cerebral edema, respiratory failure, tachycardia, tinnitus, vomiting.Metronidazole
Ataxia, nausea, vomiting.Tetracycline
GI symptoms, including diarrhea, nausea, and vomiting.
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