Bismuth Subsalicylate, Metronidazole, and Tetracycline—For H. pylori (Systemic)

Brand Names : Helidac

Before Using This Medicine

In deciding to use a medicine, the risks of taking this combination of medicines must be weighed against the good it will do. This is a decision you and your doctor will make. For this combination of medicines (bismuth subsalicylate, metronidazole, and tetracycline), the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to bismuth subsalicylate, aspirin or other salicylates, metronidazole, or tetracycline. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - The use of this combination of medicines in pregnant women is not recommended. Tetracycline may have toxic effects on the fetus during the early stages of pregnancy. Also, use of tetracycline in the last half of pregnancy may cause the unborn infant's teeth to become permanently discolored.

Breast-feeding - Use of this combination of medicines is not recommended since metronidazole and tetracycline pass into breast milk and may cause serious unwanted effects in nursing babies.

Children - Infants and children up to 8 years of age should not take this combination of medicines unless directed by the child's doctor. Tetracycline may cause permanent discoloration of the teeth.

Children or teenagers who have or who are recovering from chickenpox or influenza should not use this combination of medicines unless directed by the child's doctor. If nausea or vomiting occurs after taking this combination of medicines, check with the child's doctor. Nausea or vomiting could be early signs of Reye's syndrome, a rare but serious illness.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing the use of this combination of medicines (bismuth subsalicylate, metronidazole, and tetracycline) in the elderly with its use in other age groups.

Other medicines - Although certain medicines should not be used together at all, in other cases different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this combination of medicines (bismuth subsalicylate, metronidazole, and tetracycline), it is especially important that your health care professional know if you are taking any of the following:

• Alcohol - Consuming alcohol during treatment or for at least 1 day after treatment with metronidazole in this combination of medicines may cause stomach pain, nausea, vomiting, headaches, and flushing or redness of the face

• Antacids or
• Iron-containing medicine or
• Sodium bicarbonate or
• Zinc - Use of these medicines with tetracycline in this combination of medicines may decrease the effect of tetracycline

• Anticoagulants (blood thinners) - This combination of medicines may change the bleeding times in patients taking anticoagulants

• Antidiabetic medicines (diabetes medicine you take by mouth) or
• Insulin - The bismuth subsalicylate in this combination of medicines may make the levels of sugar in the blood become too low

• Aspirin or
• Other salicylates - The bismuth subsalicylate in this combination of medicines may add to the effects of aspirin or other salicylates, increasing the risk of toxicity

• Barbiturates, especially phenobarbital or
• Carbamazepine (e.g., Tegretol) or
• Glutethimide (e.g., Doriglute) or
• Phenylbutazone (e.g., Butazolidin) or
• Phenytoin (e.g., Dilantin) or
• Primidone (e.g., Mysoline) or
• Rifampin (e.g., Rifadin) - Taking any of these medicines with metronidazole in this combination of medicines may decrease the effects of metronidazole

• Disulfiram (e.g., Antabuse) - Patients taking disulfiram with metronidazole in this combination of medicines may have an increased risk of side effects

• Oral contraceptives (birth control pills) - Use of birth control pills with tetracycline in this combination of medicines may decrease the effect of the birth control pills and increase the chance of unwanted pregnancy

• Penicillin - Use of penicillin with tetracycline in this combination of medicines may decrease the effects of penicillin

Other medical problems - The presence of other medical problems may affect the use of this combination of medicines (bismuth subsalicylate, metronidazole, and tetracycline). Make sure you tell your doctor if you have any other medical problems, especially:

• Kidney disease or
• Liver disease - Higher blood levels of metronidazole and tetracycline in this combination of medicines may occur, resulting in an increased risk of side effects