Bismuth subsalicylate/metronidazole/tetracycline (By mouth)

Treats H pylori infection and duodenal ulcer. This medicine contains a combination of antibiotics.

Brand Name(s):

Helidac Therapy

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

This medicine is not right for everyone. Do not use it if you had an allergic reaction to bismuth, metronidazole or similar medicines, tetracycline, or aspirin or other salicylates, if you have Cockayne syndrome (genetic disorder) or severe kidney disease, or if you are pregnant

How to Use This Medicine:

Chewable Tablet, Tablet, Capsule

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Each blister card contains a capsule, tablet, and chewable tablet. Follow your doctor's instructions on how to take these properly.
• Take this medicine with meals and at bedtime.
• Capsule and tablet: Swallow the capsule and tablet whole with a full glass (8 ounces) of water. Do not crush, break, or chew it.
• Chewable tablet: Chew the tablet completely and swallow right away.
• Drink extra liquids to help prevent irritation or ulcers in your esophagus.
• Take all of the medicine in your prescription to clear up your infection, even if you feel better after the first few doses.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose. If you miss more than 4 doses , call your doctor right away.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you are also using methoxyflurane or have been using disulfiram within the last 2 weeks. Do not drink alcohol or other products containing propylene glycol while you are using this medicine and for at least 3 days after you stop taking it.
• Some foods and medicines can affect how this medicine works. Tell your doctor if you are using any of the following:
  • Aspirin, busulfan, cimetidine, lithium, penicillin, phenobarbital, phenytoin, probenecid, sulfinpyrazone
  • Antacid containing aluminum, calcium, or magnesium
  • Birth control pills
  • Blood thinner (including warfarin)
  • Diabetes medicine
  • Medicine that may cause heart rhythm problems
  • Multivitamin supplements containing iron, zinc, or sodium bicarbonate
• Do not take this medicine with milk or other dairy products.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant. Using this medicine especially during the second and later part of a pregnancy can harm your unborn baby. Birth control pills may not work as well to prevent pregnancy when used with this medicine. Use an effective form of birth control (including condoms, spermicide) during treatment with this medicine.
• Your doctor may tell you to stop breastfeeding, and pump and discard your breast milk during treatment for at least 24 hours after treatment with this medicine.
• Tell your doctor if you have kidney disease, liver disease, brain or nerve problems, any type of infection (including chickenpox, influenza, fungal infection), obesity, or a history of blood disorders.
• This medicine may cause the following problems:
  • Brain or nerve problems, including seizures, encephalopathy, peripheral neuropathy, meningitis, intracranial hypertension
  • Increased risk of Reye syndrome (in children with chickenpox or influenza)
  • Permanent discoloration of teeth in children
  • Serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS)
• This medicine may make you bleed, bruise, or get infections more easily. Take precautions to prevent illness and injury. Wash your hands often.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Call your doctor if your symptoms do not improve or if they get worse.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Changes in vision
• Change in how much or how often you urinate, difficult or painful urination
• Fever, chills, cough, sore throat, swollen, painful, or tender lymph glands in the neck, armpit, or groin
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Seizures or tremors
• Severe headache, stiff neck, dizziness, painful eye movements, eye sensitivity to light
• Sudden and severe stomach pain, nausea, vomiting, lightheadedness
• Unusual bleeding, bruising, weakness
• Warmth or redness in your face, neck, arms, or upper chest

If you notice these less serious side effects, talk with your doctor:

• Dark or black tongue or stools
• Diarrhea, change in taste
• Yellow-gray-brown tooth discoloration

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 4/23/2024