Proper Use

Drug information provided by: Merative, Micromedex®

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.

This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Each day's treatment is packaged in a blister card that contains 8 chewable tablets of bismuth subsalicylate, 4 tablets of metronidazole, and 4 capsules of tetracycline.

Pay attention to how to take each medicine. Completely chew and swallow 2 bismuth tablets. Swallow the metronidazole tablets and tetracycline capsules with a full glass (8 ounces) of water. Do not chew, crush, or break the metronidazole tablets and tetracycline capsules.

Take this medicine with meals and at bedtime.

Drink extra fluids to help prevent irritation or ulcers in the esophagus.

Your doctor will also prescribe another medicine called an H2 blocker, which will come with its own directions and must be taken along with this medicine.

Avoid taking milk, dairy products, antacids containing aluminum, calcium, or magnesium (eg, Maalox®, Tums®), or supplements containing iron, zinc, or sodium bicarbonate. This may keep tetracycline from working properly.

Do not drink milk or eat dairy products with this medicine.

Keep using this medicine for the full time of treatment, even if you begin to feel better after the first few doses. Your infection may not clear up if you stop using this medicine too soon.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (blister card containing chewable tablets, tablets, and capsules):
    • For H. pylori infection and duodenal ulcer (taken with an H2 blocker):
      • Adults—One dose (two 262.4 milligrams [mg] of bismuth subsalicylate, one 250 mg of metronidazole, and one 500 mg of tetracycline) 4 times a day, taken with meals and at bedtime, for 14 days.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss more than 4 doses of this medicine, call your doctor right away.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.