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Bismuth subcitrate/metronidazole/tetracycline (By mouth)

Bismuth Subcitrate Potassium (BIZ-muth sub-SIT-rate poe-TAS-ee-um), Metronidazole (met-roe-NYE-da-zole), Tetracycline Hydrochloride (tet-ra-SYE-kleen hye-droe-KLOR-ide)

Treats H pylori infection and duodenal ulcer.

Brand Name(s):


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 subcitrate potassium, metronidazole or similar medicines, or tetracycline, or if you are pregnant or breastfeeding.

How to Use This Medicine:


  • Your doctor will tell you how much medicine to use. Do not use more than directed.
  • Capsule: Swallow it whole with a full glass of water. Do not crush, break, or chew it.
  • 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.
  • 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 contact 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 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:
    • Busulfan, cimetidine, isotretinoin, lithium, phenobarbital, phenytoin
    • Antacid containing aluminum, calcium, or magnesium
    • Birth control pills
    • Blood thinner (including warfarin)
    • Iron, zinc, or sodium bicarbonate supplements
  • Do not have milk or dairy products while you are using this medicine.

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.
  • Tell your doctor if you have kidney disease, liver disease, fungal infections, brain and nerve problems (including encephalopathy, Cockayne Syndrome), or a history of blood problems or seizures.
  • This medicine may cause a permanent change of tooth color in children and serious skin reactions, including drug reaction with eosinophilia and systemic symptoms.
  • 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 check your progress and the effects of this medicine at regular visits. 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
  • Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes
  • 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
  • Seizure, headache, dizziness, blurred vision
  • Stiff neck, drowsiness, fever, severe headache, painful eye movements, eye sensitivity to light

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: 5/1/2020

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.

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