Bismuth subsalicylate/metronidazole/tetracycline (By mouth)


Treats a stomach infection (H pylori) that causes ulcers. 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

Do not use this medicine if you have had an allergic reaction to bismuth subcitrate potassium, metronidazole or similar medicines (such as tinidazole), tetracycline, or aspirin or other salicylates. Do not use this medicine if you have also used disulfiram (Antabuse®) within the last 2 weeks or if you have recently been or will soon be treated with methoxyflurane (Penthrane®). Do not use this medicine if you are pregnant or breastfeeding or have severe kidney disease. Do not drink alcohol while you are using this medicine.

How to Use This Medicine

Chewable Tablet, Tablet, Capsule

  • Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
  • The medicine for each day is packaged on 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 tablet and the tetracycline capsule whole with a full glass (8 ounces) of water. This will help prevent irritation of the esophagus (tube between the throat and stomach). Do not chew, crush, or break the metronidazole tablet and the tetracycline capsule.
  • Take 1 dose (all 4 pills) 4 times a day, after meals and at bedtime.
  • Keep using this medicine for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.
  • This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.

If a dose is missed:

  • If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.Call your doctor if you missed more than 4 doses of this combination of medicines.

How to Store and Dispose of This Medicine

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

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

  • Make sure your doctor knows if you also use aspirin, cimetidine (Tagamet®), lithium (Eskalith®, Lithobid®), penicillin, phenobarbital (Luminal®), phenytoin (Dilantin®), probenecid (Benemid®), sulfinpyrazone (Anturan®), diabetes medicine that you take by mouth (such as glimepiride, glyburide, metformin, Actos®, Janumet®, Januvia®), or a blood thinner (such as warfarin, Coumadin®, Jantoven®). Tell your doctor if you also take antacids that contain aluminum, calcium, or magnesium (such as Maalox®, Tums®), supplements that contain iron, zinc, or sodium bicarbonate).
  • Do not drink alcoholic beverages or other products that have propylene glycol while you are using this medicine and for 3 days after you stop.
  • Avoid taking this medicine with milk or other dairy products.

Warnings While Using This Medicine

  • Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using the medicine, tell your doctor right away.
  • Make sure your doctor knows if you have kidney disease, liver disease, nerve problems, seizures, or a history of blood disorders.
  • This medicine may make you dizzy or have trouble seeing clearly. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you.
  • This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds.
  • This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
  • This medicine should not be given to children, especially if they have or are recovering from the chicken pox or flu. Children can develop a rare but serious condition called Reye syndrome if given this medicine.
  • Birth control pills may not work well while you are using this combination of medicines. To avoid pregnancy, use another form of birth control.
  • Make sure any doctor or dentist who treats you knows that you are using this medicine. You may need to stop using this medicine several days before having surgery or medical tests.
  • Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
  • If your symptoms do not improve or if they get worse, call your doctor.

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
  • Decrease in how much or how often you urinate, difficult or painful urination
  • Fever, chills, cough, sore throat, and body aches
  • Headache, stiff neck, nausea, vomiting
  • Numbness, tingling, or burning pain in your hands, arms, legs, or feet
  • Seizures or tremors
  • Sudden and severe stomach pain, nausea, vomiting, fever, and 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:

  • Black stools, dark-colored tongue
  • Diarrhea, stomach pain, mild nausea
  • Discoloration of the teeth
  • Dizziness
  • Mild skin rash
  • White patches in your mouth or tongue

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

Version Info

  • Last Reviewed on 06/12/2013

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This page was last updated: June 18, 2013

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