Bismuth subcitrate potassium, metronidazole, and tetracycline

Do not drink alcohol while you are taking Pylera and for at least 1 day after you stop taking it. Drinking alcohol while taking Pylera may cause nausea, vomiting, headache, or flushing (warmth, redness, tingly feeling).

Certain food additives may also cause unwanted symptoms while you are taking Pylera. You may need to avoid products such as baking mixes, baked desserts, salad dressings, sauces, modified food starch, and gel capsule medicines or vitamins. Check all food and beverage labels, and avoid products that contain alcohol or propylene glycol.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Avoid taking Pylera with milk or other dairy products. Also avoid taking Pylera at the same time you take any multivitamins, mineral supplements, or antacids. These products can make it harder for your body to absorb the medicine.

Avoid exposure to sunlight or tanning beds. Pylera can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Usual Adult Dose for Helicobacter pylori Infection:

Bismuth subcitrate potassium 420 mg-metronidazole 375 mg-tetracycline 375 mg orally 4 times a day (after meals and at bedtime)
-Duration of therapy: 10 days

Comment: Omeprazole should be given orally 2 times a day during treatment (after morning and evening meals).

Use: Eradication of Helicobacter pylori infection in patients with active or a history (e.g., within 5 years) of duodenal ulcer infection and/or disease

Usual Pediatric Dose for Helicobacter pylori Infection:

8 years and older: Bismuth subcitrate potassium 420 mg-metronidazole 375 mg-tetracycline 375 mg orally 4 times a day (after meals and at bedtime)
-Duration of therapy: 10 days

Comment: Omeprazole should be given orally 2 times a day during treatment (after morning and evening meals).

Use: Eradication of Helicobacter pylori infection in patients with active or a history (e.g., within 5 years) of duodenal ulcer infection and/or disease

Bismuth subcitrate potassium 420 mg-metronidazole 375 mg-tetracycline 375 mg orally 4 times a day (after meals and at bedtime)
-Duration of therapy: 10 days

Comment: Omeprazole should be given orally 2 times a day during treatment (after morning and evening meals).

Use: Eradication of Helicobacter pylori infection in patients with active or a history (e.g., within 5 years) of duodenal ulcer infection and/or disease

Mild to moderate renal impairment: Data not available
Severe renal impairment: Contraindicated

Administration advice:
-This drug should be given with a full glass of water (e.g., 8 ounces), especially the bedtime dose.
-If a dose is missed, patients should continue the normal dosing schedule; patients should not take double doses.

Monitoring:
-Dermatologic: Erythema/photosensitivity, signs/symptoms of cutaneous reactions
-Hematologic: Initial and post-treatment total and differential leukocyte counts, especially in patients with evidence/history of blood dyscrasias
-Ocular: Ophthalmologic evaluation in patients who develop visual disturbances

Patient advice:
-Tell patients that it is important to complete the full regimen.
-Instruct patients to seek medical attention if signs/symptoms of hypersensitivity, abnormal neurological effects, photosensitivity, or other cutaneous reactions occur.
-Patients should be told to avoid unprotected exposure to sunlight/UV light during treatment.
-Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.