Uses of Bismuth Subcitrate, Metronidazole, and Tetracycline:

• It is used to treat GI (gastrointestinal) ulcers caused by infection.

What do I need to tell my doctor BEFORE I take Bismuth Subcitrate, Metronidazole, and Tetracycline?

• If you have an allergy to bismuth, metronidazole, salicylates, tetracycline, or any other part of bismuth subcitrate, metronidazole, and tetracycline.
• If you are allergic to bismuth subcitrate, metronidazole, and tetracycline; any part of bismuth subcitrate, metronidazole, and tetracycline; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
• If you have any of these health problems: Kidney disease or liver disease.
• If you have taken disulfiram within the past 2 weeks.
• If you drink alcohol or take any drugs that have alcohol.
• If you are pregnant or may be pregnant. Do not take bismuth subcitrate, metronidazole, and tetracycline if you are pregnant.
• If you are breast-feeding. Do not breast-feed for at least 48 hours after getting bismuth subcitrate, metronidazole, and tetracycline.
• If the patient is a child. This medicine is not approved for use in children.

This is not a list of all drugs or health problems that interact with bismuth subcitrate, metronidazole, and tetracycline.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take bismuth subcitrate, metronidazole, and tetracycline with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take Bismuth Subcitrate, Metronidazole, and Tetracycline?

• Tell all of your health care providers that you take bismuth subcitrate, metronidazole, and tetracycline. This includes your doctors, nurses, pharmacists, and dentists.
• Avoid alcohol and products that have alcohol or propylene glycol in them while taking bismuth subcitrate, metronidazole, and tetracycline and for at least 72 hours after your last dose. Drinking alcohol or taking products that have alcohol or propylene glycol in them, like some cough syrups, may cause cramps, upset stomach, headaches, and flushing.
• You may get sunburned more easily. Avoid sun, sunlamps, and tanning beds. Use sunscreen and wear clothing and eyewear that protects you from the sun.
• Do not use longer than you have been told. A second infection may happen.
• This medicine may affect certain lab tests. Tell all of your health care providers and lab workers that you take bismuth subcitrate, metronidazole, and tetracycline.
• Nervous system problems have happened with bismuth subcitrate, metronidazole, and tetracycline. Some people who took bismuth subcitrate, metronidazole, and tetracycline for a long time have had nerve problems that lasted for a long time. Call your doctor right away if you have a burning, numbness, or tingling feeling that is not normal; change in balance or eyesight; dizziness or passing out; headache; not able to sleep; seizures; or trouble speaking. Call your doctor right away if you feel confused, depressed, irritable, tired, or weak.
• A severe and sometimes deadly reaction has happened. Most of the time, this reaction has signs like fever, rash, or swollen glands with problems in body organs like the liver, kidney, blood, heart, muscles and joints, or lungs. If you have questions, talk with the doctor.
• A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away, and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
• This medicine may raise the chance of a very bad brain problem called aseptic meningitis. Call your doctor right away if you have a headache, fever, chills, very upset stomach or throwing up, stiff neck, rash, bright lights bother your eyes, feeling sleepy, or feeling confused.
• This medicine may cause a change in tooth color to yellow-gray-brown in children younger than 8 years old. If this change of tooth color happens, it will not go away. Talk with the doctor.
• Birth control pills and other hormone-based birth control may not work as well to prevent pregnancy. Use some other kind of birth control also like a condom when taking bismuth subcitrate, metronidazole, and tetracycline.
• This medicine may cause harm to the unborn baby if you take it while you are pregnant. If you are pregnant or you get pregnant while taking bismuth subcitrate, metronidazole, and tetracycline, call your doctor right away.

How is this medicine (Bismuth Subcitrate, Metronidazole, and Tetracycline) best taken?

Use bismuth subcitrate, metronidazole, and tetracycline as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take after meals and at bedtime.
• Swallow whole. Do not chew, break, or crush.
• Take with a full glass of water.
• Do not take dairy products, calcium, iron, magnesium, zinc, multivitamins with minerals, colestipol, cholestyramine, didanosine, or antacids within 2 hours of bismuth subcitrate, metronidazole, and tetracycline.
• Keep taking bismuth subcitrate, metronidazole, and tetracycline as you have been told by your doctor or other health care provider, even if you feel well.

What do I do if I miss a dose?

• Skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.
• If you miss 4 doses, call your doctor.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Black, tarry, or bloody stools.
• Throwing up blood or throw up that looks like coffee grounds.
• Raised pressure in the brain has happened with bismuth subcitrate, metronidazole, and tetracycline. Most of the time, this will go back to normal after bismuth subcitrate, metronidazole, and tetracycline is stopped. Sometimes, loss of eyesight may happen and may not go away even after bismuth subcitrate, metronidazole, and tetracycline is stopped. Call your doctor right away if you have a headache or eyesight problems like blurred eyesight, seeing double, or loss of eyesight.
• Low white blood cell counts have happened with bismuth subcitrate, metronidazole, and tetracycline. This may lead to a higher chance of getting an infection. Call your doctor right away if you have signs of infection like fever, chills, or sore throat.
• Diarrhea is common with antibiotics. Rarely, a severe form called C diff–associated diarrhea (CDAD) may happen. Sometimes, this has led to a deadly bowel problem (colitis). CDAD may happen during or a few months after taking antibiotics. Call your doctor right away if you have stomach pain, cramps, or very loose, watery, or bloody stools. Check with your doctor before treating diarrhea.
• Some people with Cockayne syndrome have had liver problems when taking bismuth subcitrate, metronidazole, and tetracycline. Sometimes, this has been deadly. If you have Cockayne syndrome and are taking bismuth subcitrate, metronidazole, and tetracycline, call your doctor right away if you have signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.

What are some other side effects of Bismuth Subcitrate, Metronidazole, and Tetracycline?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Upset stomach.
• Diarrhea.
• Headache.
• Belly pain.
• Dark tongue and stool.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If OVERDOSE is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out Bismuth Subcitrate, Metronidazole, and Tetracycline?

• Store at room temperature.
• Store in a dry place. Do not store in a bathroom.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

Consumer Information Use and Disclaimer

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your drugs with others and do not take anyone else's drugs.
• Some drugs may have another patient information leaflet. Check with your pharmacist. If you have any questions about bismuth subcitrate, metronidazole, and tetracycline, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.