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Bismuth subsalicylate / metronidazole / tetracycline Side Effects

Medically reviewed by Drugs.com. Last updated on Nov 14, 2023.

Applies to bismuth subsalicylate / metronidazole / tetracycline: oral capsule, oral tablet, oral tablet chewable.

Warning

Oral route (Kit)

Metronidazole has been shown to be carcinogenic in mice and rats. It is unknown whether metronidazole is associated with carcinogenicity in humans.

Serious side effects

Along with its needed effects, bismuth subsalicylate/metronidazole/tetracycline may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking bismuth subsalicylate / metronidazole / tetracycline:

Less common

Rare

Incidence not known

Get emergency help immediately if any of the following symptoms of overdose occur while taking bismuth subsalicylate / metronidazole / tetracycline:

Symptoms of overdose

Other side effects

Some side effects of bismuth subsalicylate / metronidazole / tetracycline may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Rare

For Healthcare Professionals

Applies to bismuth subsalicylate / metronidazole / tetracycline: oral kit.

General

The most commonly reported side effects included nausea, abdominal pain, and diarrhea.[Ref]

Gastrointestinal

Very common (10% or more): Nausea (up to 12%)

Common (1% to 10%): Abdominal pain, anal discomfort, constipation, diarrhea, duodenal ulcer, dyspepsia, flatulence, gastrointestinal hemorrhage, melena, stool abnormality/darkening/black stools, tongue discoloration/darkening, vomiting

Frequency not reported: Dry mouth, dysphagia, eructation, gastrointestinal monilia, glossitis, intestinal obstruction, rectal hemorrhage, stomatitis, tooth disorder

Metronidazole:

Frequency not reported: Abdominal pain, constipation, candida overgrowth, diarrhea, dry mouth, furry tongue, glossitis, nausea, pancreatitis, stomatitis, vomiting

Tetracycline:

Frequency not reported: Anogenital region inflammatory lesions/inflammatory lesions with Candida overgrowth, black hairy tongue, diarrhea, dysphagia, enterocolitis, esophagitis, esophageal ulceration, glossitis, nausea, vomiting[Ref]

Nervous system

Common (1% to 10%): Dizziness, dysgeusia/taste perversion/metallic taste, headache, paresthesia

Frequency not reported: Cerebral ischemia, somnolence, syncope

Metronidazole:

Frequency not reported: Aseptic meningitis, ataxia, convulsive seizures, dizziness, dysarthria, encephalopathy, headache, incoordination, metallic taste, peripheral neuropathy, syncope, vertigo

Tetracycline:

Frequency not reported: Intracranial hypertension, pseudotumor cerebri[Ref]

Other

Common (1% to 10%): Asthenia, pain

Frequency not reported: Infection, malaise

Metronidazole:

Frequency not reported: Fever, weakness

Tetracycline:

Frequency not reported: Tinnitus[Ref]

Respiratory

Common (1% to 10%): Sinusitis, upper respiratory infection

Frequency not reported: Rhinitis

Metronidazole:

Frequency not reported: Nasal congestion[Ref]

Psychiatric

Common (1% to 10%): Insomnia

Frequency not reported: Nervousness

Metronidazole:

Frequency not reported: Confusion, decreased libido, depression, insomnia, irritability[Ref]

Metabolic

Common (1% to 10%): Anorexia

Metronidazole:

Frequency not reported: Anorexia

Tetracycline:

Frequency not reported: Anorexia[Ref]

Dermatologic

Frequency not reported: Acne, ecchymosis, photosensitivity reaction, pruritus, rash

Metronidazole:

Frequency not reported: Erythematous rash, pruritus, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria

Tetracycline:

Frequency not reported: Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, erythema multiforme, exfoliative dermatitis, Henoch-Schonlein purpura, maculopapular/erythematous rash, nail discoloration, onycholysis, photosensitivity, Stevens-Johnson syndrome, systemic lupus erythematosus exacerbation, toxic epidermal necrolysis, urticaria[Ref]

Cardiovascular

Frequency not reported: Chest pain, hypertension, myocardial infarction

Metronidazole:

Frequency not reported: T-wave flattening, flushing

Tetracycline:

Frequency not reported: Pericarditis[Ref]

Musculoskeletal

Frequency not reported: Arthritis, rheumatoid arthritis, tendonitis

Metronidazole:

Frequency not reported: Joint pain

Tetracycline:

Frequency not reported: Myasthenic syndrome[Ref]

Hepatic

Frequency not reported: ALT increase, AST increase

Tetracycline:

Frequency not reported: Hepatotoxicity, liver failure[Ref]

Genitourinary

Frequency not reported: Urinary tract infection

Metronidazole:

Frequency not reported: Darkened urine, dyspareunia, dysuria, incontinence, proctitis, sense of pelvic pressure, vaginal/vulvar dryness[Ref]

Immunologic

Frequency not reported: Flu syndrome

Tetracycline:

Frequency not reported: Serum sickness-like reaction[Ref]

Ocular

Frequency not reported: Conjunctivitis

Metronidazole:

Frequency not reported: Optic neuropathy[Ref]

Oncologic

Frequency not reported: Neoplasm[Ref]

Hematologic

Metronidazole:

Frequency not reported: Reversible neutropenia/leukopenia, reversible thrombocytopenia

Tetracycline:

Frequency not reported: Eosinophilia, hemolytic anemia, neutropenia, thrombocytopenia, thrombocytopenic purpura

Renal

Metronidazole:

Frequency not reported: Cystitis

Tetracycline:

Frequency not reported: Increased blood urea nitrogen

Hypersensitivity

Tetracycline:

Frequency not reported: Anaphylaxis, angioedema[Ref]

References

1. Product Information. Helidac (bismuth subsalicylate/metronidazole/TCN). Prometheus Inc. 2022.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.