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Bismuth Subcitrate Potassium / Metronidazole / Tetracycline Dosage

Medically reviewed on August 3, 2017.

Applies to the following strengths: 140 mg-125 mg-125 mg

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

Renal Dose Adjustments

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

Liver Dose Adjustments

Mild to moderate hepatic dysfunction (Child-Pugh A and B): Use with caution; monitoring is recommended.
Severe hepatic dysfunction (Child-Pugh C): Not recommended.

Precautions

US BOXED WARNINGS: POTENTIAL FOR CARCINOGENICITY
-Metronidazole has been shown to be carcinogenic in mice and rats.
-It is unknown whether metronidazole is associated with carcinogenicity in humans.

Safety and efficacy have not been established in patients younger than 8 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

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.

Further information

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

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