Pylera (Metronidazole, Bismuth Subcitrate Potassium, and Tetracylcline Hydrocholoride)

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Metronidazole, Bismuth Subcitrate Potassium, and Tetracylcline Hydrocholoride (Pylera) is used to kill sensitive bacteria associated with ulcers. It is used along with omeprazole (proton pump inhibitor) for the treatment of patients with H. pylori infection.

How should it be used?

This medication is available in capsule form.

  • Take medicine capsule whole. Do not break, chew or crush before swallowing.
  • Take with a full glass of water
  • Drink extra fluids while taking this medicine.
  • Do not take an antacid that has aluminum, calcium, or magnesium or any product that has iron or zinc in it within 2 hours of taking this medicine.
  • Take the medicine for the entire course of treatment. Keep taking it even if you are feeling better in a few days.
  • If you miss a dose, take it as soon as possible. If it is almost time for the next dose, don’t take the missed dose. Do not take 2 doses at the same time. If you miss more than 4 doses of this medicine, call and report this to your doctor.

Special Precautions/Instructions

Before you start taking this medicine tell your doctor about any of the following:

    • All medications (including over the counter), vitamins, herbal products, and supplements you are taking.
    • Have a problem (hypersensitivity) to metronidazole, bismuth subcitrate potassium, tetracylcline hydrocholoride, or any other ingredient in this medicine:

Metronidazole, bismuth subcitrate potassium, and tetracylcline hydrocholoride, magnesium stearate NF, lactose monohydrate NF, Talc USP, gelatin USP, titanium dioxide NF, printed with red ink.

  • Have liver or kidney problems
  • Are taking anticoagulants
  • Are taking oral birth control pills
  • Are pregnant, plan on becoming pregnant, or breastfeeding.

Patients should be sure to use a backup method of birth control while on this medication, because Pylera has been shown to make oral birth control medications less effective.

Patients should avoid exposure to sun or sun lamps.

Avoid alcoholic beverages while taking this medication, and for at least 1 day afterward.

Stool and tongue darkening may occur while taking this medication, but should be of no concern.

Side Effects

The most common side effects include: darkened stool and/or tongue, candidal overgrowth (report to your doctor), headache, diarrhea, abdominal pain, nausea, and dyspepsia (indigestion).

Contact your doctor immediately if you experience signs of an allergic reaction including:

  • Diarrhea
  • Feeling sick
  • Fever, shivering/chills, rash
  • Muscle and bone pain
  • Kidney problems (changes in the amount of urine or color of urine)
  • Tiredness, dizziness
  • Itching
  • Swelling
  • Trouble breathing

Storage Conditions

This medication should be stored at a controlled room temperature (68-77 degrees F). Keep out of reach of children and protect from light.


Call the national poison control center 1-800-222-1222 or 911 in the event of overdose. Symptoms of an overdose include vomiting, diarrhea, sore throat, fever, chills, and other signs of infection.

Pediatric Use

Tetracyline use in children may cause permanent discoloration of the teeth. Enamel hypoplasia has also been reported. Pylera should not be used in children less than 8 years of age. Safety and effectiveness of Pylera in pediatric patient infected with H. pylori have not been established.