Uses

Triple therapy combination indicated, in conjunction with omeprazole, for the eradication of Helicobacter pylori in patients with active duodenal ulcer disease or a history of duodenal ulcer within the past five years.

Do not use if

Contraindicated in patients who have used disulfiram within the past two weeks, those who consume alcohol during or within three days after therapy, patients with Cockayne syndrome, severe renal impairment, pregnancy, or known hypersensitivity to any component.

Side effects

Most common adverse reactions (occurring in at least 5% of patients) include abnormal feces (dark stools from bismuth), diarrhea, nausea, and headache. Metronidazole may cause metallic taste and peripheral neuropathy with prolonged use.

Warnings

Metronidazole has shown carcinogenicity in rodents; clinical significance in humans is unknown. Avoid alcohol consumption during and for three days after treatment. Tetracycline may cause photosensitivity; avoid prolonged sun exposure. Bismuth may cause temporary black stools and dark discoloration of the tongue.

How it works

The combination contains two antibacterials (metronidazole and tetracycline) and bismuth subcitrate potassium. Metronidazole disrupts bacterial DNA synthesis through anaerobic reduction. Tetracycline inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit. Bismuth subcitrate has direct antibacterial activity against H. pylori and also forms a protective coating on the ulcer.

Storage

Store at room temperature between 20°C and 25°C. Protect from moisture and heat. Keep in original packaging.