Pylera (Bismuth Subcitrate Potassium / Metronidazole / Tetracycline Hydrochloride)

They need to know if you have any of these conditions: -Cockayne syndrome -history of blood diseases -if you often drink alcohol -kidney disease -liver disease -low blood counts, like low white cell, platelet, or red cell counts -seizures -tingling of the fingers or toes, or other nerve disorder -an unusual or allergic reaction to bismuth subcitrate potassium, metronidazole, tetracycline, other medicines, foods, dyes, or preservatives -pregnant or trying to get pregnant -breast-feeding

Take this medicine by mouth with a full glass of water. Do not take it with milk or other dairy products. Follow the directions on the prescription label. This medicine should be taken after meals and at bedtime. Do not take your medicine more often than directed. Take all of your medicine as directed even if you think you are better. Do not skip doses or stop your medicine early. Talk to your pediatrician regarding the use of this medicine in children. This medicine is not approved for use in children.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once. NOTE: This medicine is only for you. Do not share this medicine with others.

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses. If you miss more than 4 doses call your doctor.

Do not take this medicine with any of the following medications: - alcohol or any product that contains alcohol - disulfiram This medicine may also interact with the following medications: - antacids with aluminum, calcium, magnesium, sodium bicarbonate - birth control pills -busulfan - calcium -certain medicines that treat or prevent blood clots like warfarin - cimetidine - iron - lithium - magnesium - phenobarbital - phenytoin - zinc

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Visit your doctor for regular check ups. Tell your doctor if your symptoms do not get better or if they get worse. Do not treat diarrhea with over the counter products. Contact your doctor if you have diarrhea that lasts more than 2 days or if it is severe and watery. Avoid products with aluminum, calcium, magnesium, iron, zinc, or sodium bicarbonate for 2 hours before and after taking a dose of this medicine. This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths. Birth control pills may not work properly while you are taking this medicine. Talk to your doctor about using an extra method of birth control. You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this medicine. Do not drink alcohol while you are taking this medicine and for at least 1 day after finishing treatment. This medicine may cause dark tongue and/or grayish black stools. This is only temporary and will go away when you stop taking this medicine.

Side effects that you should report to your doctor or health care professional as soon as possible: - allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue - breathing problems - chest pain - dizziness - fast, irregular heartbeat - fever -general ill feeling or flu-like symptoms - pain, tingling, numbness in the hands or feet - redness, blistering, peeling or loosening of the skin, including inside the mouth - seizures -sore throat - trouble passing urine or change in the amount of urine -trouble swallowing - unusual bleeding or bruising - unusually weak or tired Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome): - black stools -changes in taste - dark tongue - diarrhea - headache -muscle pain - nausea - upset stomach - vaginal discharge, itching, or odor in women

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep out of the reach of children. Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Protect from light and moisture. Throw away any unused medicine after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.