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Tetracycline HCl, Bismuth subsalicylate and Metronidazole oral

Important Note

The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.


(teh-truh-SYE-kleen/meh-troh-NID-uh-zole/BIZZ-muth sub-sal-ISS-ih-late)



This medication is used to treat or prevent stomach ulcers.

How To Use

This product is used in combination with an acid blocker prescribed by your doctor. It's use is important because it helps the TCN/M/B work. Use the acid blocker exactly as directed. TCN/M/B comes as a package with 14 separate dosing cards. Each card is for one day (4 doses). There are 4 doses per day, hence 4 sections to each card. Each dose includes 4 pills: 2 round pink tablets to be chewed and swallowed, 1 white round tablet and one orange/white capsule to swallow. All 4 pills (1 dose) must be taken 4 times per day to work properly. REMEMBER: chew-chew- swallow-swallow is one dose. Take TCN/M/B at mealtimes and bedtime for 14 days with a full glass (8 oz or 240 ml) of water unless your doctor directs you otherwise. Do not lie down for 30 minutes after taking this drug. Take this medication 2-3 hours before or after taking any products containing magnesium, aluminum, or calcium. Some examples include quinapril, didanosine, vitamins/minerals, and antacids. Dairy products (e.g., milk, yogurt), calcium-enriched juice, sucralfate, iron, and zinc are also included. These products bind with the tetracycline part of this combination medicine preventing its full absorption. Continue to take this medication, plus your acid blocker, until all the medication is gone. Stopping the medication too early may allow the bacteria to continue to grow and may cause another ulcer in the future.

Side Effects

Nausea, diarrhea, constipation, loss of appetite, dizziness, painful swallowing, or painful/frequent urination may occur. Inform your doctor if any of these effects persist. Your tongue (and possibly your stools) will appear dark in color while taking this medication. This is harmless and the effect will disappear when you stop the medication. Notify your prescriber if any of the following effects occur: headache, loss of balance, blurred vision, sore mouth or throat, yeast infection (women), numbness or tingling of hands or feet, rectal pain, vomiting, weakness, ringing of the ears, fever, easy bruising. Contact your doctor immediately if you experience: severe abdominal (stomach area) pain. In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.


Before taking this medicine, tell your doctor your medical history, especially of: kidney or liver disease, nervous system problems, trouble swallowing or esophagus problems (e.g., GERD or hiatal hernia), asthma, epilepsy (seizures), blood disorders, allergies (especially drug allergies). This medication may cause a skin reaction similar to sunburn. When in the sun, wear protective clothing and sunscreen. If a sunburn begins, notify your prescriber promptly. Consult your doctor to postpone treatment if you have the flu or chickenpox. Use of this medication in children should be avoided since the tetracycline in this product can cause tooth discoloration. This drug should be used with caution in the elderly, since this group may be more sensitive to drug side effects. This medication is not recommended for use during pregnancy. Consult your doctor before taking this product. This combination product contains drugs that are excreted into breast milk. Avoid breast-feeding while using this. Consult your doctor about alternatives.

Drug Interactions

Do not take this medication if you currently use: disulfiram. Inform your prescriber or pharmacist about all the medicines you may use (both prescription and nonprescription), especially of: digoxin, penicillin-related drugs, birth control pills, anticoagulant "blood thinners", oral diabetes drugs (sulfonylureas), aspirin, gout drugs, methotrexate, terfenadine, astemizole, phenytoin, phenobarbital, methoxyflurane, lithium, vitamins/minerals (e.g., magnesium, aluminum, calcium, iron, zinc), quinapril, didanosine, antacids, sucralfate. Avoid alcoholic beverages while taking this medicine, and for one day afterward as severe stomach upset, nausea, vomiting, headache and flushing can occur. This includes cough/cold products that contain alcohol. Do not start or stop any medicine without doctor or pharmacist approval.


If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include rapid breathing, nausea, vomiting, ringing in the ears, fever, sluggishness, fast pulse, and confusion.


This medication is prescribed for your current condition only. Do not use it later for another infection or give it to someone else. A different medication may be necessary. Certain laboratory tests may be affected while using this medication (AST, ALT, LDH, TG, hexokinase glucose, Clinistix). A false positive Clinitest may occur, as well as x-ray exam interference.

Missed Dose

If you miss a dose, take it as soon as you remember, unless it is almost time for the next dose. If it is nearly time for the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. Instead, keep taking the medication on your regular schedule until gone. If you miss more than 4 doses, contact your prescriber.


Store at room temperature between 68 and 77 degrees F (20 to 25 degrees C) away from moisture and light as directed. Do not store in the bathroom. Keep out of the reach of children. Check the drug's expiration date. Taking outdated medication can result in serious illness.