When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to bismuth, metronidazole, or tetracycline, or if you are pregnant or breastfeeding.

How to Use This Medicine:
Capsule

• Each dose contains 3 capsules. You will take all 3 capsules 4 times each day for 10 days. It is best to take this medicine after meals and at bedtime.
• Swallow the capsules whole and with a full glass (8 ounces) of water. Do not crush, break, or chew the capsules.
• Drink extra liquids to help prevent irritation or ulcers in your esophagus.
• Take all of the medicine in your prescription to clear up your infection, even if you feel better after the first few doses.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you are taking penicillin.
• Some medicines and foods can affect how this medicine works. Tell your doctor if you are taking any of the following:
  
  • A blood thinner, such as warfarin
  • Antacids containing aluminum, calcium, or magnesium
  • Birth control pills
  • Cimetidine
  • Lithium
  • Phenytoin or phenobarbital
  • Supplements containing iron, zinc, or sodium bicarbonate
• Do not have milk or dairy products while you are taking this medicine.
• Do not drink alcohol while you are taking this medicine and for at least 3 days after you stop taking it. Tell your doctor if you are also using disulfiram or have taken any in the last 2 weeks.

Warnings While Using This Medicine:

• It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
• Birth control pills may not work while you are using this medicine. To prevent pregnancy, use another form of birth control along with your birth control pills.
• Tell your doctor if you have nerve problems, kidney or liver disease, a history of blood problems (such as leukopenia), or a fungal infection (such as candidiasis).
• Your tongue or stools may become dark when you use this medicine. This is only temporary and will not hurt you. Ask your doctor about this if you have any concerns.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Call your doctor if your symptoms do not improve or if they get worse.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Change in how much or how often you urinate
• Chest pain
• Fast, irregular, or pounding heartbeat
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet
• Seizure, headache, dizziness, or blurred vision
• Unusual tiredness or weakness
• Yellowing of your skin or the whites of your eyes

If you notice these less serious side effects, talk with your doctor:

• Dark or black tongue, or black stools
• Diarrhea, nausea, stomach upset or pain, or change in taste

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088