Total Daily Dosage of Pylera (Bismuth Subcitrate Potassium, Metronidazole, and Tetracycline)
When taking three Pylera capsules four times daily, the total daily amounts are: 1,680 mg bismuth subcitrate potassium, 1,500 mg metronidazole, and 1,500 mg tetracycline hydrochloride.
Breakdown of Daily Dosing
Each Pylera capsule contains 1:
- 140 mg bismuth subcitrate potassium
- 125 mg metronidazole
- 125 mg tetracycline hydrochloride
Calculation for 3 capsules × 4 times daily (12 capsules total):
- Bismuth subcitrate potassium: 140 mg × 12 = 1,680 mg/day
- Metronidazole: 125 mg × 12 = 1,500 mg/day
- Tetracycline hydrochloride: 125 mg × 12 = 1,500 mg/day
Standard Dosing Regimen
The FDA-approved dosing is three capsules taken four times daily (after meals and at bedtime) for 10 days, administered in combination with omeprazole 20 mg twice daily 1. This regimen achieves high eradication rates of approximately 90-98% in clinical practice 2, 3.
Important Clinical Context
The metronidazole dose of 1,500 mg daily falls within guideline-recommended ranges of 1.5-2 g daily for H. pylori eradication 4. This dosing should be divided throughout the day (four times daily) and taken with food to minimize gastrointestinal side effects 4, 1.
While 10-day therapy is FDA-approved, 14-day treatment durations provide higher eradication success rates and should be considered when appropriate 4.