What active ingredients are in the Pylera (bismuth subcitrate potassium, tetracycline hydrochloride, metronidazole) capsule?

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Last updated: November 15, 2026 • View editorial policy

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Pylera Composition

Pylera contains three active ingredients in a single capsule: bismuth subcitrate potassium 140 mg, metronidazole 125 mg, and tetracycline hydrochloride 125 mg 1.

Dosing Regimen

The standard 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 means patients take:

  • 12 capsules per day of Pylera (3 capsules × 4 times daily)
  • Total daily doses delivered:
    • Bismuth subcitrate potassium: 1,680 mg
    • Metronidazole: 1,500 mg
    • Tetracycline hydrochloride: 1,500 mg

Clinical Context

This fixed-dose combination is used specifically for Helicobacter pylori eradication in patients with duodenal ulcer disease (active or history within past 5 years) 1. The three-in-one formulation simplifies administration and enhances adherence while maintaining high eradication rates exceeding 90% 2, 3, 4.

Important Contraindications

The combination is contraindicated in:

  • Pregnant women (due to tetracycline causing permanent tooth discoloration and bone development inhibition) 1
  • Patients with severe renal impairment 1
  • Recent disulfiram use (within 2 weeks) 1
  • Alcohol consumption during and for 3 days after treatment 1

The bismuth component provides local antimicrobial effects in the gastric mucosa, while metronidazole and tetracycline provide systemic and local antibacterial activity against H. pylori 4, 5.

References

Related Questions

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.