What is Pylera (Bismuth Subcitrate/Metronidazole/Tetracycline)? Learn about its uses, dosage, how to take it, cost, and everything you need to know in 2026.
Bismuth Subcitrate/Metronidazole/Tetracycline is a combination prescription medication — sold under the brand name Pylera — that contains three active ingredients in a single capsule to treat Helicobacter pylori (H. pylori) stomach infections. It's taken with Omeprazole (Prilosec) as part of a 10-day treatment regimen.
If you've been prescribed Pylera or are researching H. pylori treatments, this guide covers everything you need to know: what it is, what it's used for, how to take it, who should avoid it, and how much it costs.
Pylera is the only brand name for this combination. Each capsule is a 3-in-1 formulation containing:
There is no true generic version of the combination capsule, though the individual ingredients are available separately as generics.
Pylera belongs to the H. pylori eradication agents drug class. It combines a bismuth salt with two antibiotics (a nitroimidazole and a tetracycline) to attack H. pylori bacteria through multiple mechanisms simultaneously.
Pylera is manufactured by Allergan, now part of AbbVie.
Pylera was approved by the FDA for the eradication of H. pylori in patients with active or a history of duodenal ulcer disease. It must be used in combination with Omeprazole 20mg.
Pylera is not a controlled substance. It does not have abuse potential and is not scheduled by the DEA.
Pylera is FDA-approved for one specific use:
Eradication of Helicobacter pylori infection in patients with active duodenal ulcers or a history of duodenal ulcers within the past 5 years.
H. pylori is a type of bacteria that lives in the stomach lining. It's estimated to infect about 35–40% of the U.S. population, though many people never develop symptoms. When H. pylori does cause problems, it can lead to:
Treating and eradicating H. pylori has been shown to significantly reduce the risk of ulcer recurrence.
The typical regimen is:
That's 12 Pylera capsules per day — which adds up to a daily total of:
Take it as soon as you remember, unless it's almost time for your next dose. Don't double up. If you miss more than 4 doses, call your doctor for guidance.
Pylera is not safe for everyone. Do not take it if you:
Tell your doctor if you have liver disease, Cockayne syndrome, blood disorders, or any active infections before starting Pylera.
Pylera is a brand-name medication with no generic equivalent, so it can be expensive:
If cost is a concern, you have several options:
Don't forget to budget for Omeprazole as well, though it's available OTC for under $10.
In clinical studies, Pylera plus Omeprazole achieved H. pylori eradication rates of approximately 87–93% — comparable to or better than traditional bismuth quadruple therapy using separate pills. The 3-in-1 capsule format simplifies what would otherwise be a complex multi-pill regimen.
For more on how Pylera works in your body, see our guide on how Pylera's mechanism of action works.
Common side effects include nausea, dark stools, metallic taste, diarrhea, headache, and abdominal pain. Serious side effects are rare but include seizures, peripheral neuropathy, and severe allergic reactions. Read our detailed guide on Pylera side effects.
Bismuth Subcitrate/Metronidazole/Tetracycline (Pylera) is a proven, FDA-approved treatment for H. pylori infections associated with duodenal ulcers. While the dosing schedule is demanding (12 capsules a day for 10 days), the 3-in-1 format is actually simpler than the alternative of taking each ingredient separately. Combined with Omeprazole, it offers eradication rates above 90%.
If you've been prescribed Pylera, the keys to success are: take every dose after meals, avoid alcohol and dairy, drink plenty of water, and complete the full 10-day course. If you're having trouble finding it at your pharmacy, Medfinder can help you locate a pharmacy with stock near you.
You focus on staying healthy. We'll handle the rest.
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