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Data updated: Jun 28, 2026

PYLERA (bismuth subcitrate potassium) · LABS JUVISE

Infectious Disease Approved 2006-09-28

Pylera is a fixed-dose combination therapy containing bismuth subcitrate potassium, metronidazole, and tetracycline hydrochloride. It is indicated for the treatment of patients with *Helicobacter pylori* infection and duodenal ulcer disease (either active or a history within the past 5 years). Administered in conjunction with omeprazole, this regimen is designed to eradicate *H. pylori* to reduce the risk of duodenal ulcer recurrence. In accordance with antibacterial stewardship principles, Pylera should be reserved for infections proven or strongly suspected to be caused by susceptible bacteria to prevent the development of drug resistance.

Source: FDA Label • Nitroimidazole Antimicrobial

How PYLERA Works

Pylera functions through the combined action of two antibacterial agents and a bismuth salt. Metronidazole (a nitroimidazole) and tetracycline hydrochloride (a protein synthesis inhibitor) provide synergistic antimicrobial activity against *H. pylori*. Bismuth subcitrate potassium provides additional bactericidal effects and may exert cytoprotective effects on the gastric mucosa. When used with omeprazole, which increases intragastric pH, the combination optimizes the environment for bacterial eradication.

1
Indication
--
Phase 3 Trials
19
Years on Market

Details

Status
Prescription
First Approved
2006-09-28
Routes
ORAL
Dosage Forms
CAPSULE

PYLERA Approval History

2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
20 FDA actions from 2006 to 2025
Nov 2025 SUPPL
Label · Labeling
Mar 2025 SUPPL
Label · Labeling
Sep 2024 SUPPL
Label · Labeling

What PYLERA Treats

2 indications

PYLERA is approved for 2 conditions since its original approval in 2006. These indications span multiple therapeutic areas including oncology, immunology, and more.

Source: FDA Label

PYLERA Boxed Warning

POTENTIAL FOR CARCINOGENICITY Metronidazole has been shown to be carcinogenic in mice and rats. It is unknown whether metronidazole is associated with carcinogenicity in humans [see Warning and Precautions (5.1) ]. WARNING: POTENTIAL FOR CARCINOGENICITY See full prescribing information for complete boxed warning. Metronidazole has been shown to be carcinogenic in mice and rats. It is unknown whether metronidazole is associated with carcinogenicity in humans ( 5.1 )....

PYLERA Competitive Set

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Drugs Similar to PYLERA

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FDA-approved drugs for similar conditions. Compare mechanisms and indications to understand treatment alternatives.

ACIPHEX
RABEPRAZOLE SODIUM
2 shared
EISAI MEDCL RES
Shared indications:
Duodenal UlcerHelicobacter pylori Infection
BISMUTH SUBCITRATE POTASSIUM, METRONIDAZOLE AND TETRACYCLINE HYDROCHLORIDE
BISMUTH SUBCITRATE POTASSIUM
2 shared
INGENUS PHARMS LLC
Shared indications:
Helicobacter pylori InfectionDuodenal Ulcer
CLARITHROMYCIN
CLARITHROMYCIN
2 shared
JUBILANT CADISTA
Shared indications:
Helicobacter pylori InfectionDuodenal Ulcer
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Key Completed Trials

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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

PYLERA FDA Label Details

Indications & Usage

FDA Label (PDF)

PYLERA is a combination of metronidazole, a nitroimidazole antimicrobial, tetracycline,- a tetracycline class antimicrobial and bismuth subcitrate potassium, indicated for use, in combination with omeprazole, for the treatment of patients with Helicobacter pylori infection and duodenal ulcer disease (active or history of within the past 5 years) to eradicate H. pylori. To reduce the development of drug-resistant bacteria and maintain the effectiveness of PYLERA and other antibacterial drugs, PYLERA should be used only to treat or prevent infections that are proven or strongly suspected to be c...

⚠️ BOXED WARNING

WARNING: POTENTIAL FOR CARCINOGENICITY Metronidazole has been shown to be carcinogenic in mice and rats. It is unknown whether metronidazole is associated with carcinogenicity in humans [see Warning and Precautions (5.1) ]. WARNING: POTENTIAL FOR CARCINOGENICITY See full prescribing information for ...

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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.