Bismuth subcitrate, metronidazole, and tetracycline and Disulfiram interaction
Bismuth subcitrate, metronidazole, and tetracycline and Disulfiram: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.
Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.
What the FDA labels say
From the Disulfiram label · effective 2026-05-27
CONTRAINDICATIONS Patients who are receiving or have recently received metronidazole, paraldehyde, alcohol, or alcohol-containing preparations, e.g., cough syrups, tonics and the like, should not be given disulfiram.
From the Bismuth subcitrate, metronidazole, and tetracycline (Bismuth Subcitrate Potassium, Metronidazole and Tetracycline Hydrochloride) label · effective 2026-04-13
Disulfiram usage within the last two weeks.
Disulfiram Bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride is contraindicated in patients who have taken disulfiram within the last two weeks.
Psychotic reactions have been reported in alcoholic patients who are using metronidazole, a component of bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride, and disulfiram concurrently [see Drug Interactions ( 7.1 )] .
A disulfiram-like reaction (abdominal cramps, nausea, vomiting, headaches, and flushing) may occur due to the interaction between alcohol or propylene glycol and metronidazole, a component of bismuth subcitrate potassium, metronidazole and tetracycline hydrochloride [see Drug Interactions ( 7.2 )] .
Disulfiram: Psychotic reactions can occur; do not take concurrently or within the last 2 weeks of disulfiram.
Taking more than these two? Interactions stack. Check your whole list at once; it stays in your browser.
Open in the checkerNot medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.