Bismuth Subsalicylate Metronidazole Tetracycline

Bismuth Subsalicylate Metronidazole Tetracycline Brand Name– Helidac

What is Bismuth Subsalicylate Metronidazole Tetracycline

Bismuth subsalicylate (BSS), metronidazole (MTZ), and tetracycline (TCN) are combined in a ‘kit’, known as Helidac®, for treatment of Helicobacter pylori (H. pylori) infection associated with duodenal ulcer disease.

Although Helidac® was originally approved for use with an H₂-blocker (combined use is associated with H. pylori eradication in up to 82% of patients), use with a proton pump inhibitor (PPI) has since been associated with higher H. pylori eradication rates.

The disadvantages of Helidac® and other four-drug regimens, relative to alternative triple-drug regimens (e.g., Prevpac®), include an increased frequency of dosing (four times daily vs. twice daily), a higher frequency of adverse effects, and an increased potential for metronidazole resistance.

For this reason, four-drug regimens are typically reserved for patentis with specific drug allergies or who are unable to reach acceptable (>= 80%) eradication rates with triple-drug regimens.

Clinicians should test for H. pylori infection in patients presenting non-ulcer dyspepsia; patients found to be H. pylori positive should be started on combination eradication therapy.

Eradication of H. pylori offers modest, but significant, symptom relief in non-ulcer dyspepsia and reduces the risk of developing peptic ulcer disease, atrophic gastritis, and gastric cancer.

For populations with a low prevalence of H. pylori infection (< 10%), starting a 2—4 week empiric trial of a PPI is an alternate approach.

Finally, some evidence suggests that active H. pylori infection may also play a role in decreasing iron absorption from the gut and may be a contributing cause of iron deficiency anemia and idiopathic thrombocytopenia purpura (ITP). Eradication of the infection may improve oral iron absorption in patients with asymptomatic gastritis; H. pylori infection should be investigated and treated in patients with unexplained iron deficiency.

Helidac® was approved by the FDA in August 1996.

Indications

• Helicobacter pylori
• Helicobacter pylori (H. pylori) eradication

Side Effects

1. abdominal pain
2. acne vulgaris
3. anaphylactoid reactions
4. angioedema
5. anorexia
6. arthralgia
7. aseptic meningitis
8. asthenia
9. ataxia
10. azotemia
11. blurred vision
12. candidiasis
13. chest pain (unspecified)
14. confusion
15. conjunctivitis
16. constipation
17. cystitis
18. depression
19. diarrhea
20. diplopia
21. dizziness
22. drowsiness
23. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
24. dysarthria
25. dysgeusia
26. dyspareunia
27. dyspepsia
28. dysphagia
29. dysuria
30. ecchymosis
31. elevated hepatic enzymes
32. enamel hypoplasia
33. encephalopathy
34. eosinophilia
35. eructation
36. erythema
37. erythema multiforme
38. esophageal ulceration
39. esophagitis
40. fever
41. flatulence
42. flushing
43. GI bleeding
44. GI obstruction
45. glossitis
46. headache
47. hemolytic anemia
48. hepatic failure
49. hepatotoxicity
50. hyperphosphatemia
51. hypertension
52. increased intracranial pressure
53. infection
54. insomnia
55. irritability
56. leukopenia
57. libido decrease
58. lupus-like symptoms
59. maculopapular rash
60. malaise
61. melena
62. metallic taste
63. myocardial infarction
64. nail discoloration
65. nasal congestion
66. nausea
67. neutropenia
68. new primary malignancy
69. odynophagia
70. optic neuritis
71. pancreatitis
72. papilledema
73. paresthesias
74. pericarditis
75. peripheral neuropathy
76. photophobia
77. photosensitivity
78. polyuria
79. proctitis
80. pruritus
81. pseudotumor cerebri
82. purpura
83. rash
84. rhinitis
85. seizures
86. sinusitis
87. Stevens-Johnson syndrome
88. stomatitis
89. stool discoloration
90. superinfection
91. syncope
92. thrombocytopenia
93. thrombotic thrombocytopenic purpura (TTP)
94. tinnitus
95. tongue discoloration
96. tooth discoloration
97. toxic epidermal necrolysis
98. urinary incontinence
99. urine discoloration
100. urticaria
101. vertigo
102. visual impairment
103. vomiting
104. weakness
105. xerostomia

Monitoring Parameters

• LFTs
• serum creatinine/BUN

Contraindications

• alcoholism
• anticoagulant therapy
• bone marrow suppression
• breast-feeding
• children
• coagulopathy
• Cockayne syndrome
• colitis
• Crohn’s disease
• dental disease
• diabetes mellitus
• diarrhea
• esophagitis
• ethanol intoxication
• fungal infection
• G6PD deficiency
• gastritis
• GI bleeding
• GI disease
• gout
• hematological disease
• hemophilia
• hepatic disease
• hypoprothrombinemia
• infants
• inflammatory bowel disease
• influenza
• labor
• laboratory test interference
• leukopenia
• neonates
• neurological disease
• neutropenia
• new primary malignancy
• obstetric delivery
• peptic ulcer disease
• peripheral neuropathy
• pregnancy
• pseudomembranous colitis
• renal disease
• renal failure
• renal impairment
• Reye’s syndrome
• salicylate hypersensitivity
• seizure disorder
• seizures
• sunlight (UV) exposure
• surgery
• tetracyclines hypersensitivity
• thrombotic thrombocytopenic purpura (TTP)
• tobacco smoking
• ulcerative colitis
• varicella
• vitamin K deficiency

Interactions

• Acetaminophen
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetazolamide
• Acidifying Agents
• Acitretin
• Alfuzosin
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Alkalinizing Agents
• Alogliptin
• Alogliptin; Metformin
• Alogliptin; Pioglitazone
• Alosetron
• Alpha-glucosidase Inhibitors
• Aluminum Hydroxide
• Aluminum Hydroxide; Magnesium Carbonate
• Aluminum Hydroxide; Magnesium Hydroxide
• Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
• Aluminum Hydroxide; Magnesium Trisilicate
• Amantadine
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Aminoglycosides
• Amiodarone
• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amoxapine
• Amoxicillin
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amoxicillin; Clavulanic Acid
• Amphotericin B
• Amphotericin B cholesteryl sulfate complex (ABCD)
• Amphotericin B lipid complex (ABLC)
• Amphotericin B liposomal (LAmB)
• Ampicillin
• Ampicillin; Sulbactam
• Anagrelide
• Angiotensin-converting enzyme inhibitors
• Antacids
• Antithrombin III
• Antithymocyte Globulin
• Apixaban
• Apomorphine
• Ardeparin
• Aripiprazole
• Arsenic Trioxide
• Artemether; Lumefantrine
• Ascorbic Acid, Vitamin C
• Asenapine
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atenolol; Chlorthalidone
• Atomoxetine
• Atovaquone
• Atovaquone; Proguanil
• Atracurium
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Azilsartan; Chlorthalidone
• Azithromycin
• Bacitracin
• Barbiturates
• Bedaquiline
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Benazepril
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Benztropine
• Beta-blockers
• Bethanechol
• Bexarotene
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Bortezomib
• Bosentan
• Bromocriptine
• Bumetanide
• Buprenorphine
• Buprenorphine; Naloxone
• Busulfan
• Caffeine; Ergotamine
• Calcium
• Calcium Acetate
• Calcium Carbonate
• Calcium Carbonate; Magnesium Hydroxide
• Calcium Carbonate; Risedronate
• Calcium Carbonate; Simethicone
• Calcium Chloride
• Calcium Gluconate
• Calcium; Vitamin D
• Canagliflozin
• Canagliflozin; Metformin
• Candesartan; Hydrochlorothiazide, HCTZ
• Capreomycin
• Captopril
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbenicillin
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbidopa
• Carbidopa; Levodopa
• Carbidopa; Levodopa; Entacapone
• Cefixime
• Cefotetan
• Celecoxib
• Ceritinib
• Chloroquine
• Chlorothiazide
• Chlorpheniramine; Pseudoephedrine
• Chlorpromazine
• Chlorthalidone
• Chlorthalidone; Clonidine
• Cholestyramine
• Chromium
• Cidofovir
• Cimetidine
• Ciprofloxacin
• Cisapride
• Cisatracurium
• Citalopram
• Citric Acid; Potassium Citrate
• Citric Acid; Potassium Citrate; Sodium Citrate
• Clarithromycin
• Clofazimine
• Clomipramine
• Clozapine
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• Colchicine; Probenecid
• Colesevelam
• Colestipol
• Colistimethate, Colistin, Polymyxin E
• Corticosteroids
• Crizotinib
• Crofelemer
• Cyclobenzaprine
• Cyclophosphamide
• Cyclosporine
• Dabigatran
• Dalteparin
• Dapagliflozin
• Dapagliflozin; Metformin
• Dapagliflozin; Saxagliptin
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Dasatinib
• Deferasirox
• Degarelix
• Desflurane
• Desipramine
• Deutetrabenazine
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Diclofenac
• Diclofenac; Misoprostol
• Dicloxacillin
• Dicyclomine
• Didanosine, ddI
• Dienogest; Estradiol valerate
• Diflunisal
• Digoxin
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Disopyramide
• Disulfiram
• Dofetilide
• Dolasetron
• Dolutegravir; Rilpivirine
• Donepezil
• Donepezil; Memantine
• Doravirine; Lamivudine; Tenofovir disoproxil fumarate
• Doxacurium
• Doxepin
• Doxercalciferol
• Dronabinol
• Dronedarone
• Droperidol
• Drospirenone
• Drospirenone; Estradiol
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Drotrecogin Alfa
• Edoxaban
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Eliglustat
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Empagliflozin
• Empagliflozin; Linagliptin
• Empagliflozin; Linagliptin; Metformin
• Empagliflozin; Metformin
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Emtricitabine; Tenofovir disoproxil fumarate
• Enalapril, Enalaprilat
• Enalapril; Felodipine
• Enalapril; Hydrochlorothiazide, HCTZ
• Encorafenib
• Enflurane
• Enoxaparin
• Entrectinib
• Eprosartan; Hydrochlorothiazide, HCTZ
• Ergonovine
• Ergotamine
• Eribulin
• Ertugliflozin; Metformin
• Ertugliflozin; Sitagliptin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
• Esomeprazole; Naproxen
• Estradiol
• Estradiol Cypionate; Medroxyprogesterone
• Estradiol; Levonorgestrel
• Estradiol; Norethindrone
• Estradiol; Norgestimate
• Ethacrynic Acid
• Ethanol
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Ethotoin
• Etodolac
• Ezogabine
• Famotidine
• Famotidine; Ibuprofen
• Fenoprofen
• Fingolimod
• Flecainide
• Floxuridine
• Fluconazole
• Fluorouracil, 5-FU
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluphenazine
• Flurbiprofen
• Fluvoxamine
• Fondaparinux
• food
• Foscarnet
• Fosinopril
• Fosinopril; Hydrochlorothiazide, HCTZ
• Fosphenytoin
• Furosemide
• Gallium Ga 68 Dotatate
• Gemifloxacin
• Gemtuzumab Ozogamicin
• Gilteritinib
• Glasdegib
• Glimepiride; Pioglitazone
• Glimepiride; Rosiglitazone
• Glipizide; Metformin
• Glyburide; Metformin
• Goserelin
• Granisetron
• Griseofulvin
• H2-blockers
• Halobetasol; Tazarotene
• Halogenated Anesthetics
• Haloperidol
• Halothane
• Heparin
• Hetastarch; Dextrose; Electrolytes
• Histrelin
• Hyaluronidase
• Hyaluronidase, Recombinant; Immune Globulin
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone; Ibuprofen
• Hydroxychloroquine
• Hydroxyzine
• Ibritumomab Tiuxetan
• Ibuprofen
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Ibutilide
• Iloperidone
• Imipramine
• Immune Globulin IV, IVIG, IGIV
• Incretin Mimetics
• Indapamide
• Indomethacin
• Inotersen
• Inotuzumab Ozogamicin
• Insoluble Prussian Blue
• Insulins
• Iron
• Iron Salts
• Iron Sucrose, Sucroferric Oxyhydroxide
• Isoflurane
• Isotretinoin
• Itraconazole
• Ivosidenib
• Ixabepilone
• Ketoconazole
• Ketoprofen
• Ketorolac
• Lamivudine; Tenofovir Disoproxil Fumarate
• Lansoprazole; Naproxen
• Lanthanum Carbonate
• Lapatinib
• Lefamulin
• Lenvatinib
• Leuprolide
• Leuprolide; Norethindrone
• Levofloxacin
• Levonorgestrel
• Linaclotide
• Linagliptin
• Linagliptin; Metformin
• Lisinopril
• Lithium
• Lofexidine
• Lomitapide
• Long-acting beta-agonists
• Loop diuretics
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Low Molecular Weight Heparins
• Lubiprostone
• Macimorelin
• Magnesium
• Magnesium Citrate
• Magnesium Hydroxide
• Magnesium Salts
• Mannitol
• Maprotiline
• Measles Virus; Mumps Virus; Rubella Virus; Varicella Virus Vaccine, Live
• Mebendazole
• Meclofenamate Sodium
• Mefenamic Acid
• Mefloquine
• Meglitinides
• Meloxicam
• Meperidine; Promethazine
• Mesoridazine
• Mestranol; Norethindrone
• Metformin
• Metformin; Pioglitazone
• Metformin; Repaglinide
• Metformin; Rosiglitazone
• Metformin; Saxagliptin
• Metformin; Sitagliptin
• Methadone
• Methazolamide
• Methotrexate
• Methoxsalen
• Methyclothiazide
• Methylergonovine
• Methysergide
• Metoclopramide
• Metolazone
• Midostaurin
• Mifepristone
• Mipomersen
• Mirtazapine
• Mivacurium
• Moexipril
• Molindone
• Moxifloxacin
• Mycophenolate
• Nabumetone
• Nafcillin
• Naproxen
• Naproxen; Pseudoephedrine
• Naproxen; Sumatriptan
• Nateglinide
• Neuromuscular blockers
• Nilotinib
• Nitazoxanide
• Nizatidine
• Norethindrone
• Norgestrel
• Nortriptyline
• Octreotide
• Ofloxacin
• Olanzapine
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole
• Omeprazole; Amoxicillin; Rifabutin
• Omeprazole; Sodium Bicarbonate
• Ondansetron
• Opiate Agonists
• Oral Contraceptives
• Osilodrostat
• Osimertinib
• Oxacillin
• Oxaliplatin
• Oxaprozin
• Oxybutynin
• Paclitaxel
• Paliperidone
• Pancuronium
• Panobinostat
• Paroxetine
• Pasireotide
• Pazopanib
• Penicillin G
• Penicillin G Benzathine
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Penicillin V
• Penicillins
• Pentamidine
• Pentosan
• Perindopril
• Perindopril; Amlodipine
• Perphenazine
• Perphenazine; Amitriptyline
• Phentermine; Topiramate
• Phenylephrine; Promethazine
• Phenytoin
• Phosphorated Carbohydrate Solution
• Phosphorus
• Photosensitizing agents (topical)
• Pimavanserin
• Pimozide
• Pioglitazone
• Piperacillin
• Piperacillin; Tazobactam
• Piroxicam
• Pitolisant
• Polycarbophil
• Polymyxins
• Polysaccharide-Iron Complex
• Porfimer
• Posaconazole
• Potassium Bicarbonate
• Potassium Chloride
• Potassium Citrate
• Potassium Phosphate
• Potassium Phosphate; Sodium Phosphate
• Pramlintide
• Primaquine
• Probenecid
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Protriptyline
• Psyllium
• Pyridostigmine
• Quetiapine
• Quinapril
• Quinidine
• Quinine
• Ramelteon
• Ramipril
• Ranitidine
• Ranolazine
• Rapacuronium
• Repaglinide
• Ribociclib
• Ribociclib; Letrozole
• Rilpivirine
• Risperidone
• Ritonavir
• Rituximab; Hyaluronidase
• Rivaroxaban
• Rocuronium
• Romidepsin
• Rosiglitazone
• Salicylic Acid
• Saquinavir
• Saxagliptin
• Segesterone Acetate; Ethinyl Estradiol
• Selective serotonin reuptake inhibitors
• Serotonin norepinephrine reuptake inhibitors
• Sertraline
• Sevoflurane
• Short-acting beta-agonists
• Simvastatin; Sitagliptin
• Siponimod
• Sirolimus
• Sitagliptin
• Sodium Bicarbonate
• Sodium Ferric Gluconate Complex; ferric pyrophosphate citrate
• Sodium Hyaluronate, Hyaluronic Acid
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Sodium Thiosulfate; Salicylic Acid
• Solifenacin
• Sorafenib
• Sotalol
• Spironolactone
• St. John’s Wort, Hypericum perforatum
• Succinylcholine
• Sucralfate
• Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
• Sulfinpyrazone
• Sulfonamides
• Sulfonylureas
• Sulindac
• Sunitinib
• Tacrolimus
• Tamoxifen
• Tapentadol
• Tazarotene
• Telavancin
• Telithromycin
• Tenofovir Alafenamide
• Tenofovir, PMPA
• Tetrabenazine
• Tetracyclines
• Thalidomide
• Thiazide diuretics
• Thiazolidinediones
• Thioridazine
• Thrombin Inhibitors
• Thrombolytic Agents
• Ticarcillin
• Ticarcillin; Clavulanic Acid
• Tinzaparin
• Tipranavir
• Tolmetin
• Tolterodine
• Topiramate
• Toremifene
• Torsemide
• Trandolapril
• Trandolapril; Verapamil
• Trastuzumab; Hyaluronidase
• Trazodone
• Treprostinil
• Tretinoin, ATRA
• Triamterene
• Tricyclic antidepressants
• Trifluoperazine
• Trimipramine
• Triptorelin
• Tubocurarine
• Valproic Acid, Divalproex Sodium
• Vancomycin
• Vandetanib
• Vardenafil
• Varicella-Zoster Virus Vaccine, Live
• Vecuronium
• Vemurafenib
• Venlafaxine
• Verteporfin
• Vilazodone
• Voriconazole
• Vorinostat
• Vortioxetine
• Warfarin
• Zalcitabine, ddC
• Zinc
• Zinc Salts
• Ziprasidone