Indications
- Treatment of protozoal infections: intestinal and extraintestinal amebiasis, trichomoniasis.
- Infections caused by gram-negative anaerobes of the Bacteroidaceae family: brain and lung abscesses, necrotizing pneumonia, infections of the osteoarticular system, bacterial endocarditis and sepsis.
- The drug is effective against clostridial flora, which causes infections of the genitourinary system and infections of the abdominal organs.
- Metronidazole is used in gastroenterology for the treatment of gastritis, gastric and duodenal ulcers associated with H. pylori.
- Prophylactic use during operations on the colon and gynecological interventions.
Indications for use
Protozoal infections: extraintestinal amebiasis, including amoebic liver abscess, intestinal amebiasis (amoebic dysentery), trichomoniasis (including trichomonas vaginitis, trichomonas urethritis).
Infections caused by Bacteroides spp. (including B. fragilis, B. distasonis, B. ovatus, B. thetaiotaomicron, B. vulgatus): infections of bones and joints, infections of the central nervous system, including meningitis, brain abscess, bacterial endocarditis, pneumonia, empyema and lung abscess, sepsis.
Infections caused by Clostridium spp., Peptococcus niger and Peptostreptococcus spp.: abdominal infections (peritonitis, liver abscess), pelvic infections (endometritis, fallopian tube and ovarian abscess, vaginal vault infections).
Prevention of postoperative complications (especially interventions on the colon, pararectal area, appendectomy, gynecological operations).
Instructions for use of the drug metronidazole
Inside, with a glass of water.
The daily dose is divided into 3 doses for adults, and 2 doses for children 6-15 years old. For trichomoniasis infection, 2 treatment regimens are used: 2 g of the drug once or 0.250 g twice a day, course 10 days.
When Helicobacter pylori is irradiated, metronidazole is combined with penicillin antibacterial drugs to suppress drug resistance. The daily dose of metronidazole is 1.5 g.
Metronidazole in the treatment of intestinal amebiasis is used in a daily dose of 1.5 g.
For acute amoebiasis, the daily dose is 2.250 g. The daily dose for children is 0.5 g.
Treatment of extraintestinal forms of amebiasis requires combination with tetracycline antibacterial drugs. The daily dose of metronidazole is 2.5 g in adults and 0.5 g in children.
Prevention of complications after surgical interventions involves taking 0.750 - 1.5 g of the drug per day for 4 days before surgery and 0.750 in the postoperative period for a week.
Metronidazole-AKOS (Metronidazole-AKOS)
Gastrointestinal disorders
: epigastric pain, nausea, vomiting, diarrhea, glossitis, stomatitis, “metallic” taste in the mouth, decreased appetite, anorexia, dry eating and diet of the oral cavity, constipation, pancreatitis (reversible cases), change in tongue color/”coated tongue” (due to the growth of fungal microflora).
Immune system disorders
: angioedema, anaphylactic shock.
Nervous system disorders
: peripheral sensory neuropathy, headache, convulsions, dizziness, the development of encephalopathy and subacute cerebellar syndrome (impaired coordination and synergism of movements, ataxia, dysarthria, gait disturbances, nystagmus, tremor), which are reversible after discontinuation of metronidazole, aseptic meningitis, has been reported.
Mental disorders
: psychotic disorders, including confusion, hallucinations; depression, insomnia, irritability, increased excitability.
Visual disorders
: transient visual impairments, such as diplopia, myopia, blurred contours of objects, decreased visual acuity, impaired color perception; neuropathy/optic neuritis.
Blood and lymphatic system disorders
: agranulocytosis, leukopenia, neutropenia, thrombocytopenia.
Disorders of the liver and biliary tract
: increased activity of “liver” enzymes (aspartate aminotransferase, alanine aminotransferase, alkaline (phosphatase), development of cholestatic or mixed hepatitis and hepatocellular liver damage, sometimes accompanied by jaundice; in patients treated with metronidazole and combinations with other antibacterial agents, cases of liver failure were observed, requiring liver transplantation.
Skin and subcutaneous tissue disorders
: rash, itching, skin flushing, urticaria, pustular skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis.
Renal and urinary tract disorders:
staining of urine in a brownish-reddish color, due to the presence in the urine of a water-soluble metabolite of metronidazole, dysuria, polyuria, cystitis, urinary incontinence, candidiasis.
General and administration site disorders
: fever, nasal congestion, arthralgia, weakness, thrombophlebitis (pain, hyperemia or swelling at the injection site).
Laboratory and instrumental data : flattening of the T wave on the electrocardiogram.
Side effects and features of administration
The most common violations:
- Gastrointestinal tract: abdominal discomfort, nausea, vomiting, impaired taste perception (“metallic” taste in the mouth), diarrhea;
- immunity: anaphylactic shock, angioedema;
- skin: rash, itching, urticaria;
- genitourinary system: change in the color of urine up to a reddish-brown color, candidiasis.
The drug crosses the placental barrier, which completely limits its use in the first trimester of pregnancy. In the second and third trimester, metronidazole is used if the estimated risk to the fetus is lower than the possible benefit to the pregnant woman. Treatment of a lactating woman requires cessation of breastfeeding.
When treating trichomoniasis, it is necessary to carry out therapy simultaneously in both partners and to exclude sexual contact for the period of therapy.
Metronidazole, 5 mg/ml, solution for infusion, 100 ml, 1 pc.
Gastrointestinal disorders:
epigastric pain, nausea, vomiting, diarrhea, glossitis, stomatitis, “metallic” taste in the mouth, loss of appetite, anorexia, dry oral mucosa, constipation, pancreatitis (reversible cases), change in tongue color/“coated tongue” (from - for the growth of fungal microflora).
Immune system disorders:
angioedema, anaphylactic shock.
Nervous system disorders:
peripheral sensory neuropathy, headache, convulsions, dizziness, the development of encephalopathy and subacute cerebellar syndrome (impaired coordination and synergy of movements, ataxia, dysarthria, gait disturbances, nystagmus, tremor), which are reversible after discontinuation of metronidazole, aseptic meningitis, has been reported.
Mental disorders:
psychotic disorders, including confusion, hallucinations; depression, insomnia, irritability, increased excitability.
Visual disorders:
transient visual impairments, such as diplopia, myopia, blurred outlines of objects, decreased visual acuity, impaired color perception; neuropathy/optic neuritis.
Blood and lymphatic system disorders:
agranulocytosis, leukopenia, neutropenia, thrombocytopenia.
Disorders of the liver and biliary tract:
increased activity of “liver” enzymes (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase), the development of cholestatic or mixed hepatitis and hepatocellular liver damage, sometimes accompanied by jaundice; In patients treated with metronidazole in combination with other antibacterial agents, cases of liver failure requiring liver transplantation have been observed.
Disorders of the skin and subcutaneous tissues:
rash, itching, skin flushing, urticaria, pustular skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis.
Renal and urinary tract disorders:
staining of urine in a brownish-reddish color, caused by the presence in the urine of a water-soluble metabolite of metronidazole, dysuria, polyuria, cystitis, urinary incontinence, candidiasis.
General disorders and disorders at the injection site:
fever, nasal congestion, arthralgia, weakness, thrombophlebitis (pain, hyperemia or swelling at the injection site).
Laboratory and instrumental data:
flattening of the T wave on the electrocardiogram.
Interaction with other medications
Sulfonamides potentiate the main effect of metronidazole.
Simultaneous use with disulfiram increases the risk of developing psychosis. The medications should be taken two to three weeks apart.
During therapy with metronidazole, it is necessary to stop drinking alcohol, including drugs made from ethanol. Neglect will lead to disulfiram-like reactions.
Metranidazole potentiates the activity of indirect anticoagulants, which increases the risk of bleeding. While taking metronidazole, it is necessary to strengthen monitoring of prothrombin time and adjust the dose of anticoagulants.
special instructions
Long-term use of the drug should preferably be carried out under the control of peripheral blood parameters.
IV administration of a solution for infusion is indicated for patients in whom oral administration of the drug is impossible. For mixed infections, metronidazole infusion solution can be used in combination with parenteral antibiotics without mixing the drugs with each other.
When administered intravenously, it should not be mixed with other drugs. When using the drug, an exacerbation of candidiasis may occur.
Drinking alcohol during the course of therapy is strictly prohibited (a disulfiram-like reaction may develop: cramping abdominal pain, nausea, vomiting, headache, sudden rush of blood to the face).
When using the drug, slight leukopenia may occur, so it is advisable to monitor the blood picture (the number of leukocytes) at the beginning and at the end of therapy.
With leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process.
The appearance of ataxia, dizziness and any other deterioration in the neurological status of patients requires cessation of treatment.
May immobilize treponemes and lead to a false-positive Nelson test. When treating trichomonas vaginitis in women and trichomonas urethritis in men, it is necessary to abstain from sexual activity. Simultaneous treatment of sexual partners is mandatory. After treatment for trichomoniasis, control tests should be carried out during 3 consecutive cycles before and after menstruation.
When carrying out therapy for more than 10 days - only in justified cases, with strict monitoring of the patient and regular monitoring of laboratory blood parameters. If a longer course of therapy is necessary due to the presence of chronic diseases, the balance between the expected effect and the potential risk of complications should be carefully weighed.
Metronidazole-LekT
Gastrointestinal disorders
: epigastric pain, nausea, vomiting, diarrhea, glossitis, stomatitis, “metallic” taste in the mouth, decreased appetite, anorexia, dry oral mucosa, constipation, pancreatitis (reversible cases), tongue discoloration / “coated tongue” ( due to the growth of fungal microflora).
Immune system disorders
: angioedema, anaphylactic shock.
Nervous system disorders
: peripheral sensory neuropathy, headache, convulsions, dizziness, the development of encephalopathy and subacute cerebellar syndrome (impaired coordination and synergism of movements, ataxia, dysarthria, gait disturbances, nystagmus, tremor) has been reported, which are reversible after discontinuation of metronidazole, aseptic meningitis.
Mental disorders
: psychotic disorders, including confusion, hallucinations; depression, insomnia, irritability, increased excitability.
Visual disorders
: transient visual impairments, such as diplopia, myopia, blurred contours of objects, decreased visual acuity, impaired color perception; neuropathy/optic neuritis.
Blood and lymphatic system disorders
: agranulocytosis, leukopenia, neutropenia, thrombocytopenia.
Disorders of the liver and biliary tract
: increased activity of “liver” enzymes (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase), development of cholestatic or mixed hepatitis and hepatocellular liver damage, sometimes accompanied by jaundice; In patients treated with metronidazole in combination with other antibacterial agents, cases of liver failure requiring liver transplantation have been observed.
Skin and subcutaneous tissue disorders
: rash, itching, skin flushing, urticaria, pustular skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis.
Renal and urinary tract disorders
: staining of urine in a brownish-reddish color, caused by the presence of a water-soluble metabolite of metronidazole in the urine, dysuria, polyuria, cystitis, urinary incontinence, candidiasis.
General and administration site disorders
: fever, nasal congestion, arthralgia, weakness (for dosage forms for oral and parenteral use), thrombophlebitis (pain, redness or swelling at the injection site) (for dosage forms for parenteral use).
Laboratory and instrumental data : flattening of the T wave on the electrocardiogram.
Prescription of Metronidazole, contraindications and side effects
The instructions for the drug indicate the following indications for use:
- For suppositories - for urethritis, trichomonas vaginitis, amoebic dysentery, giardiasis. Metronidazole is used to prevent infection during surgery, exacerbation of ulcers, chronic gastroduodenitis associated with Helicobacter pylori infection. Prescribed for chronic alcohol dependence.
- For ointment - for bacterial vaginosis, vulgar or rosacea acne, wounds, trophic ulcers that do not heal for a long time. The medication is prescribed to patients with demodicosis, amoebiasis, trichomoniasis, limbliasis, cystitis, and urethritis. Shows sufficient effectiveness in the treatment of infections of the central nervous system, bacterial damage to the bone tissue of the joints, pelvic organs or abdominal cavity.
Metronidazole tablets and other forms are used for the development of pseudomembranous colitis, ulcers, gastroduodenitis, and for the prevention of complications in the postoperative period.
The medication is contraindicated in patients:
- with individual intolerance to the component composition;
- organic lesions of the central nervous system, including epilepsy;
- leukopenia, liver failure;
- when breastfeeding.
Particular care is taken when treating pregnant women or people with renal failure. In these cases, the treatment regimen and dosage are calculated by the doctor.
The main adverse reactions to Metronidazole are:
- attacks of nausea, vomiting, refusal to eat, diarrhea, constipation, intestinal colic, stomatitis, pancreatitis, dry oral mucosa;
- impaired coordination of movements, ataxia, attacks of dizziness, confusion, depression, hallucinations, unreasonable irritability, excitability, convulsive syndrome, headache, sleep disturbances;
- nettle fever, rashes, redness, arthralgia;
- candidiasis, urinary incontinence, polyuria, cystitis, reddish-brown coloration of urine;
- thrombophlebitis.
Laboratory tests show a decrease in the number of neutrophils and leukocytes.
Similar drugs:
- Metronidazole Nycomed Oral tablets
- Metrogyl (Metrogyl) Solution for injection
- Metronidazole-LekT Oral tablets
- Atrican 250 Capsule
- Lotrimin Cream for external use
- Ginalgin Vaginal tablets
- Metron (Metron) Solution for infusion
- Osarbon (Osarbonum) Vaginal suppositories
- Metronidazole-AKOS Oral tablets
- Metrogyl Oral suspension
** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before starting to use the drug Metronidazole-ESKOM, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.
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Directions for use and doses
Intravenous infusion.
Intravenous administration of metronidazole is indicated for severe infections, as well as in the absence of the possibility of taking the drug orally.
For adults and children over 12 years of age, the single dose is 500 mg, the rate of intravenous continuous (jet) or drip administration is 5 ml per minute. The interval between injections is 8 hours. The duration of treatment is determined individually. The maximum daily dose is no more than 4 g. According to indications, depending on the nature of the infection, a transition to maintenance therapy with oral forms of metronidazole is carried out.
For children under 12 years of age, metronidazole is administered at 7.5 mg/kg body weight in 3 doses at a rate of 5 ml per minute.
To prevent anaerobic infection before planned surgery on the pelvic organs and urinary tract for adults and children over 12 years of age, metronidazole is prescribed as an infusion at a dose of 500-1000 mg, on the day of surgery and the next day - at a dose of 1500 mg / day (500 mg every 8 ocloc'k). After 1-2 days, they usually switch to maintenance therapy with oral forms of metronidazole.
For patients with severe renal impairment (creatinine clearance less than 30 ml/min) and/or liver, the daily dose of metronidazole is 1000 mg; (multiplicity of administration is 2 times).
