Medicines/Generics/Metronidazole

Metronidazole

Generic medicine reference

Not yet clinically reviewed

This entry was migrated from the earlier Pharmapedia app bundle and has not been reviewed by a named clinician on this site. It is provided for educational reference only — verify dosage and safety information against current, authoritative sources and a qualified healthcare professional before any clinical use.

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Overview

Metronidazole is an antibiotic that may be used to treat certain infections of the vagina, stomach, liver, skin, joints, brain and spinal cord, lungs, heart, or bloodstream. Metronidazole has been approved to treat: Symptomatic trichomoniasis (a sexually transmitted infection) in adults that has been confirmed by culture or wet smear test Asymptomatic trichomoniasis in females when associated with cervical changes, and in asymptomatic sexual partners Amebiasis (an infection caused by a parasite) in adults and children Anaerobic bacterial infections (infections caused by bacteria that do not need oxygen to survive). Metronidazole is thought to work by first diffusing into the cytoplasm of the anaerobic bacteria where it is then activated and reduced into a short-lived nitroso free radical which can interact with DNA, causing a loss of the helical DNA structure, strand breakage, and bacterial death. Metronidazole is well absorbed after oral administration, with peak concentrations being reached in one to two hours. Although it starts to work quickly, it may take a couple of days before you start to feel better or notice an improvement in your symptoms. It is important that you still finish the course of metronidazole that your doctor has prescribed, even if you feel better, because the infection may still be present, and it could flare up or recur if you haven’t finished the course. Metronidazole was first FDA-approved in 1963.

Indications

Contraindications

You should not use this medicine if you are allergic to metronidazole, secnidazole, or tinidazole, or if you: drank alcohol in the past 3 days consumed foods or medicines that contain propylene glycol in the past 3 days or took disulfiram (Antabuse) within the past 14 days have Cockayne Syndrome (a rare genetic disorder that affects growth and development). Before taking metronidazole, tell your healthcare provider about all of your medical conditions, including if you: liver disease kidney disease (or if you are on dialysis) a heart rhythm disorder a stomach or intestinal disease such as Crohn's disease a blood cell disorder such as anemia (lack of red blood cells) or low white blood cell (WBC) counts medical problems that affect the brain or a nerve disorder a yeast infection or a fungal infection anywhere in your body a history of blood problems or take any medications, especially warfarin, lithium, busulfan, cimetidine, phenytoin, or phenobarbital. Tell your doctor if you are pregnant or intend to become pregnant. The use of metronidazole during pregnancy has been well-studied and a review of 17 studies found that treating bacterial vaginosis and trichomoniasis with metronidazole reduced the risk of preterm birth and was effective and offered no teratogen risk. Conversely, isolated studies have suggested its use may result in low birth weight or preterm delivery. Talk to your doctor about the risks and benefits of taking metronidazole during pregnancy. Some product labels for metronidazole say it is contraindicated during the first trimester. Tell your doctor if you are breastfeeding or plan to breastfeed. Metronidazole can pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking metronidazole. If you are breastfeeding, you may consider pumping and throwing away your breast milk during treatment with metronidazole and for 48 hours after your last dose and feeding your infant stored human milk or formula. Not all uses of metronidazole are approved for treating children and teenagers. Metronidazole is not approved to treat vaginal infections in girls who have not begun having menstrual periods.

Side Effects

Get emergency medical help if you have signs of an allergic reaction to metronidazole (hives, itching, warmth, or tingling; fever, joint pain; dry mouth, dry vagina; stuffy nose, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Metronidazole may cause serious side effects including: Nervous system problems, including brain disorder (encephalopathy), inflammation of the brain and spinal cord membranes (aseptic meningitis), numbness or tingling in the hands or feet (peripheral neuropathy), and seizures (convulsions). Tell your healthcare provider right away if you have any nervous system problems while taking metronidazole Worsening yeast infection (candidiasis) symptoms in people with a known yeast infection or a yeast infection they were not aware of Low white blood cell count (leukopenia) in people with a history of blood problems. This can affect how well the body fights infection. The most common side effects of metronidazole include Diarrhea Nausea Headache Pain in the upper abdomen and abdominal cramping Vomiting Weight loss Constipation. Other side effects of metronidazole may include allergic reactions: such as itching, hives (urticaria), flushing of the skin, red skin rash that can be widespread, blisters and separation of skin layers, nasal congestion, dryness of the mouth and vagina, and fever. Abnormal heart rhythms (QT prolongation) may also occur. Metronidazole can cause life-threatening liver problems in people with Cockayne syndrome. If you have this condition, stop taking this medicine and contact your doctor if you have signs of liver failure--nausea, stomach pain (upper right side), dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes). These are not all the possible side effects of metronidazole. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Warnings

To reduce the development of drug-resistant bacteria, do not use metronidazole to treat any condition that has not been checked by your doctor. This medicine will not treat a viral infection such as the common cold or flu. Metronidazole has been shown to be carcinogenic in rats and mice and unnecessary use should be avoided. Do not use metronidazole if you recently drank alcohol, or have taken disulfiram (Antabuse) within the past 2 weeks. Do not drink alcohol or consume foods or medicines that contain propylene glycol while you are taking metronidazole and for at least 3 days after you stop taking it. Seizures and other nervous system abnormalities have been reported in patients treated with metronidazole. You should stop using this medicine immediately if you experience any neurological symptoms such as seizures, headaches, visual changes, weakness, numbness, or tingling.

High Risk Groups

Adult Dosage

30 mg/kg (30 (30)) As recommended. IV — 500 to 2000 mg (1200 (1250)) 8 hourly PO — For 5 to 10 days Scraped Dose — Take metronidazole exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. The dose depends on the infection being treated. The dosage should be reduced by 50% in those with severe hepatic impairment. In patients undergoing hemodialysis, consider a supplementary dose following the hemodialysis session, depending on the patient's clinical situation. Metronidazole will not treat a vaginal yeast infection. You may even develop a new vaginal yeast infection, which may need to be treated with antifungal medication. Tell your doctor if you have symptoms such as itching or discharge during or after treatment with this medicine. If you are treating a vaginal anaerobic bacterial infection, your sexual partner may also need to take metronidazole so you don't become reinfected. Do not share this medicine with another person, even if they have the same symptoms you have. Metronidazole is usually given for up to 10 days in a row. You may need to repeat this dosage several weeks later. Keep using this medicine even if your symptoms quickly improve. Skipping doses could make your infection resistant to medication. This medicine will not treat a viral infection (flu or a common cold).

Child Dosage

15 mg/kg (15 (15)) As recommended. IV Infusion — Over 60 mins.Initial then 7.5 mg/kg every 24 hour is given starting 48 hours after initial dose. 7.5 mg/kg (7.5 (7.5)) 8 hourly Intra Venous — - 7.5 mg/kg (7.5 (7.5)) 8 hourly Oral — -

Neonatal Dosage

7.5 mg/kg (7.5 (7.5)) 8 hourly Iv Infusion — 7.5 mg/kg (7.5 (7.5)) 8 hourly Oral —

Drug Interactions

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective. Tell your doctor about all your current medicines. Many drugs can affect metronidazole, especially: antidepressants, such as escitalopram albuterol, an asthma medication busulfan or other cancer medications some heart or blood pressure medications lithium or other antipsychotics medicines to treat malaria, HIV, or other infections blood thinners such as warfarin. Drinking alcohol while taking metronidazole is not recommended because the combination can cause a reaction (often referred to as a disulfiram-like reaction) in some people. Symptoms may include flushing, headaches, nausea, vomiting, and stomach cramps. The product information and health professionals recommend not drinking alcohol or taking products that contain propylene glycol during metronidazole treatment and for 3 days after finishing the course. This list is not complete and many other drugs may interact with metronidazole. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here. This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using this medicine.

Storage

Tab, Susp, Inj Store Below 30°C. Protect from Sunlight.

Available Brands in Pakistan

171 active brands listed alphabetically.

Metronidazole

Available Brands in Pakistan

ALDEZOLE

AMIBAZOL

AMIZOLE

AMOEBIC

AMOROB

ANABACT

ANABACT

ANAROB

ANATA

ANIZOL

ANZOLE INJECTION

ASCOZOLE

ASKNID

BARIGYL

BYDIN

CAYZOLE

DANIZOL

DAZO

DIAR-DS

DIAZOL

DILOMET

DILOMET

DILOMET DS

DILOMET DS

DILOXAMET

DILOXAZOLE

DIPROTOP-MD

DIRAZOLE

DIZET

DIZOLE

ECOGYL

ENBREL

ENCOGYL

ENTAMETOX

ENTAMIZOLE

ESPERCIL

FASIGYL

FLAGYL

FLAGYL PLUS

FLATOX

FLAZOL

FLEZOLE

FLGE

FLINT

FLOW-MTZ

FRIEZOLE

FRIZOLE

FURAMID

FYGIN

GASTRIZOLE

GASTRIZOLE SUS

GENRYL

GEOMET

GONAPAN-DF

GRANID

G-ZOLE

INGLEE

INTOBIX

JEMZOX

J-METRO

KLINT

KOZIL

LAKSOL-METRO

LEXAZOLE

LEXAZOLE

LORGYL

LOXON

MACNEDA

MARKGYL

MD

MEDEL

MEDIGYL

MEDILE

MEDOXOL

MEGAZOL

MEITREO

MELICA

MENIDAZOLE