Metronidazole
A to Z Drug Facts
Metronidazole |
(meh-troe-NID-uh-zole) |
Flagyl |
Tablets |
250 mg |
Tablets |
500 mg |
Flagyl 375 |
Capsules |
375 mg |
Flagyl ER |
Tablets, extended-release |
750 mg |
Flagyl I.V. |
Powder for Injection, lyophilized |
500 mg |
Flagyl I.V. RTU |
Injection |
5 mg/mL |
Metonidazole |
Injection |
5 mg/mL |
Metro I.V. |
Injection, ready-to-use |
500 mg/100 mL |
MetroGel |
Gel |
0.75% |
MetroGel-Vaginal |
Gel |
0.75% |
MetroLotion |
Lotion |
0.75% |
Noritate |
Cream |
1% |
Protostat |
Tablets |
250 mg |
Tablets |
500 mg |
Apo-Metronidazole |
Metro Cream |
Nida Gel |
Noritate |
Novo-Nidazol |
PMS-Metronidazole |
Trikacide |
Class: Anti-infective |
Action Enters bacterial or protozoal cell and impairs synthesis of DNA, resulting in cell death.
Indications Treatment of serious infections caused by susceptible anaerobic bacteria; prophylaxis of postoperative infection in patients undergoing colorectal surgery; treatment of amebiasis; treatment of trichomoniasis and asymptomatic partners of infected patients; bacterial vaginosis.
Topical: Treatment of inflammatory papules, pustules, and erythema of acne rosacea.
Vaginal: Treatment of bacterial vaginosis.
Treatment of hepatic encephalopathy, Crohn disease, antibiotic-associated pseudomembranous colitis, Helicobacter pylori infections.
Contraindications Hypersensitivity to nitroimidazole derivatives; first trimester of pregnancy in patients with trichomoniasis.
Anaerobic Bacterial Infections
ADULTS: IV 15 mg/kg loading dose infused over 1 hr (approximately 1 g for a 70 kg adult); then 7.5 mg/kg infused over 1 hr q 6 hr (approximately 500 mg for a 70-mg adult). Do not exceed 4 g in 24 hr. May follow with similar oral dose. For prophylaxis, loading dose is to be completed 1 hr before surgery, followed by maintenance dose 6 and 12 hr later.
Bacterial Vaginosis
ADULTS: PO 750 mg (Flagyl ER) once daily for 7 consecutive days. Vaginal 1 applicatorful (approximately 37.5 mg metronidazole) intravaginally bid for 5 days.
Anticoagulants: Anticoagulant effect may be increased.
Barbiturates: Therapeutic failure of metronidazole may occur.
Disulfiram: Concurrent use may result in acute psychosis or confusional state. Metronidazole should not be given to patients who have taken disulfiram within last 2 wk.
Ethanol: Disulfiram-like reaction including flushing, palpitations, tachycardia, nausea, and vomiting may occur with concurrent use.
Do not use aluminum-containing equipment with metronidazole because solution will turn orange/rust color.
Lab Test Interferences May interfere with chemical analyses for AST, ALT, LDH, triglycerides, and hexokinase glucose; zero values may occur.
CARDIOVASCULAR: Flattening of T-wave. CNS: Seizures; peripheral neuropathy; dizziness; vertigo; incoordination; ataxia; confusion; depression; insomnia; syncope. DERMATOLOGIC: Thrombophlebitis; urticaria; erythematous rash; flushing. EENT: Metallic taste; glossitis; stomatitis. GI: Nausea; anorexia; vomiting; diarrhea; epigastric distress; cramps; proctitis; pseudomembranous colitis. GU: Darkening of urine; dysuria; cystitis; polyuria; incontinence; vaginal Candida proliferation; decreased libido. HEMATOLOGIC: Mild leukopenia. OTHER: Hypersensitivity reactions including dermatologic reactions, nasal congestion, dry mouth or vagina, and fever; fleeting joint pain; pancreatitis. Topical or vaginal use may cause similar adverse effects. After prolonged IV use, thrombophlebitis may occur.
Pregnancy: Category B. Lactation: Excreted in breast milk. Children: Safety and efficacy not established, except for amebiasis. Elderly: Monitoring serum levels may be necessary for proper dosing. Hepatic Impairment: Patients with severe hepatic disease metabolize drug slowly; use caution and lower dose. Neurologic Effects: Seizures and peripheral neuropathy have occurred. Use extra caution with prolonged use, high doses, or history of CNS disease.
PATIENT CARE CONSIDERATIONS |
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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts