Metronidazole Tablets: Properties And Instructions For Use

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Metronidazole Tablets: Properties And Instructions For Use
Metronidazole Tablets: Properties And Instructions For Use
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Metronidazole tablets have a wide spectrum of action and are used to treat various diseases. The drug effectively fights various harmful bacteria and is often prescribed to patients. Before using Metronidazole, you must carefully read the instructions, since the drug has contraindications and side effects.

The content of the article:

  • 1 Tablets Metronidazole
  • 2 Composition and form of release of the drug metronidazole
  • 3 Indications for the use of metronidazole
  • 4 Release form, composition and packaging of metronidazole tablets
  • 5 How to take metronidazole correctly
  • 6 Method of administration and dosage of the drug metronidazole

    6.1 Oral suspension

  • 7 Side effects of the drug metronidazole
  • 8 Interaction of metronidazole with drugs
  • 9 Special instructions for treatment with metronidazole

Metronidazole tablets

The drug metronidazole is one of those drugs that have a wide spectrum of action against not only microbial, but also protozoal flora. It can be used not only for infectious diseases of the genitourinary sphere, but also in the treatment of inflammatory processes of the gastrointestinal tract, in dentistry and dermatology. The basis of the bactericidal action is the violation of the process of oxygen exchange in the cellular structure of the pathogen.

Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets

This is achieved due to the direct effect of the nitroagent released from metronidazole during reproduction in the tissues of various organs. Due to this, the drug can be successfully used against infections caused by bacteria of the anaerobic group. The therapy of diseases that are caused by the introduction of the simplest microorganisms into the living cells of the human body is being successfully carried out.

With prolonged use, a violation of biological and genetic bonds in the DNA chains of pathogenic microorganisms is achieved. This helps prevent recurrence of the disease and the transition of the disease into a chronic form.

Bactericidal activity is observed against the vast majority of grams of positive and negative microorganisms. In combination with other antibacterial agents, it can be used to eradicate Helicobacter pylori, which is the main cause of the development of erosion of the gastric mucosa and the appearance of ulcerative lesions.

Composition and form of release of the drug metronidazole

Active active ingredient: Metronidazole tablets are available in the form of yellowish-green flat-cylindrical, with a chamfer and risk.

One tablet contains 0.25 g of metronidazole.

Metronidazole is produced in the form of a cream for external use, in 1 g of which the content of metronidazole is 0.01 g.

Metronidazole is produced in the form of elongated white-yellow intravaginal suppositories. 1 candle contains metronidazole 0.125 g, or 0.25 g, or 0.5 g.

Metronidazole is available as a 0.5% greenish solution for injection. 1 ml of solution contains 5 mg of metronidazole.

Metronidazole tablets. Additional substances: in tablets - potato starch, cetylacetic acid, steatite. The cream contains propanetriol, liquid paraffin, emulsion wax, propanediol, nipagin, para-hydroxybenzoic acid, propyl ester, sodium salt, sterile water. In candles - polyethylene glycol 400, polyethylene glycol 1500. In solution - sodium dihydrogen phosphate, citric acid, sodium chloride, purified water.

Packing: one blister contains 10 tablets; 1 tablet contains 0.25 g of metronidazole; 1% cream is in a 25g tube. 1 g of cream contains 10 mg of metronidazole;

1 cell package contains 7 vaginal suppositories. 1 candle contains 500 mg of metronidazole; 1 bottle for infusion contains 10 ml of solution. 1 ml of solution contains 5 mg of metronidazole; 1 ampoule of 0.5% injection solution contains 20 ml of the drug. 1 ml of solution contains 5 mg of metronidazole.

Indications for the use of metronidazole

According to the instructions Metronidazole tablets are used to treat:

  • infections caused by Bacteroides species - of the abdominal cavity, including peritonitis and abscess of the liver, pelvic organs, including endomyometritis, endometritis, infections of the vaginal vault after surgery, abscess of the fallopian tubes and ovaries, as well as infections of soft tissues and skin;
  • infections caused by Bacteroides and Clostridium species - sepsis; Gastritis or duodenal ulcers caused by Helicobacter pylori;
  • protozoal infections - intestinal amebiasis, balantidiasis, extraintestinal amebiasis, trichomoniasis, including amoebic liver abscess, trichomonas vaginitis, giardiasis, cutaneous leishmaniasis, trichomonas urethritis;
Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets
  • infections caused by Bacteroides spp., including B. distasonis, B. fragilis, B. vulgalus B. ovatus, B. thetaiotaomicron - infections of joints, bones, central nervous system, including brain abscess and meningitis, as well as pneumonia, bacterial endocarditis, empyema and lung abscess;
  • alcoholism;
  • pseudomembranous colitis, which is associated with the use of antibiotics.;
  • also Metronidazole Tablets are used according to the instructions: for the prevention of postoperative complications in the peri-rectal region and colon, gynecological operations and appendectomy; For radiation therapy in oncology, as a radiosensitizing agent. Suppositories Metronidazole are used for urogenital trichomoniasis and bacterial vaginitis, which cause microorganisms that are sensitive to the drug.

Release form, composition and packaging of metronidazole tablets

Tablets metronidazole 250 mg (1 tab.)

10 pieces. - contour cell packages (2) - cardboard packs.

10 pieces. - contour cell packaging (PVC / boom) (2) - cardboard packs.

10 pieces. - non-cell contoured packaging (2) - cardboard packs.

20 pcs. - cans (1) - packs of cardboard.

Metronidazole tablets are an antiprotozoal and antimicrobial drug derived from 5-nitroimidazole. The mechanism of action consists in the biochemical reduction of the 5-nitro group by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitro group interacts with the DNA of the cell of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria.

Metronidazole tablets: properties and instructions for use
Metronidazole tablets: properties and instructions for use

Metronidazole tablets are active against Trichomonas vaginalis, Entamoeba histolytica, Gardnerella vaginalis. Giardia intestinalis, Lamblia spp., As well as obligate anaerobes Bacteroidcs spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacleroides vulgatus), Fusobacterium spp., Veillonela spp., Prevotella (P.bivia, P.buccae, microorganisms and P..dismpos) Eubacterium spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp.). The minimum inhibitory concentration for these strains is 0.125-6.25 μg / ml.

In combination with ammoxicillin, it is active against Helicobacter pylori (amoxicillin inhibits the development of resistance to metronidazole).

Aerobic microorganisms and facultative anaerobes are not sensitive to metronidazole, but in the presence of mixed flora (aerobes and anaerobes), metronidazole acts synergistically with antibiotics effective against conventional aerobes. Metronidazole tablets increase the sensitivity of tumors to radiation, induce sensitization to alcohol (disulfiram-like action), and stimulate reparative processes.

How to take metronidazole correctly

The dosage and dosage regimen of the drug depends on the age of the patient and the disease for which the treatment is being carried out. Take Metronidazole exactly as your doctor tells you to. Do not change the dose or duration of treatment without your doctor's consent.

Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets

Metronidazole tablets (retard form) should be taken on an empty stomach (1 hour before meals or 2 hours after meals). Do not chew or crush Metronidazole tablets, as this may interfere with the effectiveness of the drug or quickly get a large dose of the drug into the bloodstream.

Take tablets or capsules whole. In some cases, your doctor may order repeated blood or liver function tests to test the safety of your Metronidazole treatment. Be sure to pass all the tests that your doctor has prescribed for you.

Metronidazole may interfere with the results of some medical tests, so be sure to tell your doctor that you are taking this medicine before getting any test. Store Metronidazole at room temperature, in a dry and dark place.

Method of application and dose of the drug metronidazole

Metronidazole tablets - orally and parenterally. Inside, during or after food (or with milk), without chewing.

  • With trichomoniasis - 250 mg 2 times a day for 10 days or 400 mg 2 times a day for 5-8 days. Women need to additionally prescribe metronidazole in the form of vaginal suppositories or tablets. If necessary, you can repeat the course of treatment or increase the dose to 0.75-1 g / day. Between courses, you should take a break of 3-4 weeks with repeated control laboratory tests. An alternative treatment regimen is the appointment of 2 g once to the patient and his sexual partner;
  • children 2-5 years old - 250 mg / day; 5-10 years old - 250-375 mg / day, over 10 years old - 500 mg / day. The daily dose should be divided into 2 doses. The course of treatment is 10 days;
  • with giardiasis - 500 mg 2 times a day for 5-7 days;
  • children under 1 year old - 125 mg / day, 2-4 years - 250 mg / day, 5-8 years - 375 mg / day, over 8 years - 500 mg / day (in 2 doses). The course of treatment is 5 days;
Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets
  • with giardiasis - 15 mg / kg / day in 3 divided doses for 5 days;
  • for adults: with asymptomatic amebiasis (if a cyst is detected), the daily dose is 1-1.5 g (500 mg 2-3 times a day) for 5-7 days;
  • in chronic amebiasis, the daily dose is 1.5 g in 3 doses for 5-10 days, in acute amoebic dysentery - 2.25 g in 3 doses until symptoms stop;
  • with liver abscess, the maximum daily dose is 2.5 g in 1 or 2-3 doses, for 3-5 days, in combination with antibiotics (tetracyclines) and other methods of therapy;
  • children 1-3 years old - 1/4 adult dose, 3-7 years old - 1/3 adult dose, 7-10 years old - 1/2 adult dose;
  • with balantidiasis - 750 mg 3 times a day for 5-6 days;
  • for ulcerative stomatitis, adults are prescribed 500 mg 2 times a day for 3-5 days; in this case, the drug is not indicated for children;
  • with pseudomembranous colitis - 500 mg 3-4 times a day;
Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets
  • for the eradication of Helicobacter pylori - 500 mg 3 times a day for 7 days (as part of a combination therapy, for example, a combination with amoxicillin 2.25 g / day);
  • in the treatment of anaerobic infection, the maximum daily dose is 1.5-2 g;
  • in the treatment of chronic alcoholism, 500 mg / day is prescribed for a period of up to 6 (no more) months;
  • for the prevention of infectious complications - 750-1500 mg / day in 3 doses 3-4 days before surgery or once 1 g on the first day after surgery. 1-2 days after surgery (when ingestion is already allowed) - 750 mg / day for 7 days;
  • with severe renal impairment (CC less than 10 ml / min), the daily dose should be reduced by 2 times;

Oral suspension

  • Anaerobic bacterial infections: children - 7 mg / kg every 8 hours, the course of treatment is 7-10 days;
  • giardiasis: children 2-5 years old - 200 mg / day, 5-10 years old - 300 mg / day, 10-15 years old - 400 mg / day. The duration of treatment for giardiasis is 5 days. The course of treatment can be repeated after 10-15 days;

Parenteral Adults and children over 12 years old at an initial dose of 0.5-1 g intravenous drip (duration of infusion - 30-40 minutes), and then every 8 hours, 500 mg at a rate of 5 ml / min. With good tolerance, after the first 2-3 infusions, they switch to jet administration. The course of treatment is 7 days. If necessary, intravenous administration is continued for a longer time. The maximum daily dose is 4 g. According to indications, a transition is made to a maintenance intake in a dose of 400 mg 3 times a day. Children under the age of 12 are prescribed according to the same scheme in a single dose - 7.5 mg / kg;

  • for purulent-septic diseases, 1 course of treatment is usually carried out;
  • for prophylactic purposes, adults and children over 12 years old are prescribed intravenous drip, 0.5-1 g on the eve of the operation, on the day of the operation and the next day - 1.5 g / day (500 mg every 8 hours). After 1-2 days, they switch to supportive therapy inside. For patients with chronic renal failure and CC less than 30 ml / min and / or liver failure, the maximum daily dose is not more than 1 g, the frequency of administration is 2 times a day;
Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets
  • as a radiosensitizing drug, intravenous drip is administered at the rate of 160 mg / kg or 4-6 g / m2 of body surface 0.5-1 hours before the start of irradiation. Apply before each irradiation session for 1-2 weeks. During the remaining period of radiation treatment, metronidazole is not used. The maximum single dose should not exceed 10 g, course dose - 60 g. To relieve the intoxication caused by radiation, drip injection of 5% dextrose solution, Gemodez or 0.9% NaCl solution is used;
  • for cervical and uterine body cancer, skin cancer, it is used in the form of local applications (3 g is dissolved in a 10% DMSO solution), tampons are moistened, which are used topically, 1.5-2 hours before irradiation). In case of poor regression, the swollen applications are carried out during the entire course of radiation therapy. With positive dynamics of cleansing the tumor from necrosis - during the first 2 weeks of treatment.

In case of an overdose during metronidazole therapy, the following undesirable symptoms may appear: lightheadedness, vomiting, impaired coordination of movements, convulsions, damage to the nerves of the peripheral nervous system.

Side effects of the drug metronidazole

When treating with metronidazole (intravenous and intramuscular injections) by the method, manifestations of undesirable effects are possible:

  • dry mouth, nausea, colic, poor appetite, metal taste in the mouth;
  • diarrhea, vomiting, constipation, stomatitis;
  • loss of consciousness, impaired coordination of movements, imbalance, nervousness, depression, excessive activity, apathy, weakness, sleep disturbance, migraine,;
  • nettle rash, skin rash, runny nose, convulsions;
  • violation of urination, inflammation of the bladder, increased urination, candidiasis, brown urine staining;
Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets
  • thrombosis (swelling and pain at the injection site);
  • decrease in the number of neutrophils, decrease in the number of leukocytes;
  • exacerbation of ischemic heart disease;
  • fainting, convulsions, illusions;
  • inflammation of the pancreas.
  • with metronidazole therapy in the idea of ​​tablets, manifestations of undesirable effects are possible in the form of:
  • convulsions, numbness of the limbs. In this case, stop taking the drug and you should consult a doctor;
Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets
  • nausea, vomiting, diarrhea, weight loss, colic, migraine;
  • metallic taste in the mouth, stomatitis;
  • a decrease in the number of leukocytes in the blood, a decrease in the number of platelets;
  • exacerbation of ischemic heart disease;
  • seizures, fainting, loss of balance, confusion, sleep disturbance, irritability, weakness;
  • nettle rash, runny nose, dry mouth, vagina, fever, delayed-type allergic reactions.

Patients suffering from chronic inflammation of the gastrointestinal tract may develop breast cancer, colon cancer. Metronidazole is not recommended for patients with Crohn's disease.

When metronidazole is used in the form of a gel, its amount in plasma is negligible, which is why the risk of undesirable effects is so small.

Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets

May manifest:

  • nettle rash, skin rash, peeling, dry and burning skin, lacrimation;
  • undesirable effects of metronidazole in sections may be as follows:
  • nettle rash, skin rash;
  • burning sensation of mucous membranes, frequent urination, itching, burning pain in the external genital area;
  • change in taste, taste of metal in the mouth, loss of consciousness, dry mouth, nausea, vomiting, decreased appetite, colic, constipation, diarrhea, a decrease in the level of leukocytes in the blood.
  • in case of termination of the use of the drug, the manifestation of vaginal candidiasis is possible.

Interaction of metronidazole with drugs

Metronidazole for infusion should not be administered with other medications. The drug activates the effect of warfarin, increasing the period of prothrombin synthesis. Provokes ethyl rejection. Combined therapy with anti-alcohol drugs contributes to the disruption of the nervous system, so the break between applications should be at least fourteen days. Histodil inhibits the synthesis of metronidazole and increases its content in the blood, provoking the possibility of undesirable effects.

The synchronous use of drugs that accelerate the enzymatic reactions of biotransformation in the liver (luminal, diphenin) stimulate the excretion of metronidazole from the body in natural ways, as a result of which its content in the blood decreases. In the case of the simultaneous use of metronidazole with preparations containing lithium, an increase in the amount of lithium in the blood is observed, which leads to intoxication.

It is undesirable to use metronidazole with drugs that stop muscle fiber contraction (norkuron). Streptocide activates the antibacterial effect of metronidazole.

In the case of external use of metronidazole in the form of a gel, its effect with other drugs is very small, however, there is a risk in the case of simultaneous administration of the drug with Warfarex or angithrombotic drugs (prolongation of blood clotting time).

Special instructions for treatment with metronidazole

Metronidazole tablets. During the treatment period, ethanol is contraindicated (a disulfiram-like reaction may develop: spastic abdominal pain, nausea, vomiting, headache, sudden flushing of the face). In combination with amoxicillin, it is not recommended for use in patients under 18 years of age.

Instructions for the use of Metronidazole tablets
Instructions for the use of Metronidazole tablets

With prolonged therapy, it is necessary to control the blood picture. 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 of the neurological status of patients requires discontinuation of treatment. It can immobilize treponema and lead to a false positive Nelson's test. Stains urine dark.

When treating Trichomonas vaginitis in women and Trichomonas urethritis in men, it is necessary to refrain from sexual activity. Simultaneous treatment of sexual partners is mandatory. Treatment does not stop during menses. After trichomoniasis therapy, control tests should be performed during three successive cycles before and after menstruation.

After treatment of giardiasis, if symptoms persist, after 3-4 weeks, conduct 3 fecal analyzes at intervals of several days (in some successfully treated patients, lactose intolerance caused by invasion may persist for several weeks or months, resembling the symptoms of giardiasis).

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