Indications
Treatment of susceptible protozoal infections such as trichomoniasis, amoebiasis, balantidiasis, Blastocystis hominis infections, giardiasis, dracunculiasis.
Treatment and prophylaxis of anaerobic bacterial infections. Specific bacterial infections include bacterial vaginosis, acute necrotising ulcerative gingivitis, pelvic inflammatory disease and antibiotic-associated colitis.
Eradicate Helicobacter pylori in peptic ulcer disease (in combination with other drugs).
Contraindications
Hypersensitivity to other nitroimidazole derivatives or any ingredient of the drug.
The first trimester of pregnancy.
Compositon/Ingredients
Metronidazole 250mg
Dosage and administration
Trichomoniasis: A single 2g dose or a 7-day course of 250mg, 3 times daily. Sexual partners should also be treated.
Amoebiasis
- Acute intestinal amoebiasis caused by E. histolytica: Adult: 750mg, 3 times daily for 5 – 10 days. Children: 35 – 50mg/kg daily in 3 divided doses for 5 – 10 days.
- Amoebic liver abscess: Adult: 500 – 750mg, 3 times daily for 5 – 10 days or 1.5 – 2.5g as a single daily dose for 2 or 3 days. Children: 35 – 50mg/kg daily in 3 divided doses for 5 – 10 days.
Balantidiasis and Blastocystis hominis infection: 750mg, 3 times daily for 5 – 10 days, respectively.
Giardiasis: Adult: 2g once daily for 3 successive days or 250mg three times daily for 5 – 7 days; children: 15mg/kg daily in 3 divided doses for 5 – 7 days.
Dracunculiasis: Adult: 250mg, 3 times daily or 25 mg/kg daily for 10 days; children: 25mg/kg daily for 10 days, not be exceeded 750mg daily (include children over 30 kg)
Anaerobic bacterial infections: 5mg/kg to maximum of 1 g every 6 hours for 7 days or more.
Bacterial vaginosis: A single 2g dose or as a 5 to 7-day course of 500mg twice daily.
Acute necrotising ulcerative gingivitis: 250mg three times daily is given orally for 3 days; similar doses are used in acute oral infections.
Antibiotic-associated colitis: 500mg, 3 – 4 times daily.
Pelvic inflammatory: 500mg twice daily in conjunction with ofloxacin given orally in a dosage of 400mg twice daily; therapy should be continued for 14 days.
Prevention of postoperative anaerobic bacterial infections: 20 – 30mg/kg daily in 3 divided doses.
H. pylori associate peptic ulcer disease: 500mg, 3 times daily in combination with at least one other agent that has activity against H. pylori (e.g. bismuth subsalicylate, amoxicillin) for 1 – 2 weeks.
Precaution
Mild disulfiram – like reactions including flushing, headache, nausea, vomiting, abdominal cramps, and sweating.
Clinical and laboratory monitoring is advised if treatment exceeds 10 days.
Used with caution and in reduced dosage in patients with severe hepatic impairment. Plasma concentration of metronidazole should be monitored in such patients.
Patients with wheat allergy (different from coeliac disease) should not take this medicine.
Pregnancy/ lactation: Only use when clearly needed.
Driving or operating machinery.
Storage
Store at temperature below 30°C, protect from light.
