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). Colonic Crohn’s disease.
Contraindications
Patients with known hypersensitivity to metronidazole or other nitroimidazole derivatives or any ingredient of the drug. The first trimester of pregnancy.
Compositon/Ingredients
Metronidazole 400mg
Dosage and administration
Trichomoniasis: A single 2-g dose or a 2-day course of 800 mg in the morning and 1.2 g in the evening or a 7-day course of 600 mg to 1 g daily in two or three divided doses. Sexual partners should also be treated. Amoebiasis, balantidiasis and Blastocystis hominis infections: Adults: 400 – 800 mg three times daily for 5 – 10 days or 1.5 – 2.5 g as a single daily dose for 2 or 3 days. Children: 7 – 10 years old: ½ the total adult daily dose. 1 year old and older: 35 – 50 mg/kg daily in 3 divided doses. Giardiasis: Adults: 2 g once daily for 3 successive days, or 400 mg three times daily for 5 days. Children: 15 mg/kg daily in 3 divided doses. Dracunculiasis: 400 mg three times daily for 5 days, or 40 mg/kg daily in 3 divided doses (to a maximum daily dose of 2.4 g) for 3 days or 400 mg daily for 10 to 20 days, or 25 mg/kg daily for 10 days. Anaerobic bacterial infections: Initial dose of 800 mg followed by 400 mg every 8 hours, usually for about 7 days. Prevention of postoperative anaerobic bacterial infections: 400 mg every 8 hours in the 24 hours before surgery, followed postoperatively by intravenous or rectal administration until oral therapy is possible (200 mg or 400 mg every 8 hours). Bacterial vaginosis: A single 2-g dose or a 5 to 7-day course of 400 mg twice daily. Acute necrotising ulcerative gingivitis: 200 mg three times daily for 3 days; similar doses are used in acute dental infections. Pelvic inflammatory disease: 500 mg twice daily in conjunction with ofloxacin given orally in a dosage of 400 mg twice daily; therapy should be continued for 14 days. Helicobacter pylori-associated peptic ulcer disease: 400 mg three times daily in combination with at least one other agent that has activity against Helicobacter pylori (e.g., bismuth subsalicylate, amoxicillin…) for 1 – 2 weeks. Colonic Crohn’s disease: 400 mg twice daily. It is usually given for 3 months.
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 rare hereditary problems of galactose intolerance, total lactase deficiency or glucose – galactose malabsorption 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.
