Metronidazole

Indication

• All forms of amoebiasis (intestinal and extra-intestinal disease including liver abscess and that of symptomless cyst passers)

• Trichomoniasis

• Giardiasis

• Bacterial vaginosis

• Acute ulcerative gingivitis

• Anaerobic infections including

septicaemia, bacteraemia, peritonitis,

brain abscess, necrotising pneumonia,

osteomyelitis, puerperal sepsis, pelvic

abscess, pelvic cellulitis etc.

• Anaerobically-infected leg ulcers and pressure sores

• Acute dental infections (e.g. acute pericoronitis and acute apical infections)

• Surgical prophylaxis (prevention of postoperative infections due to anaerobic bacteria, particularly species of bacteroides and anaerobic streptococci

• Chronic symptomatic peptic ulcer disease (as an agent of triple therapy to

eradicate H. pylori-the most important aetiological factor of peptic ulcer)

• Dosage and Administration

Indication	Duration of dosage in days	Adults and  children over10 years	Children 7-10 years 3-7 years 1-3 years
Trichomoniasis	7	200 mg t.i.d or 400 mg b.i.d	100 mg t.i.d	100 mg t.i.d	50 mg t.i.d
	2	800 mg in the morning and 1.2 gm at night
	1	2.0 gm as a single dose
Invasive intestinal amoebiasis	5	800 mg t.i.d.	400 mg t.i.d.	200 mg q.i.d.	200 mg t.i.d.
Extra intestinal amoebiasis (including liver abscess) and symptomless amoebic cyst passers	5-10	400 -800 mg t.i.d.	200 -400 mg t.i.d	100-200 mg q.i.d	100-200 mg q.i.d
Giardiasis	3	2.0 gm once daily 1.0 gm once daily 600-800 mg 500 mg	1.0 gm once daily	6 0 0 - 8 0 0 mg once daily	500 mg once daily
Acute ulcerative gingivitis	3	200 mg t.i.d. mg t.i.d.	100 mg	100 mg b.i.d.	50 mg t.i.d.
Acute dental infections	3-7	200 mg t.i.d.
Bacterial vaginosis	5-7	400–500 mg twice daily
	1	2.0 gm as a single dose
Leg ulcers and pressure sores	7	400 mg t.i.d.
Anaerobic infections	7	Either 400 mg every 8 hours or 500 mg every 8 hours	7.5 mg/kg t.i.d.	7.5 mg/kg t.i.d	7.5 mg/kg t.i.d
Surgical prophylaxis		400–500 mg 2 hours b e f o r e surgery; up to 3 further doses of 400–500 mg may be given every 8 hours for h i g h - r i s k procedures	7.5 mg/kg t.i.d.	7.5 mg/kg t.i.d.	7.5 mg/kg t.i.d.

Side Effect

Metalic taste, furred tongue, nausea, vomiting, diarrhoea, drowsiness, rashes and mild reversible leucopenia may be observed during treatment.

Drug Interaction

Metronidazole interacts with warfarin, nicoumalone, phenytoin, phenobarbitone, fluorouracil, disulfiram, lithium, cimetidine etc.

A   Use in Pregnancy & Lactation

      Not recommended during first & later trimesters. Breast feeding should be delayed until 48 hours after discontinuing metronidazole in the mother.

Presentation: 400 mg Tablet, 500 mg Tablet & 200 mg/5ml Suspension.