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.

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Carbamazepine

Indication

Carbamazepine is indicated for

• partial and secondary generalized tonicclonic

Seizures

• primary generalized tonic-clonic

Seizures

• trigeminal neuralgia

• prophylaxis of bipolar disorder

 is indicated for

• partial and secondary generalized tonicclonic

Seizures

• primary generalized tonic-clonic

Seizures

• trigeminal neuralgia

• prophylaxis of bipolar disorder

Dosage & Administration

 Epilepsy:

Adults and children over 12 years of age - Initial: Either 200 mg b.i.d. for tablets and XR tablets, or 1 teaspoon q.i.d. for suspension (400 mg/day).

Maintenance: usually 800-1200 mg daily. Children 6-12 years of age - Initial: Either 100 mg b.i.d. for tablets or XR tablets,

Contraindication & Precaution

 This medicine should not be used if anybody is allergic to one or any of its ingredients. It cannot be used also in the following conditions:

• Problems with the electrical message

pathways in the heart (atrioventricular

block).

. History of decreased blood cell production

by the bone marrow (bone marrow

depression).

• Hereditary blood disorders called

porphyrias.

• Allergy to tricyclic antidepressants, eg

amitriptyline.

• People who have taken a monoamineoxidase

inhibitor antidepressant (MAOI) in

the last 14 days.

Side Effect

Dizziness, drowsiness, ataxia, dry mouth, abdominal pain, nausea,

vomiting, anorexia, leucopenia, proteinuria, bradycardia, heart failure and hypotension. Erythematous skin rash, aplastic anemia may also be observed.

Use in Pregnancy & Lactation

 Pregnancy category D. Carbamazepine and its epoxide metabolite are transferred to breast milk. Because of the potential serious side Effects, decision should me made whether to discontinue nursing or discontinue the

drug.

Preparation

 200 mg Tablet, 200 mg CR Tablet, 100 mg/5 ml (100 ml) Suspension.

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