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Thursday, April 10, 2014

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.