Metronidazole, Inf/Oral

Amoebicide · Nitroimidazole

Indications

Infection due to anaerobic pathogens. Amoebic dysentery, liver abscess and other forms of amoebic disease. Eradication of E. histolytica from symptomless cyst passers. Acute ulcerative gingivitis. Trichomoniasis. Non-specific vaginitis.

Dosage

Adults: Infections due to anaerobic pathogens: ORAL: 400 mg three times daily. INJECTION: 500 mg eight hourly by IV infusion then oral therapy. Invasive intestinal diseases in susceptible subjects: ORAL: 800 mg three times daily for five days: less susceptible subjects: 400 mg three times daily for five to ten days. Hepatic diseases, including amoebic liver abscess and hepatitis and other forms of extra-intestinal amoebic disease: ORAL: 400-800 mg three times daily for five days. Pelvic inflammatory disease: ORAL: 400 mg twice daily for 14 days. Symptomless cyst passers: ORAL: 400-800 mg three times daily for five to ten days. Acute ulcerative gingivitis: ORAL: 400 mg three times daily for three days. Acute oral infections: ORAL: 400 mg every 8 hr for 3-7 days. Leg ulcers and pressure sores: ORAL: 400 mg every 8 hr for 7 days. Trichomoniasis/Non-specific vaginitis: ORAL: 400 mg twice…

Administration

Administered by continuous intravenous infusion or by intermittent IV infusion over one hour. Do not give by direct IV injection. Do not administer IV metronidazole with aluminum needles or hubs or through same IV line as other drugs. Compatibility: Stable in D5W, NS. Y-site administration: Drug to Drug IV Compatibility: Acyclovir, amikacin, cephazolin, cefepime, ceftriaxone, cimetidine, ciprofloxacin, cisatracurium, diltiazem, dopamine, enalapril, esmolol, fluconazole, heparin, hydrocortisone, hydromorphone, labetalol, levofloxacin, linezolid, lorazepam, magnesium sulphate, methylprednisolone, midazolam, milrinone, morphine, piperacillin/tazobactam, vasopressin. Drug to Drug IV Incompatibility: Amphotericin B cholesteryl sulphate complex, aztreonam, filgrastim, lansoprazole, meropenem, pantoprazole, warfarin. When admixed: Incompatible with aztreonam, dopamine, meropenem. Stability: It…

Adverse Effects

GI upset, dysgeusia, leucopenia, urticaria, angioedema, CNS disturbances, dark urine. Neuropathy and epileptiform seizures on long term therapy. Severe bullous skin reactions.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Precautions: Hepatic impairment or hepatic encephalopathy. Haemodialysis. Active or chronic severe peripheral and CNS disease. Treatment duration exceeding 10 days; clinical and laboratory monitoring recommended. Cockayne syndrome; monitor LFTs before, during and after treatment.

Interactions

Alcohol, anticoagulants, phenobarbital, lithium, phenytoin.

Advice to Patient

Take with or without meals. To reduce GI upset, take with meals. Contact prescriber if there is difficulty in breathing, numbness/swelling/tingling of extremities, fever or chills, unrelieved or severe fatigue, weakness, mouth or vaginal sores, seizures, change in vision or if there is no improvement or worsening of condition. Avoid alcohol during therapy and for 3 days after last dose. If you are being treated for trichomoniasis, avoid intercourse or use a barrier contraceptive.

Pharmacokinetics

Absorption: Oral: Well absorbed. Metabolism: Hepatic (30% to 60%). Half-life elimination: Neonates <7 days: Within first week of life, more prolonged than with lower GA: GA 28 to 30 weeks: 75.3 ± 16.9 hours. GA 32 to 35 weeks: 35.4 ± 1.5 hours. GA 36 to 40 weeks: 24.8 ± 1.6 hours. Neonates =7 days: Approx. 22.5 hours. Children and Adolescents: 6 to 10 hours. Adults: Approx. 8 hours. Time to peak, serum: Oral: Immediate release: 1 to 2 hours; Extended release: Approx. 5 hours. Excretion: Urine (unchanged drug and metabolites: 60% to 80%; approx. 20% of total as unchanged drug); feces (6% to 15%).

Brands with this active ingredient

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