Metronidazole

Indications & Dose:

• Anaerobic infections (usually treated for 7 days and for 10 days in antibiotic-associated colitis), by mouth, either 800mg initially then 400mg every 8 hours or 500mg every 8 hours, Child: 7.5mg/kg every 8 hours; by rectum, 1g every 8 hours for 3 days, then 1g every 12 hours, Child: every 8 hours for 3 days, then every 12 hours, age up to 1 year 125mg, 1-5 years 250mg, 5-10 years 500mg, over 10 years, adult dose: by intravenous infusion over 20 minutes, 500mg every 8 hours; Child 7.5mg/kg every 8 hours.

• Leg ulcers and pressure sores,

by mouth, 400mg every 8 hours for 7 days.

• Bacterial vaginosis,

by mouth, 400-500mg twice daily for 5-7 days or 2g as a single dose.

• Pelvic inflammatory disease

by mouth, 400mg twice daily for 14 days

• Acute ulcerative gingivitis,

by mouth, 200-250mg every 8 hours for 3 days; Child 1-3 years 50mg every 8 hours for 3 days; 3- 7 years 100mg every 12 hours; 7-10 years 100mg every 8 hours

• Acute oral infections,

by mouth, 200mg every 8 hours for 3-7 days; Child 1-3 years 50mg every 8 hours for 3-7 days; 3-7 years 100mg every 12 hours; 7-10 years 100mg every 8 hours

• Surgical prophylaxis,

by mouth, 400-500mg 2 hours before surgery; up to 3 further doses of 400-500mg may be given every 8 hours for high-risk procedures; Child 7.5mg/ kg 2 hours before surgery; up to 3 further doses of 7.5mg/kg may be given every 8 hours for highrisk procedures.

By rectum, 1g 2 hours before surgery; up to 3 further doses of 1 g may be given every 8 hours for high-risk procedures; Child 5-10 years 500mg 2 hours before surgery; up to 3 further doses of 500mg may be given every 8 hours for high-risk procedures

By intravenous infusion (if rectal administration inappropriate), 500mg at induction; up to 3 further doses of 500mg may be given every 8 hours for high-risk procedures; Child 7.5mg/kg at induction; up to 3 further doses of 7.5mg/kg may be given every 8 hours for high-risk procedures

Adults

Amoebiasis: 400-800mg thrice daily for 5-7 days. Giardiasis: 200mg thrice daily for 7-10 days. Inj: i.v. 500mg 8hourly all upto 7 days. 

Children

Amoebiasis: 35-50mg/kg/day. Giardiasis: 10-15mg/kg/day divide into 3 dose. Inj: Below 12 years 7.5mg/kg body wt.

BY VAGINA USING VAGINAL GEL

¶% Adult: 1 applicatorful daily for 5 days, dose to be administered at night

Contraindications:

Active CNS disease, blood dyscrasias, hypersensitivity

Side Effects:

Nausea, metallic taste, headache, dry mouth, abdominal distress, vomiting, diarrhoea, glossitis, stomatitis. Vertigo, dizziness, ataxia, thrombophlebitis and very rarely convulsions. It shows disulfiram like effect. Urticaria, pruritus. 

Cautions:

Precautions:

Severe renal dysfunction, severe obstructive hepatic disease, alcoholic cirrhosis 

Pregnancy: Use only if clearly needed.

Breastfeeding & old Age: May be used.

Interaction:

Drugs

Warfarin and other coumarin anticoagulants: Potentiates the anticoagulants effect resulting in increased prothrombin time.

Alcohol: A disulfiram like reaction: Abdominal cramps, nausea, vomiting, headache and flushing.

Disulfiram: Acute psychotic reaction or confusional state.

Phenobarbital and Phenytoin: Increased metabolism of metronidazole resulting in decreased efficacy.

Lithium: Increased lithium levels and toxicity.

Fluorouracil: Increased toxicity of fluorouracil. Lab tests: May interfere with chemical analysis for AST, SGOT, ALT, SGPT, LDH, triglycerides and hexokinase glucose. Zero values may occur.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: