Compound
The product is available in different forms, all forms contain the active substance metronidazole .
The solution for infusion contains 5 mg of active substance.
Metronidazole tablets contain 0.25 g of active ingredient.
Vaginal suppositories with metronidazole contain 0.125 g, 0.25 g or 0.5 g of the active ingredient. It also contains additional ingredients - polyethylene oxide
1500 and polyethylene oxide 400.
Metronidazole vaginal gel contains 1 g of metronidazole, as well as additional components: carbomer , propylene glycol, disodium edetate, propyl parahydroxybenzoate, sodium hydroxide, water.
Metronidazole cream contains 10 mg of metronidazole, as well as additional components: synthetic olbrot, cetyl alcohol, sodium lauryl sulfate, glycerol , stearic acid, propyloxybenzoate, methyl oxybenzoate, water.
Metronidazole gel for external use contains 10 mg of active ingredient, as well as additional components: ethanol, disodium EDTA, methyl oxybenzoate, carboxypolymethylene 940, propylene glycol, triethanolamine, propyloxybenzoate, water.
Release form
The drug is produced in several forms. The medicine in the form of a solution for infusion is a clear liquid that has a greenish tint. Fits in 100 ml bottles, they are placed in a cardboard pack.
The tablets are contained in blister packs of 10 pieces. A pack can contain one, two or five cell packs.
Vaginal suppositories are torpedo-shaped and white or yellowish in color. There are 10 pieces in a cardboard pack.
The vaginal gel is contained in a 30 g tube; the kit includes a special applicator for vaginal administration.
Gel and cream for external use are also produced; these products are contained in 15 g tubes, packaged in cardboard packs.
The medicine is produced in the form of a suspension for oral administration; vaginal tablets Metronidazole, the drug Metronidazole Lect, etc. are also produced.
pharmachologic effect
Pharmacological group - antimicrobial medicine, a group of antibiotics with high anaerobic activity.
When using Metronidazole for treatment, it should be taken into account that this drug has an antimicrobial and antiprotozoal effect. Its mechanism of action is based on the biochemical reduction of the 5-nitro group of metronidazole by transport intracellular proteins of protozoa and anaerobic microorganisms.
Bacteria die due to the interaction of the reduced 5-nitro group of metronidazole with the DNA of microorganism cells and, as a consequence, inhibition of the synthesis of their nucleic acids.
The product is active against Gardnerella vaginalis , Trichomonas vaginalis , Lamblia spp. , Entamoeba histolytica , Giardia intestinalis , the active substance is also active against obligate anaerobes Bacteroides spp. , Prevotella , Veillonella spp. , Fusobacterium spp . and in relation to individual gram-positive microbes ( Clostridium spp. , Eubacter spp. , Peptostreptococcus spp. , Peptococcus spp. ).
If the drug is combined with amoxicillin , it is active against Helicobacter pylori .
At the same time, facultative anaerobes and aerobic microorganisms do not show sensitivity to metronidazole. But if mixed flora is present (that is, aerobes and anaerobes), it acts synergistically with antibiotics that are effective against ordinary aerobes.
The medicine helps to increase the sensitivity of neoplasms to radiation, stimulates reparative processes, and promotes the manifestation of disulfiram-like reactions.
Pharmacological properties of the drug Metronidazole
A nitroimidazole derivative that has antiprotozoal and bactericidal effects. Active against Trichomonas vaginalis, Entamoeba histolytica , Giardia Lamblia , as well as against obligate anaerobes, including anaerobic gram-negative bacteria ( Bacteroides spp. , including the Bacteroides fragilis group , Fusobacterium spp. ), anaerobic gram-positive bacteria ( Clostridium spp. and sensitive strains Eubacterium ), anaerobic gram-positive cocci (including Peptococcus spp. and Peptostreptoccus spp. ). Not active against aerobic bacteria. The formation of resistance of infectious agents to metronidazole has not been observed. Metronidazole penetrates into microorganisms, and its nitro group is probably converted into hydroxylamine, which contributes to the effect on the DNA of microorganisms, leading to their death. Almost completely absorbed after oral administration. Concomitant food intake does not affect the absorption of metronidazole. After oral administration at a dose of 200 mg, the maximum plasma concentration (about 5 mcg/ml) is achieved in approximately 1–2 hours. Less than 10% of metronidazole is bound to plasma proteins. Quickly distributed in the body. It enters the liver and is excreted in high concentrations in bile. Partially excreted in urine unchanged and in the form of metabolites.
Pharmacokinetics and pharmacodynamics
The drug label indicates that after administration of the drug intravaginally, systemic absorption of the active substance occurs. Approximately 56% is absorbed.
There is a twofold higher relative bioavailability of the product used in the form of a vaginal gel compared to vaginal tablets when using a single dose of 500 mg. The highest concentration when using vaginal gel is achieved 6-12 hours after use.
Metronidazole is less than 20% bound to blood proteins. The substance passes through the placental barrier, the BBB, and enters all tissues in the body. It is noted to be excreted in breast milk.
Metabolism takes place in the liver, excretion occurs mainly through the kidneys (approximately 60-80%, with about 20% excreted unchanged from the body). Another 6-15% is excreted from the body through the intestines.
Treatment of recurrent cystitis and preventive measures
Treatment and prevention of recurrent urinary system infections are based on the possible elimination of negative factors that cause recurrent diseases, and also include lifestyle changes, adequate antibacterial therapy and antibacterial prophylaxis.
The concept of “lifestyle change” includes:
- washing after defecation from front to back, avoiding wearing tight synthetic underwear, avoiding vaginal douching, forced urination immediately after sexual intercourse (in modern studies, the role of these measures in reducing the risk of relapse of the disease has not been convincingly proven, but it is believed that their use is possible);
- Drink plenty of fluids: 2 to 3 liters per day (in a recent randomized trial of 140 women with recurrent cystitis who were drinking little fluid initially, 1.5 liters of water was added to their diet, which resulted in a 50% reduction in the rate of recurrent cystitis).
In postmenopausal women, local estrogen replacement therapy is effective. The use of estrogen suppositories allows you to restore the number of lactobacilli in the vagina, which helps eliminate the growth of pathogens. Since a common cause of relapses in this category of women is the presence of genital prolapse (prolapse or prolapse of the pelvic organs through the vagina), correction of prolapse is necessary - conservative or surgical.
The effectiveness of prophylaxis with immunoactive drugs (Uro-Vaxom, StroVac) has been proven. Uro-Vaxom is a medicine registered in Russia. The active ingredient is a lyophilized lysate of Escherichia coli bacteria. The drug is used for recurrent cystitis, can be prescribed in conjunction with antibacterial drugs, and has a small number of side effects. Course admission - up to 3 months.
It is possible to use antibiotic prophylaxis, which differs in dosage regimens: continuous and postcoital. Both regimens have proven effective in the treatment of recurrent cystitis. Numerous studies have shown that continuous prophylaxis reduces relapses by up to 95% compared to placebo. Fosfomycin, Nitrofurantoin, Ciprofloxacin can be used as a prophylactic drug.
Postcoital prophylaxis may be the method of choice in patients with exacerbations clearly associated with sexual intercourse. This also applies to women who want to prevent episodes of cystitis during pregnancy. However, in this case, the choice of medications is limited; it is possible to take Nitrofurantoin and a cephalosporin antibiotic.
Recently, D-mannose, a natural type of sugar that is a compound that mimics the receptors in the bladder wall, has been gaining popularity. It can competitively bind to bacteria and reduce the number of bacteria adhering to the bladder lining. This reduces the likelihood of developing cystitis. However, existing data regarding the effectiveness of the drug are not yet convincing enough and are few in number. It is also not very clear exactly what doses of D-mannose are effective, how and in what quantities they should be used. A number of studies have shown that D-mannose at a daily dose of 2 g is superior to placebo and comparable in effect to 50 mg of Nitrofurantoin (Furamaga). Produced in the form of a dietary supplement, it is not officially produced in Russia. May serve as an alternative for patients with postcoital cystitis along with postcoital antibacterial prophylaxis.
If conservative treatment is ineffective and a clear connection between the symptoms of cystitis and sexual activity is identified, it is possible to perform surgical treatment - surgical correction of the anatomical location of the external urethral opening (transposition of the distal urethral opening). The essence of the operation is to isolate the final section of the urethra and move it above the entrance to the vagina.
Intravesical instillations of hyaluronic acid (Uro-hyal, Urolife) are used to restore the protective glycosaminoglycan layer and are effective in the treatment of interstitial, post-radiation cystitis, and can also be used for the treatment and prevention of recurrent cystitis. There are methods for submucosal administration of hyaluronic acid into the urethra and bladder, the effectiveness of which is still being studied.
How is recurrent cystitis treated at the Rassvet Clinic?
Treatment of recurrent cystitis in Rassvet is carried out in accordance with the recommendations of leading foreign urological associations and medical communities. To diagnose urological diseases, our specialists use the latest generation digital urography, computer uroflowmetry, and expert-level ultrasound. Urologists at Dawn adhere to the principles of evidence-based medicine, do not prescribe unnecessary examinations or ineffective medications, and conduct extensive consultations aimed at preventing diseases of the genitourinary system.
Indications for use of Metronidazole
There are the following indications for the use of Metronidazole in suppositories:
- urethritis and trichomonas vaginitis (for men and women);
- amoebic dysentery;
- giardiasis;
- manifestation of anaerobic infections that develop due to the action of microorganisms sensitive to metronidazole;
- for the treatment of mixed severe aerobic-anaerobic infections;
- for the prevention of anaerobic infection in case of surgery;
- with alcoholism in chronic form.
Also prescribed for exacerbations of chronic gastritis ; for ulcers associated with Helicobacter pylori (combined with amoxicillin).
Metronidazole ointment and other forms of the drug are prescribed for the following diseases and conditions:
- acne vulgaris and rosacea , bacterial vaginosis (applied externally);
- wounds and trophic ulcers that do not heal for a long time;
- with demodicosis ;
- manifestation of protozoal infections (with extraintestinal amebiasis, intestinal amebiasis, amoebic liver abscess, giardiasis, trichomoniasis , trichomonas vaginitis, giardiasis, balantidiasis, cutaneous leishmaniasis , trichomonas urethritis, ureaplasma, cystitis );
- in case of infections caused by Bacteroides spp. (for infections of the central nervous system, for infections of the bones of the joints);
- for infections that are provoked by Clostridium spp., Peptococcus and Peptostreptococcus (for infections of the pelvic organs, abdominal cavity);
- pseudomembranous colitis (due to the use of antibiotics);
- ulcers and gastritis, which are associated with Helicobacter pylori;
- for the purpose of preventing complications after operations, in particular after interventions in the peri-rectal area, as well as after gynecological operations and appendectomy;
- as a radiosensitizing drug during radiation therapy for people suffering from tumors, if resistance is associated with hypoxia in tumor cells.
You can learn more about why the medicine helps, what Metronidazole in tablets and other forms helps with, from specialists.
Diagnostics
The diagnosis is confirmed by bacteriological examination of urine and identification of pathogenic pathogens in the analysis.
Ultrasound and cystoscopy are not used to make a diagnosis because they have low diagnostic value. However, it is advisable to carry out these studies in case of atypical symptoms and manifestations of cystitis, the presence of repeated episodes of hematuria (blood in the urine) - in order to exclude other pathologies of the bladder, such as tumors and bladder stones.
Contraindications
The following contraindications are defined for the use of all forms of this medicine:
- high sensitivity to the drug;
- lesions of the central nervous system of an organic nature ( epilepsy , etc.);
- leukopenia (including a history);
- liver failure (the dosage must be accurate; large doses of the drug should not be used);
- breast-feeding.
Prescribe the drug with caution during pregnancy or in case of renal failure. In such conditions, the dosage should only be prescribed by a doctor.
Side effects of Metronidazole
Side effects may develop while taking the drug:
- side effects in the functions of the gastrointestinal tract : nausea, vomiting, loss of appetite, diarrhea , constipation, manifestation of intestinal colic, dry mouth, pancreatitis , stomatitis ;
- functions of the nervous system : impaired coordination, dizziness , ataxia, disturbances of consciousness, depression , irritability, hallucinations, high excitability, weakness, convulsions, headaches, insomnia , peripheral neuropathy;
- allergic manifestations : skin rash, urticaria , skin hyperemia, fever, arthralgia;
- urinary system : polyuria, candidiasis , dysuria, urinary incontinence, cystitis, red-brown urine;
- local manifestations : thrombophlebitis ;
- other side effects : leukopenia, neutropenia, flattening of the T wave (manifested on the ECG).
Side effects of the drug Metronidazole
Nausea, vomiting, epigastric discomfort, diarrhea, metallic taste in the mouth, candidiasis of the oral and intestinal mucosa, headache, dizziness, drowsiness, lack of coordination, depression; when using high doses - peripheral neuropathy, manifested by myalgia, paresthesia; leukopenia, allergic reactions (skin rash, fever). With intravaginal administration, candidal cervicitis, vaginitis, itching, burning and irritation in the vagina, vulva, swelling of the vulva, vaginal discharge, and frequent urination are possible.
Instructions for use of Metronidazole (Method and dosage)
The dosage and features of administration are determined by the form in which the patient is prescribed the drug.
Metronidazole tablets, instructions for use
The medicine in tablets should be taken orally, doing this during or after meals. No need to chew.
Patients with trichomoniasis are prescribed 250 mg twice a day, taken for 10 days. You can also use the drug at a dose of 400 mg twice a day for 5-8 days. During treatment, women should additionally use vaginal tablets or suppositories.
A repeated course of treatment or an increase in dose may be practiced. After the first course, it is important to take a break for about 1 month and conduct laboratory tests for control. As an alternative method of administration, 2 g of the drug is prescribed once to both sexual partners.
In the case of asymptomatic amebiasis (if a cyst is detected), adult patients are prescribed 500 mg of the drug 2-3 times a day, therapy lasts 5-7 days.
In the case of chronic amebiasis,
In the case of severe amoebic dysentery, a dose of 2.25 g per day is prescribed, divided into three doses, taken until the symptoms stop.
Patients with liver abscess are prescribed 2.5 g of the drug per day; it can be taken in one or 2-3 doses. Treatment lasts for 3-5 days, and a combination of metronidazole with tetracyclines .
For ulcerative stomatitis, it is recommended to take 500 mg of the drug twice a day, take 3-5 days.
In the case of pseudomembranous colitis - 500 mg tablets 3-4 times a day.
To eradicate Helicobacter pylory, take 500 mg 3 times a day, this should be done for seven days. Combination treatment is practiced, with amoxicillin and others.
In order to prevent infectious complications, 750-1500 mg of medication per day is prescribed before surgery, 3-4 days before the procedure. Also, a dose of 750 mg per day can be taken for 7 days after surgery.
To treat anaerobic infection, 1.5-2 g of Metronidazole or Metronidazole LekT is prescribed per day.
Metronidazole suppositories, instructions for use
Suppositories, vaginal gel, vaginal tablets are prescribed intravaginally in a dose of 500 mg, they should be administered once before bedtime or twice - in the morning and in the evening.
As a rule, treatment lasts for 10 days. Depending on the diagnosis or course of the disease, the dosage and duration of therapy should be adjusted by the doctor. During the period of using vaginal medications, you should refrain from sexual intercourse.
Metronidazole ointment, instructions for use
As a rule, ointment and gel should be applied topically and externally twice a day, the dosage is set on an individual basis. The skin should first be cleaned, the layer of product should be thin. If necessary, an occlusive dressing can be applied.
As a rule, treatment lasts from 3 to 9 weeks. You can alternate the use of gel and cream. The effect of treatment is observed after 3 weeks.
Metronidazole veterinary
In veterinary medicine it is used in the form of tablets and granulates. For animals, it is used orally to treat trichomoniasis in cattle, histomoniasis in ducks and geese, dysentery and balantidiasis in pigs.
Treatment in veterinary medicine is carried out according to the scheme prescribed by a specialist. For turkey poults and chickens, the dose is calculated at the rate of 10 mg per 1 kg of bird. The product should be given three times a day for 10 days. The veterinarian determines how to give the product to turkey poults or other birds in the first days of life.
For the treatment of trichomoniasis in cattle, the drug is prescribed at a dose of 10 mg per 1 kg of weight for 3-4 days. In veterinary medicine, there are certain treatment regimens that are used after being prescribed by a specialist.
Metronidazole IV is prescribed to children over 12 years of age and adults, the initial dose is 0.5-1 g. It is administered by drip, with the duration of infusions being about 40 minutes.
If the drug is well tolerated, the dropper is later administered as a stream. As a rule, treatment is carried out within 1 week. If there is such a need, the duration of treatment can be extended.
Metronidazole
Metronidazole
(lat.
metronidazole
) - antibacterial antiprotozoal drug.
Metronidazole is a chemical
Chemical Compound: 2-Methyl-5-nitro-1H-imidazole-1-ethanol. 5-nitroimidazole derivative. White or slightly greenish crystalline powder. Metronidazole is slightly soluble in water and sparingly soluble in alcohol. Empirical formula: C6H9N3O3.
Metronidazole - medicine
Metronidazole is the international nonproprietary name (INN) of the drug. According to the pharmacological index, metronidazole belongs to the groups “Other synthetic antibacterial agents” and “Medicines for the correction of disorders in alcoholism, toxic and drug addiction”; according to ATC, metronidazole is included in the groups:
- “A02 Drugs for the treatment of diseases associated with acidity disorders” as part of combinations intended for the eradication of Helicobacter pylori
: - "omeprazole, amoxicillin and metronidazole", code A02BD01,
- "lansoprazole, tetracycline and metronidazole", code A02BD02,
- "lansoprazole, amoxicillin and metronidazole", code A02BD03,
- "rabeprazole, amoxicillin and metronidazole", code A02BD13,
- “vonoprazan, amoxicillin and metronidazole”, code A02BD15;
Metronidazole is also a trade name for the drug.
Metronidazole is an antibiotic agent
Metronidazole is active against the following microorganisms:
- protozoa (protists): Trichomonas vaginalis, Entamoeba histolytica, Giardia intestinalis , Lamblia spp.
- bacteria:
- anaerobic:
- Gram-negative Bacteroides spp.
(including
Bacteroides fragilis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus
),
Parabacteroides distasonis
,
Fusobacterium spp.
,
Veillonella spp.,
Prevotella
bivia, Prevotella buccae
and
Prevotella disiens - gram-positive Clostridium spp., Eubacterium spp., Peptococcus spp., Peptostreptococcus spp.
The following bacteria are resistant to metronidazole: Mobiluncus spp
.
Indications for use of metronidazole
- Intestinal amebiasis, trichomoniasis, balantidiasis, giardiasis, cutaneous leishmaniasis.
- Trichomonas vaginitis and urethritis.
- Infections of bones and joints, central nervous system (including meningitis and brain abscess), bacterial endocarditis, pneumonia, empyema and pulmonary abscess caused by Bacteroides spp
. - Infections of the abdominal cavity (peritonitis, liver abscess), infections of the pelvic organs (endometritis, endomyometritis, abscess of the fallopian tubes and ovaries, infections of the vaginal vault after surgery), infections of the skin and soft tissues caused by Bacteroides spp ., Clostridium spp., Peptococcus spp. ., Peptostreptococcus spp.
- Sepsis caused by Bacteroides spp., Clostridium spp.
- Pseudomembranous colitis caused by antibiotics.
- Prevention of postoperative complications, including operations on the colon, rectal area, female genital organs, removal of the appendix.
- Radiation therapy for patients with tumors - as a radiosensitizing agent, in cases where tumor resistance is due to hypoxia in tumor cells.
- For intravaginal use: urogenital trichomoniasis (including urethritis and vaginitis), nonspecific vaginitis of various etiologies, confirmed by clinical and microbiological data.
- For external and local use: rosacea and vulgar acne, bacterial vaginosis, long-term non-healing wounds, trophic ulcers, infectious skin diseases, oily seborrhea, seborrheic dermatitis, bedsores, hemorrhoids, anal fissures.
- Mixed (aerobic and anaerobic) infections of various localizations, periodontal diseases, purulent-inflammatory processes of the maxillofacial area.
- Chronic alcoholism.
- Gastrointestinal diseases associated with Helicobacter pylori
: gastric and duodenal ulcers, atrophic gastritis, MALToma, condition after gastric resection for cancer.
Metronidazole in Helicobacter pylori eradication regimens
Metronidazole is classified by WHO as a drug active against Helicobacter pylori
(Podgorbunskikh E.I., Maev I.V., Isakov V.A.).
However, in Russia the level of resistance to metronidazole is almost twice as high as the European average: 55.5% in Russia and 25.5% in Europe, data from 2001 (Maev I.V., Vyuchnova E.S., Shchekina M.I. .). The figure on the right (taken from the article by Belousova Yu.B., Karpov O.I., Belousov D.Yu. and Beketov A.S.) shows the dynamics of resistance to metronidazole, clarithromycin and amoxicillin in Helicobacter pylori
isolated from adults (top) and from children (bottom).
Its very widespread and inappropriate use has led to increased resistance to metronidazole. Currently, in treatment regimens it is recommended to use nifuratel instead of metronidazole (Shcherbakov P.L.). As a result, modern Russian Standards for the diagnosis and treatment of acid-dependent and Helicobacter pylori-associated diseases recommend metronidazole in only one of the “second-line” regimens (applied only if the patient had an unsuccessful attempt to eradicate Helicobacter pylori
using one of the “first-line” regimens). : metronidazole 500 mg 3 times a day, tripotassium bismuth dicitrate 120 mg 4 times a day, tetracycline 500 mg 4 times a day and one of the proton pump inhibitors in a standard dosage (omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg, esomeprazole 20 mg, rabeprazole 20 mg 2 times a day) for 10–14 days.
When assessing the level of resistance to metronidazole, the following results were obtained: in the mid-1990s, there was a steady increase in the average European level of resistance.
Initial data typical for Russia, where the number of Helicobacter pylori
resistant to nitroimidazole derivatives continues to grow, reached 56.6% by 1998 (see figure on the left).
The reason for such a high level of resistance is the widespread use of the drug for the treatment of urogenital and other infections, as well as their irrational use in eradication therapy regimens in previous years. However, attention is drawn to data on the possibility of restoring sensitivity to metronidazole in a previously resistant strain of H. pylori under anaerobic conditions. Researchers explain this phenomenon by the fact that, while in the stomach cavity, Helicobacter pylori
periodically enters anaerobic conditions, and therefore, in a number of patients with resistant strains, radiation therapy with the inclusion of metronidazole achieves success (Kazyulin A.N. et al.).
Order of use of metronidazole and dose
When taking metronidazole orally:
- adults and children over 12 years old - 7.5 mg of metronidazole per kg of body weight every 6 hours or 250-750 mg 3-4 times a day
- children under 12 years of age - 5–16.7 mg of metronidazole per kg of body weight 3 times a day
When administered intravenously
to adults and children over 12 years of age, the initial dose is 15 mg of metronidazole per kg of body weight, then 7.5 mg of metronidazole per kg of body weight every 6 hours or 500–750 mg every 8 hours. The duration of taking metronidazole is determined by your doctor.
With intravaginal administration
500 mg of metronidazole 1 time at night.
For external and local use
The dose of metronidazole is determined by the doctor, the frequency of treatment is twice a day.
Daily dose
metronidazole for adults when taken orally and intravenously should not exceed 4 g
.
This order of use of metronizadol and dose do not apply to the treatment of Helicobacter pylori-associated gastrointestinal diseases, for the treatment of which see Standards for the diagnosis and treatment of acid-dependent and Helicobacter pylori-associated diseases, 2010.
Use of metronidazole during pregnancy and breastfeeding
Metronidazole is contraindicated in the first trimester of pregnancy; in the second and third trimesters it should be taken with caution only if the benefit to the pregnant woman outweighs the risk to the unborn child, given that metronidazole crosses the placenta.
FDA Category of Effect on the Fetus is B. Metronidazole is excreted into human milk, creating concentrations similar to those in blood plasma. May impart a bitter taste to breast milk. To exclude the effect of metronidazole on the child, breastfeeding during metronidazole therapy and for another 2 days after stopping its use is not recommended.
Professional medical publications addressing the use of metronidazole in the eradication of Helicobacter pylori
- Ivashkin V.T., Sheptulin A.A., Baranskaya E.K. and others. Recommendations for the diagnosis and treatment of peptic ulcer disease (a manual for doctors). - M. - 2004.
- Belousova Yu.B., Karpov O.I., Belousov D.Yu., Beketov A.S. Pharmacoeconomics of the use of bismuth tripotassium dicitrate for peptic ulcer disease // Therapeutic archive. – 2007. – T. 79. – No. 2. – P. 58–66.
On the website gastroscan.ru in the literature catalog there is a section “Antibiotics used in the treatment of gastrointestinal diseases”, containing articles on the use of antimicrobial agents in the treatment of diseases of the digestive tract.
Medicines containing the active ingredient metronidazole
Bacimex, Deflamon, Klion, Metrovagin, Metrogyl, Metroxan, Metrolacare, Metron, Metronidazole, Metronidazole IV Brown, Metronidazole Nycomed, Metronidazole-AKOS, Metronidazole-UBF, Metronidazole tablets 0.25 g, Metronidal, Metroseptol, Orvagil, Rosamet, Rozeks, Siptrogil, Tricho-PIN, Trichobrol, Trichopol, Trichosept, Flagyl, Eflora.
Instructions for use of metronidazole
Some official instructions from manufacturers of drugs with the active substance metronidazole (pdf):
- Nycomed (Denmark):
- “Instructions for medical use of the drug Metronidazole Nycomed”, tablets of 250 and 500 mg, dated July 31, 2001.
- “Instructions for medical use of the drug Metronidazole Nycomed”, infusion solution, 500 mg of metronidazole in 100 ml of solution, dated November 23, 2000.
- “Information for medical professionals and specialists regarding the drug Klion”, tablets containing 250 mg of metronidazole, solution for infusion
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Interaction
You should know when using Metronidazole that this is a drug that interacts in a certain way with other drugs.
The medicine enhances the effect of indirect anticoagulants . As a result, the time for prothrombin formation increases.
When using this drug, ethanol .
When taking disulfiram , the patient may develop various neurological symptoms. It is important that at least two weeks pass between prescribing these drugs.
Before taking Metronidazole intravenously, it should be noted that this drug should not be mixed with other medications.
The metabolism of metronidazole is inhibited by cimetidine . As a result, the concentration of metronidazole in the blood increases, and the likelihood of adverse reactions increases.
With the simultaneous use of drugs that stimulate microsomal oxidation enzymes in the liver , the concentration of metronidazole in plasma may decrease.
When used at the same time as Li+ preparations, an increase in the concentration of lithium is possible, which leads to the manifestation of signs of intoxication.
non-depolarizing muscle relaxants should not be practiced .
The antimicrobial effect of metronidazole is stimulated by sulfonamides .
Drug interactions Metronidazole
With the simultaneous use of metronidazole and indirect anticoagulants, it is possible to increase their concentrations in the blood plasma and increase the risk of bleeding, and therefore regular monitoring of the coagulogram is necessary. With the simultaneous use of metronidazole and lithium salts, an increase in the concentration of lithium in the blood plasma is possible. The simultaneous administration of barbiturates and phenytoin leads to a decrease in the effectiveness of metronidazole. Cimetidine in some cases may slow down the elimination of metronidazole and increase its concentration in the blood serum. When used simultaneously with disulfiram, dizziness and confusion may occur.
List of pharmacies where you can buy Metronidazole:
- Moscow
- Saint Petersburg
special instructions
It should be borne in mind that Metronidazole is an antibiotic that cannot be combined with ethanol. Otherwise, serious side effects may occur.
Metronidazole should not be combined with amoxicillin when treating children and adolescents under 18 years of age.
If treatment is carried out over a long period of time, it is important to carefully monitor laboratory blood values.
In patients with leukopenia, the likelihood of using the drug for treatment depends on whether there is a risk of developing an infection.
It is important to immediately stop treatment if the patient experiences dizziness, ataxia, or worsening neurological status.
When taking the drug, a false positive Nelson test , which should be taken into account when using Metronidazole for thrush and other diseases.
It is important to abstain from sexual activity if trichomonas vaginitis and urethritis are being treated. It is very important to treat both partners at the same time. Treatment should not be suspended during menstruation.
When using the product externally, it should be noted that if it gets into the eyes, the gel or cream can cause lacrimation. If this happens, it is important to immediately rinse your eyes with plenty of water.
When used externally, it is important to apply the product completely to the entire area affected by the disease. The gel does not leave greasy stains on clothes and skin.
The use of this drug in gardening and in the vegetable garden is also practiced. Metronidazole is used for plants against late blight. It is also used for onions to protect the plant from onion flies.
Many specialists in the field of dermatology use Metronidazole for acne. Acne gel effectively relieves inflammation and prevents scarring. At the same time, it also affects the cause of the rash. However, only a doctor should prescribe a regimen for how to take any form of Metronidazole for acne. Sometimes the patient is also prescribed pills to eliminate problems in the body that cause acne.
Before starting to take the drug, patients are often interested in whether Metronidazole is an antibiotic or not. It should be borne in mind that this is an antibacterial agent, which is why these tablets and other forms of the drug should be prescribed only by a specialist after examination and tests.
Special instructions for the use of the drug Metronidazole
For organic diseases of the central nervous system and granulocytopenia, metronidazole is prescribed only for health reasons. The use of metronidazole in the first trimester of pregnancy is not recommended; In the second and third trimesters of pregnancy, metronidazole can be used only for health reasons. If it is necessary to prescribe metronidazole, breastfeeding should be temporarily discontinued. Breastfeeding can be resumed 2-3 days after stopping metronidazole. When prescribing a course, systematic monitoring of the peripheral blood picture is necessary. During treatment with metronidazole, you should not drink alcohol due to the possibility of developing a disulfiram-like reaction (dizziness, vomiting). During therapy with metronidazole, it is possible to obtain falsely reduced values of ALT and AST activity in the blood plasma when determined by the spectrometric method. During the use of metronidazole, the urine becomes dark in color.
Metronidazole analogs
Level 4 ATC code matches:
Batsimex
Ornisol
Ornidazole
Meratin
Ornidazole-Vero
Klion
Tinidazole
Metronidazole analogues are drugs that contain a similar active substance in the composition. Please note that replacement of the drug can only be done after approval by the doctor.
Analogues of the drug are the drugs Deflamon , Batsimex , Metrogyl , Metron , Metronidal , Rozex , Orvagil , Siptrogil , Trichopolum , Metronidazole-LekT, Trichosept, Metronidazole Nycomed , etc.
Metronidazole or Trichopolum - which is better?
Both drugs have the same mechanism of action on the body. Therefore, we can assume that Trichopolum and Metronidazole are one and the same.
Indications for use are also similar: drugs are prescribed for thrush and other diseases of the genitourinary system. What one or another medicine treats in gynecology is determined by a specialist, but, as a rule, these drugs are interchangeable.
For children
The dosage and regimen of taking the drug for children should only be prescribed by a doctor. As a rule, children under 1 year of age are prescribed 125 mg per day, children 2-4 years old should receive 250 mg per day, children 5-8 years old should receive 375 mg per day.
Children over 8 years of age are prescribed 500 mg of the drug per day. Why tablets are prescribed, and whether it is advisable, depends on the diagnosis. Products for external use are prescribed to children after reaching 12 years of age.
Metronidazole and alcohol
When discussing the compatibility of this medicine with alcohol, it should be noted that you should under no circumstances take alcoholic beverages during treatment. Reviews indicate that this combination significantly increases the severity of side effects.
A person who has consumed even a small amount of alcohol during treatment with Metronidazole may experience a significant decrease in blood pressure . Therefore, when taking the drug for thrush and other diseases, you should abstain from alcohol.
Metronidazole reviews
There are often reviews on the Internet about Metronidazole tablets, which write both about the effectiveness of this drug and about certain concerns associated with taking the drug. In particular, more than one specialized forum contains information about side effects.
It is also noted that alcohol during treatment provokes the manifestation of serious negative actions. Reviews of Metronidazole suppositories indicate that when used correctly, they can completely cure many unpleasant diseases.
There is information that gel and ointment are effective if you need to get rid of acne. Reviews often write about what the drug treats and what the results of therapy are.
Causes
The main role in the occurrence of recurrent cystitis is played by behavioral factors:
- frequent sexual intercourse;
- the use of antibiotics that negatively affect the intestinal and vaginal flora;
- the appearance of a new sexual partner within the last year.
The following are likely to develop recurrent cystitis:
- women who use a diaphragm with spermicide as contraception (the use of spermicidal-coated condoms by a partner also increases the risk of relapse);
- Postmenopausal women (often suffer from urinary tract infections).
Possible causes of recurrent cystitis:
- the presence of residual urine after urination associated with genital prolapse;
- a decrease in estrogen levels, leading to changes in the vaginal microflora, a decrease in the number of lactobacilli and an increase in the colonization of E. coli in the vagina;
- anatomical features of the location of the woman’s urethra (some women have a lower location of the urethra or increased mobility of the external opening of the urethra, causing its displacement into the vagina during sexual intercourse and the reflux of vaginal flora into the bladder, which causes so-called postcoital cystitis).
Metronidazole price, where to buy
The price of Metronidazole in tablets of 250 mg is on average 10 rubles per 10 pieces. Buy 250 mg tablets in a package of 20 pcs. You can get it for an average of 12-15 rubles per package. The cost of 500 mg tablets is approximately 80 rubles per pack of 20 pieces.
The price of Metronidazole suppositories in Russia is approximately 100 rubles per package. The price of the gel is on average 120 rubles per tube. Metronidazole suppositories, as well as cream and ointment, can be purchased at any pharmacy. The price of Metronidazole in Ukraine (Kyiv, Kharkov and other cities) is on average 25 hryvnia per package of 20 pcs. How much tablets cost in other packages depends on the manufacturer.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Facial care lotion with metronidazole and herbs Epideril demodex bottle 100 mlKOSMOPHARM LLC RU
460 rub.order - Shower gel care with metronidazole and herbs Epideril demodex bottle 100mlKOSMOPHARM LLC RU
RUB 404 order
- Metronidazole vaginal suppositories. 500 mg 10 pcs. LLC Avexima Siberia
184 RUR order
- Metronidazole tablets 250 mg 40 pcs. Pharmstandard-Leksredstva OJSC
134 RUR order
- Metronidazole tablets 250 mg 20 pcs. Ozon LLC
44 RUR order
Pharmacy Dialogue
- Metronidazole tablets 250 mg No. 24) Update PFK JSC
83 RUR order
- Metronidazole (supp. vag. 500 mg No. 10) Avexima Siberia LLC
RUB 196 order
- Metronidazole (250 mg tablet No. 20) Welfarm LLC
68 RUR order
- Metronidazole (vial 5 mg/ml 100 ml) Elfa SPC CJSC/Elfa Laboratories
29 RUR order
- Metronidazole tablets 250 mg No. 20 Medisorb
40 rub. order
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Pharmacy24
- Metronidazole Denta gel 20 g TOV "Arpimed", Republic of Virmenia
48 UAH.order - Metronidazole 0.5% 100 ml solution for infusion
11 UAH order
- Metronidazole-Darnitsa 5 mg/ml 100 ml No. 1 PrAT solution" Pharmaceutical company "Darnitsa", Ukraine
15 UAH order
- Metronidazole 0.5% 100 ml solution for infusion
20 UAH order
- Metronidazole 0.25g No. 20 tablets PAT "Lubnipharm", Ukraine
26 UAH order
PaniPharmacy
- Metronidazole tablets Metronidazole tablets 0.25g No. 20 Ukraine, Lubnyfarm PJSC
30 UAH order
- Metronidazole infusion Metronidazole infusion solution 0.5% 100ml Ukraine, Novofarm-Biosintez LLC
13 UAH order
- Metronidazole tablets Metronidazole tablets 0.25g No. 10 Ukraine, Lubnyfarm PJSC
16 UAH order
- Metronidazole infusion Metronidazole solution inf. 0.5% 100ml Ukraine, Darnitsa ChAO
17 UAH order
- Metronidazole infusion Metronidazole solution for infusion. 0.5% 100ml Ukraine, Infusion JSC
21 UAH order
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