Metronidazole

General characteristics. Structure:

Active ingredient: 250 mg of metronidazole.

Pharmacological properties:

Pharmacodynamics. Metronidazole concerns to family of nitro-5-imidazoles and possesses a broad spectrum of activity concerning anaerobic microorganisms — Peptostreptococcus, Clostridium spp., Bacteroides spp., Fusobacterium, Prevotella, Veilonella. Suppresses development of protozoa — Trichomonas vaginalis, Giardia intestinalis (Lamblia intestinalis), Entamoeba histolytica.

Pharmacokinetics. At intake metronidazole quickly and almost is completely soaked up. Meal does not influence drug absorption. The elimination half-life is equal to 8 — 10 hours, communication with blood proteins insignificant also does not exceed 10 — 20%.

Drug quickly gets into fabrics (lungs, kidneys, a liver, skin, bile, cerebrospinal fluid, saliva, semen, a vaginal secret), in breast milk and passes through a placental barrier. Metronidazole is metabolized by oxidation in a liver. Removal of drug is carried out for 40 — 70% through kidneys (in an invariable form — about 20% of the accepted dose).

Indications to use:

Mecotic vaginitis and urethritis at women, a mecotic urethritis at men, a lambliasis, amoebic dysentery; the mephitic gangrenes caused by microorganisms, sensitive to drug. A combination therapy of the heavy mixed aerobic-anaerobic infections. Prevention of a mephitic gangrene at surgical interventions (especially on abdominal organs, urinary tract). Alcoholism.

In a combination with amoxicillin: chronic gastritis in an aggravation phase, a peptic ulcer of a stomach and duodenum in an aggravation phase, associated with Helicobacter pylori.

Route of administration and doses:

At an amebiasis metronidazole is applied inside. The adult appoint within 7 days on 1,5 g a day in three steps. To children appoint in a dose 30 — 40 mg/kg a day, also in three steps, within 7 days.

Lambliasis treat within 5 days — the adult appoint 750 — 1000 mg of metronidazole a day in 3 receptions. Children of 2 — 5 years receive 250 mg a day, children of 5 — 10 years — on 375 mg a day and children of 10 — 15 years — on 500 mg a day (in 3 receptions).

At trichomoniasis at women (an urethritis and a vaginitis) metronidazole is appointed once in a dose of 2 g or in the form of course treatment within 10 days: on 1 tablet (250 mg) 2 times a day.

At trichomoniasis at men (urethritis) metronidazole is appointed once in a dose of 2 g or in the form of course treatment within 10 days on 1 tablet (250 mg) by 2 times a day.

At nonspecific vaginita 2 times a day within 7 days apply 500 mg of metronidazole.

At treatment of mephitic gangrenes by the adult and to children 12 years are more senior appoint metronidazole on 400 mg 3 times a day within 7 — 10 days. To children up to 12 years appoint 7,5 mg/kg 3 times a day.

Features of use:

The use of alcoholic beverages during treatment by metronidazole contraindicated.

It is desirable to carry out long administration of drug under control of a blood count. At a leukopenia the possibility of continuation of treatment depends on danger of infectious process.

It is necessary to stop treatment at emergence of an ataxy, dizziness, development of hallucinations, at deterioration in the neurologic status of patients.

It is necessary to take into account that metronidazole can immobilize treponemas that leads to the lozhnopozitivny test of Nelson.

Side effects:

Nausea, metal taste in a mouth, anorexia, pains in epigastriums, vomiting, diarrhea, a headache, dizziness, and also local skin reactions in the form of urticaria and an itch are in rare instances observed. Extremely seldom — spasms, confusion of consciousness, a hallucination.

At prolonged treatment can be observed by high doses a leukopenia, peripheral neuropathy which usually regress at the treatment termination.

Extremely seldom found and reversible cases of pancreatitis are described. Coloring of urine in brown and reddish color because of presence of the pigments connected with metronidazole metabolism is possible.

Interaction with other medicines:

The metronidazole combination to Disulfiramum (эспераль), anticoagulants of indirect action (warfarin) and not depolarizing muscle relaxants (векурониум), lithium drugs is undesirable.

Metronidazole at simultaneous use exponentiates effect of warfarin, a vekuronium, strengthens toxic effects 5 — a ftoruratsila, increases lithium level in a blood plasma.

Contraindications:

Hypersensitivity to imidazoles; organic lesions of TsNS, abnormal liver function, blood disease, I trimester of pregnancy.

In II and III trimesters of pregnancy apply only according to vital indications.

Use of metronidazole for nursing mothers as metronidazole gets into breast milk is not recommended (it is necessary to stop a chest vskramlivaniye).

Issue conditions:

According to the recipe

Packaging:

Tablets on 250 mg. in planimetric bezjyacheykovy packaging No. 10.