Metronidazole - Uses, Dosage, Side Effects, Drug Warnings, and Precautions.

Overview:

Metronidazole is an antibiotic widely prescribed to treat and prevent various conditions, including bacterial, viral, and other parasitic infections. It is also used to treat trichomoniasis (a sexually transmitted disease caused by a parasite, Trichomonas vaginalis). It is available as an oral tablet, extended-release tablet, immediate-release tablet, creams, gels, suppository, and IV solution for injection (to be given by a healthcare professional only). It acts by preventing the growth of the infection-causing organism. Do not consume alcohol or alcoholic products while on this medication. If any side effects are experienced while on Metronidazole, stop its use and seek emergency medical help.

Drug Group:

Metronidazole is an antiparasitic medication that belongs to the class of drugs called the nitroimidazoles, which is used to treat bacterial infections, and inflammations caused by members of the Rosaceae family amebiasis, giardiasis, trichomoniasis, and other parasitic infections. The other drugs of the nitroimidazole class include Tinidazole, Ornidazole, Nimorazole, etc.

What Is Metronidazole Used For?

Metronidazole is mainly used for parasitic infections caused by bacteria. The common infections caused by these bacteria are those in the skin, vagina, stomach, heart, lungs, and blood.

Metronidazole is also used in Crohn's disease to treat stomach ulcers caused by H.pylori. It is also employed to prevent bacterial infections post-surgery and is studied for its use in preventing the preterm birth of babies. Never take Metronidazole or any other medicine without consulting the physician first.

How Does Metronidazole Work?

Metronidazole acts by facilitating a process called passive diffusion in the cytoplasm of the bacteria. Thus, it diffuses into the bacterial body and binds with the bacteria's DNA (genetic material). This interaction will result in the inhibition of the synthesis of certain proteins which are required by the bacteria for its survival. Thus, Metronidazole directly has a destructive effect on the bacteria.

Onset of Action:

When orally administered, almost 90 to 100 % of the Metronidazole reaches the blood circulation. It reaches its maximum concentration in the blood within 20 to 180 minutes post-administration (the presence of food may delay this). Most of the drug is excreted via feces and urine, and almost 12 % is excreted in the urine in its unchanged form. In short, the onset of action for Metronidazole is between 20 to 180 minutes after oral administration. And the action may last up to 8-10 hours.

Habit-Forming:

There have been no reports of habit-forming tendency in people taking Metronidazole.

Expiry Date:

Avoid taking this medicine after it expires. The expiry date and related details will be available on the back of the pack.

What Is the Dosage of Metronidazole?

Metronidazole dosing depends upon your body weight and the type of infection. The doctor may adjust the dose as required based on the response. Ensure to inform the doctor how well the drug works and if any side effects are experienced.

Metronidazole is available in 200mg, 250 mg, 375 mg, 500 mg and 750 mg oral tablets.

How to Use Metronidazole?

1. Tablets: Swallow the medication as a whole after food.

2. Liquid: Measure the right dose using a syringe or measure and take each dose, preferably after food.

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3. Suppository: Follow the instructions given on the package.

4. Gel and Cream: Apply on the affected area and rub gently, as directed by the doctor.

Missed Dose:

Take this medication as soon as you remember if a dose is missed. If the next dose is near, skip the missed one and take the regular dosing regimen. Do not take two or double doses together.

Overdose:

In case of overdosing on the medication, contact the emergency department or the nearest poison control center immediately.

What Are the Contraindications of Metronidazole?

Do not use Mteronidazole in the following conditions:

• A known allergy to the medication or any of its components.

• Concomitant administration with alcohol or products containing Propylene Glycol.

• Administration of drug Disulfiram with or within two weeks.

• Cockayne syndrome (a genetic condition characterized by small head size, stature, and slow development).

• First trimester (1 to12 week) of pregnancy.

What Are the Drug Warnings and Precautions?

Inform the doctor if any of these conditions are present:

• Dermatologic: Topical cream use may cause skin irritation, necessitating withdrawal.

• Metabolic: Caution is advised if on current therapy with corticosteroid drugs, those on a controlled sodium diet, or those predisposed to edema (swelling of face, limbs, etc.).

• Liver Problems: Inform the doctor before starting medication, as the dose needs to be adjusted.

• Kidney Diseases: Kidney diseases can slow down the excretion of the medication. Hence, inform the doctor before administration, as dose adjustments may be required.

• Low Blood Cell Counts: Metronidazole may cause low blood counts. Hence, inform the doctor if the blood counts are low.

• Pregnancy: Pregnant women with trichomoniasis vaginalis, regardless of the pregnancy stage, should be tested and assessed by their physician before starting the medication.

What Are the Side Effects of Metronidazole?

The common side effects of Metronidazole include

• Unsteadiness or fainting.

• Burning sensations in the chest and abdomen region are accompanied by a sense of being constantly in motion.

• Difficulty sleeping.

• Weight loss.

• Pain or soreness around the eyes and cheekbones or a change in taste sensation.

• Throat discomfort due to enlarged, painful neck glands and vocal alterations that are unpleasant or strongly metallic in flavor.

• Seizures.

• Slurred speech.

Most of the mild symptoms will go away in a few days. Alert the physician immediately if symptoms worsen or persist for more extended periods. In addition, Metronidazole causes other side effects not included here, so always seek medical advice for any questions.

What Are the Interactions of Metronidazole?

Drugs usually interact with other drugs, food, or supplements. These interactions must be considered and countered carefully to avoid unwanted side effects. The common interactions are listed below:

1. With Other Drugs:

• Disulfiram: Avoid taking this medication if you have been on therapy with disulfiram within the last 14 days. Concomitant administration can lead to serious side effects that require medical attention.

• Alfuzosin.

• Amiodarone.

• Amisulpride.

• Bupropion.

• Chlorpromazine.

• Ciprofloxacin.

• Clarithromycin.

• Clomipramine.

• Desipramine.

• Donepezil.

• Erythromycin.

• Felbamate.

• Fluconazole.

• Fluorouracil.

• Fluoxetin.

• Fosphenytoin.

• Gemifloxacin.

• Haloperidol.

• Levofloxacin.

• Moxifloxacin.

• Olanzapine.

• Probucol.

• Quetiapine.

• Quinidine.

• Sotalol.

• Warfarin.

These are some of the significant interacting drugs with Metronidazole. Contact the physician or pharmacist to check for interactions before taking the drug with other drugs.

2. With Alcohol: The combination of Metronidazole with alcohol may cause nausea, vomiting, rapid heartbeat, and facial flushing. While using Metronidazole and for at least three days following the last dose, avoid alcohol completely.

3. With Diseases: Make sure to inform the doctor or pharmacist if there is a history of the following conditions:

• Liver Diseases: Dose adjustment may be required.

• Kidney Diseases: Delayed elimination of drug reported. It may require dose adjustment.

• Low Blood Counts: Taking this medication may worsen these signs

• Cockayne Syndrome: A rare genetic disorder.

What are the Common Brand Names or Trade Names of Metronidazole?

• Tablet Aldezole 200 mg.

• Tablet Flagyl 200 mg.

• Tablet Metrogyl 200 mg.

• Tablet Metron 200 mg.

• Tablet Largyl 200 mg.