Metronidazole

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Generic Name of Metronidazole - Learn More

Metronidazole

Metronidazole Precaution - What You Need to Know

Before using Metronidazole, it is important for patients to consult their healthcare provider to evaluate their specific medical conditions and potential interactions. Key precautions include:
- Alcohol Consumption: Patients must avoid consuming alcohol during treatment with Metronidazole and for at least 48 hours after completing the medication. Alcohol can trigger a disulfiram-like reaction, leading to symptoms like flushing, nausea, vomiting, and headache.
- Liver Disease: Caution is necessary for individuals with liver impairment or hepatic disease, as Metronidazole is metabolized by the liver. In such cases, dosage adjustments may be required, and liver function should be closely monitored.
- Neurological Effects: Metronidazole can cause neurological side effects, including seizures, dizziness, or confusion, particularly with prolonged use or high doses. Patients with central nervous system (CNS) disorders should use this drug with caution.
- Pregnancy and Breastfeeding: Metronidazole is classified as Category B for pregnancy, meaning it is generally considered safe but should be used only if the benefits outweigh the risks. It can pass into breast milk, so caution is advised in breastfeeding women, and consultation with a healthcare provider is essential.
- Blood Disorders: Metronidazole may cause leukopenia (low white blood cell count) or thrombocytopenia (low platelet count), particularly with prolonged use. Blood counts should be monitored during treatment, especially in patients receiving long-term therapy.

Metronidazole Indication - Uses and Benefits

Metronidazole is an antibiotic and antiprotozoal medication commonly prescribed to treat a variety of infections caused by anaerobic bacteria and certain protozoa:
- Bacterial Infections: Metronidazole is effective against anaerobic bacterial infections, such as bacterial vaginosis, pelvic inflammatory disease (PID), intra-abdominal infections (e.g., diverticulitis, appendicitis), and skin infections.
- Protozoal Infections: It is used to treat protozoal infections like trichomoniasis (a sexually transmitted infection caused by *Trichomonas vaginalis*), amebiasis (caused by *Entamoeba histolytica*), and giardiasis (a parasitic infection caused by *Giardia lamblia*).
- Clostridium difficile-associated Diarrhea: Metronidazole is sometimes used as part of the treatment regimen for Clostridium difficile infections that cause severe diarrhea.
- Helicobacter pylori Eradication: It is used in combination with other antibiotics to eradicate Helicobacter pylori in patients with peptic ulcers.
- Surgical Prophylaxis: Metronidazole is used in certain surgeries, particularly those involving the abdominal area, to prevent anaerobic infections.

Metronidazole Contraindications - Important Warnings

Metronidazole should not be used in the following situations:
- Hypersensitivity: It is contraindicated in patients who have a known hypersensitivity or allergy to Metronidazole or any of its components.
- First Trimester of Pregnancy: Although generally safe during pregnancy, Metronidazole should be avoided during the first trimester unless absolutely necessary. Consultation with a healthcare provider is critical in this case.
- Alcohol Use: Alcohol consumption during Metronidazole therapy is contraindicated due to the risk of a disulfiram-like reaction.
- Severe Liver Disease: Patients with severe liver impairment should avoid Metronidazole or use it only with close monitoring and dosage adjustments.
- Central Nervous System Disorders: Patients with a history of seizures or other neurological disorders may be contraindicated for Metronidazole therapy due to its potential to cause neurological side effects.

Metronidazole Side Effects - What to Expect

Metronidazole is generally well tolerated, but it can cause side effects, some of which may be severe:
- Gastrointestinal Distress: The most common side effects include nausea, vomiting, diarrhea, and metallic taste. These effects are usually mild and resolve after completing the course of therapy.
- Neurological Effects: Rarely, Metronidazole can cause seizures, dizziness, headache, and peripheral neuropathy (tingling or numbness in the hands or feet). These symptoms are more likely with prolonged use or high doses.
- Allergic Reactions: Some patients may develop skin rashes, pruritus (itching), or more severe reactions like angioedema (swelling of the face, lips, or throat). Severe allergic reactions, though rare, should be treated promptly.
- Blood Disorders: Metronidazole may cause leukopenia (low white blood cell count), thrombocytopenia (low platelet count), and anemia. Routine blood tests are advised for long-term use.
- Hepatotoxicity: Rarely, liver toxicity can occur, presenting as yellowing of the skin or eyes (jaundice), dark urine, and elevated liver enzymes. Liver function tests should be monitored during therapy.
- Disulfiram-like Reaction: As mentioned, consuming alcohol during Metronidazole treatment may lead to a disulfiram-like reaction, causing symptoms like flushing, nausea, vomiting, and abdominal pain.

Metronidazole Pregnancy Category ID - Safety Information

2

Metronidazole Mode of Action - How It Works

Metronidazole works by disrupting the DNA of microorganisms, inhibiting their ability to replicate and causing cell death. It has the following actions:
- DNA Inhibition: Metronidazole is metabolized inside the anaerobic microorganisms (bacteria and protozoa), where it is reduced to an active form. This active form interferes with the DNA of the organisms by breaking its strands, preventing the microorganism from replicating and leading to its death.
- Selective Targeting: Metronidazole selectively targets anaerobic bacteria and protozoa, which lack oxygen-based metabolic processes. It is effective against a wide range of organisms, including those that do not respond well to other antibiotics.

Metronidazole Drug Interactions - What to Avoid

Metronidazole interacts with several medications and substances, affecting its efficacy or safety:
- Alcohol: The most significant interaction is with alcohol. A disulfiram-like reaction can occur, leading to symptoms such as flushing, nausea, vomiting, and headache. Alcohol should be completely avoided during treatment and for 48 hours after completion.
- Warfarin: Metronidazole can enhance the anticoagulant effect of warfarin, increasing the risk of bleeding. Close monitoring of international normalized ratio (INR) is recommended, and dose adjustments may be needed.
- Lithium: Metronidazole may increase the serum levels of lithium, leading to lithium toxicity. Regular monitoring of lithium levels is required.
- Cimetidine: The use of cimetidine (a histamine-2 blocker) can reduce the metabolism of Metronidazole, increasing its concentration in the blood. This can enhance the risk of adverse effects.
- Phenytoin and Phenobarbital: These medications may reduce the effectiveness of Metronidazole by increasing its metabolism. Dosage adjustments may be needed for patients on these anticonvulsants.
- Cyclosporine: Metronidazole can increase the concentration of cyclosporine, a drug used to prevent organ rejection, raising the risk of toxicity. Monitoring of cyclosporine levels is necessary.
- 5-Fluorouracil (5-FU): Metronidazole can enhance the toxicity of 5-fluorouracil, an anti-cancer medication, requiring careful monitoring and dose adjustments.

Metronidazole Adult Dose - Recommended Dosage

The usual adult dosage for Metronidazole varies depending on the condition being treated:
- For bacterial vaginosis: The standard dose is 500 mg twice daily for 7 days.
- For trichomoniasis: The typical dose is 2 g as a single dose or 500 mg twice daily for 7 days.
- For amebiasis: The dose is usually 750 mg three times daily for 7-10 days.
- For Clostridium difficile-associated diarrhea: The typical dose is 500 mg three times daily for 10-14 days.
- For Helicobacter pylori eradication: The typical dose is 500 mg three times daily in combination with other antibiotics like clarithromycin.

Metronidazole Child Dose - Dosage for Children

In children, Metronidazole dosage is based on age and weight:
- For pediatric infections like trichomoniasis or giardiasis, the

dose is usually 15 mg/kg/day divided into 2-3 doses, typically given for 5-10 days.
- For bacterial infections, the dose for children ranges from 7.5-15 mg/kg/day depending on the severity and type of infection, with the total daily dose divided into 2-3 doses.

Metronidazole Renal Dose - Dosage for Kidney Conditions

Metronidazole is primarily eliminated by the liver, but patients with renal impairment may require dose adjustments:
- For patients with severe renal impairment (CrCl <30 mL/min), a reduced dose may be necessary to avoid drug accumulation, especially in cases of prolonged treatment.
- Regular monitoring of renal function is recommended for patients receiving long-term Metronidazole therapy.