Metronidazole pills 250mg №40

Interaction

When used simultaneously with antacids containing aluminum hydroxide, with Kolestiramine, the absorption of Metronidazole from the gastrointestinal tract is slightly reduced. With simultaneous use of metronidazole potentiates the effect of indirect anticoagulants. With simultaneous use with disulfiram may develop acute psychosis and impaired consciousness. An increase in the concentration of Carbamazepine in the blood plasma and an increase in the risk of the development of a toxic effect with simultaneous use with metronidazole cannot be ruled out. With simultaneous use with lansoprazole, glossitis, stomatitis and / or dark coloring of the tongue are possible; with lithium carbonate - possible increase in the concentration of lithium in the blood plasma and the development of symptoms of intoxication; with prednisone - increases the excretion of metronidazole from the body due to the acceleration of its metabolism in the liver under the influence of prednisone. Perhaps a decrease in the effectiveness of metronidazole. With simultaneous use with rifampicin, the clearance of metronidazole is increased from the body; with phenytoin - perhaps a slight increase in the concentration of phenytoin in the blood plasma, described the case of the development of toxic action. With simultaneous use with phenobarbital significantly increases the excretion of metronidazole from the body, apparently due to the acceleration of its metabolism in the liver under the influence of phenobarbital.Perhaps a decrease in the effectiveness of metronidazole. With simultaneous use with Fluorouracil increases the toxic effect, but not the effectiveness of fluorouracil. A case of acute dystonia after taking a single dose of chloroquine in a patient receiving metronidazole is described. With simultaneous use with cimetidine may inhibit the metabolism of metronidazole in the liver, which can lead to a slowdown of its excretion and an increase in plasma concentration. With the simultaneous use of ethanol in patients receiving metronidazole, disulfiram-like reactions may develop.

Dosage

In amebiasis, metronidazole is administered orally to adults for 7 days, 1.5 g per day in 3 divided doses; children 30-40 mg / kg per day, also in 3 doses When giardiasis, the drug is prescribed for 5 days, adults 750-1000 mg per day, children 2-5 years old 250 mg per day, children 5-10 years - 375 mg per day, children 10-15 years old - 500 mg per day. Take after meals 2-3 times a day. With trichomoniasis in women (urethritis and vaginitis) Metronidazole is administered once a dose of 2 g or as a course of treatment for 10 days: 1 pill (250 mg) 2 times a day. In parallel with oral administration, it is prescribed in the evening with 1 vaginal suppository or a vaginal pill containing 250 mg of metronidazole. To exclude possible reinfection, it is necessary to treat simultaneously sexual partners. The course of treatment is repeated if necessary after 4-6 weeks. With trichomoniasis in men (urethritis), metronidazole is administered once a dose of 2 g or as a course of treatment for 10 days, 1 pill (250 mg) 2 times a day. For non-specific vaginitis, 500 mg of Metronidazole is used 2 times a day for 7 days.In the treatment of anaerobic infections, adults are prescribed metronidazole at 1-1.5 g per day, for children - at the rate of 20-30 mg / kg per day.

Overdosage

Symptoms: nausea, vomiting, ataxia; when taken as a radiosensitizing agent - convulsions, peripheral neuropathy. Treatment: no specific antidote, symptomatic and supportive therapy.

Side effects

Allergic reactions: urticaria, skin rash. Local reactions: burning sensation or irritation of the penis in the sexual partner, burning sensation or frequent urination, vulvitis (itching, burning pain or hyperemia of the mucous membrane in the area of ​​the external genital organs). After the abolition of the drug may develop vaginal candidiasis. Systemic reactions: possible changes in taste, including "metallic" taste, dizziness, headache, dry mouth, nausea, vomiting, loss of appetite, abdominal cramping, constipation or diarrhea, dark urine staining, leukopenia or leukocytosis.

Indications

• protozoal infections (extraintestinal amebiasis / including liver abscess), intestinal amebiasis, trichomoniasis, balantidiasis, giardiasis (giardiasis), cutaneous leishmaniasis, trichomonas vaginitis, trichomonas urethritis);
• infections caused by Bacteroides spp., incl. Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus (infections of bones and joints, infections of the central nervous system / including meningitis, brain abscess), bacterial endocarditis, pneumonia, empiema and abscess, abscess of the brain, abscess of the brain /, bacterial endocarditis, pneumonia, empiema and abscess, and abscess of the brain, abscess of the brain /, bacterial endocarditis, pneumonia, empiema and abscess of the brain, abscess of the brain
• infections caused by Bacteroides spp. (includingBacteroides fragilis), Clostridium spp., Peptococcus spp., Peptostreptococcus spp. (infections of the abdominal cavity / peritonitis, abscess of the liver), infections of the pelvic organs / endometritis, endomyometritis, abscess of the fallopian tubes and ovaries, infections of the vaginal fornix after surgical interventions /, infections of the skin and soft tissues);
• sepsis caused by Bacteroides spp. (including Bacteroides fragilis) and Clostridium spp.;
• pseudomembranous colitis (associated with the use of antibiotics);
• gastritis or duodenal ulcer associated with Helicobacter pylori;
• alcoholism;
• as a radiosensitizing agent in radiotherapy (in cases where tumor resistance is due to hypoxia in the tumor cells);
• prevention of postoperative infections (especially after operations on the colon, near-rectal area, appendectomy, gynecological interventions).

Contraindications

• leukopenia (including in history);
• hypersensitivity to the drug;
• lack of coordination of movements, organic lesions of the central nervous system (including epilepsy);
• liver failure (in the case of the appointment in high doses);
• I trimester of pregnancy;
• lactation period;
• Hypersensitivity to nitroimidazole derivatives.

With care to apply in II and III trimesters of pregnancy.

Special instructions

Ethanol is contraindicated during the treatment period (a disulfiram-like reaction may develop: spastic abdominal pain, nausea, vomiting, headache, sudden flushing). In combination with Amoxicillin is not recommended for use in patients younger than 18 years. With prolonged therapy, it is necessary to control the blood picture.In case of leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process. The appearance of ataxia, dizziness, and any other deterioration in the neurological status of patients requires discontinuation of treatment. It can immobilize treponema and lead to a false-positive Nelson test. It paints urine in a dark color. When treating Trichomonas vaginitis in women and Trichomonas urethritis in men, it is necessary to abstain from sex. Necessarily simultaneous treatment of sexual partners. The treatment does not stop during menstruation. After treatment of trichomoniasis, control tests should be carried out during three regular cycles before and after menstruation. After giardiasis treatment, if symptoms persist, after 3–4 weeks to perform 3 feces analyzes at intervals of several days (in some successfully treated patients, lactose intolerance caused by invasion may persist for several weeks or months, recalling the symptoms of giardiasis). During the period of treatment it is recommended to stop breastfeeding.

Storage conditions

In the dark place at room temperature; do not freeze. Keep out of the reach of children.