Metronidazole solution for infusions 500mg/100ml bottle №1

Mechanism of action

Anti-protozoal. It is believed that the mechanism of action is associated with a violation of the structure of the DNA of sensitive microorganisms. It is active against Trichomonas vaginalis, Gardnerella vaginalis, Giardia intestinalis, Entamoeba histolytica, Lamblia, as well as obligate anaerobes, in particular Bacteroides spp., Fusobacterium spp. and some other microorganisms. Aerobic microorganisms are resistant to Metronidazole.
In combination with Amoxicillin, it is active against Helicobacter pylori. Amoxicillin is believed to inhibit the development of metronidazole resistance by Helicobacter pylori.

Well absorbed after ingestion. Bioavailability is 80%. Distributed in tissues and body fluids. It penetrates through the placenta and the BBB. Binding to plasma proteins - 20%. Metabolized in the liver by oxidation and binding to glucuronic acid. The elimination half-life makes 8 hours. It is removed with urine (60-80%) and feces (6-15%).

Indications and usage

Trichomonas vaginitis and urethritis in women, Trichomonas urethritis in men, giardiasis, amebic dysentery, anaerobic infections caused by microorganisms susceptible to metronidazole, combination therapy for severe mixed aerobic anaerobic infections. Prevention of anaerobic infection during surgical interventions (especially on the abdominal organs, urinary tract). Chronic alcoholism.
In combination with amoxicillin: chronic gastritis in the acute phase, peptic ulcer and duodenal ulcer in the acute phase associated with Helicobacter pylori.
For external and local use: treatment of pink and acne vulgaris, bacterial vaginosis, treatment of non-healing wounds, trophic ulcers.

Inside adults and children over 12 years old - 7.5 mg / kg every 6 hours or 250-750 mg 3-4 times / day. Children under 12 years old - 5-16.7 mg / kg 3 times / day.
When on / in the introduction of adults and children over 12 years old, the initial dose is 15 mg / kg, then 7.5 mg / kg every 6 hours or, depending on the etiology of the disease, 500-750 mg every 8 hours. The duration of treatment courses and their frequency conducting is determined individually.
Intravaginal - 500 mg 1 time per night.
In combination with amoxicillin (2.25 g / day) daily dose of metronidazole - 1.5 g; the frequency of admission - 3 times / day. For patients with severe impaired renal function (CC less than 30 ml / min) and / or liver, the daily dose of metronidazole is 1 g (amoxicillin 1.5 g / day); a frequency rate of reception - 2 times / days.
Outwardly and topically applied 2 times / day, the dose is set individually.
Maximum doses: for ingestion and in / in the introduction for adults daily dose - 4 g.

Adverse reactions

Gastrointestinal: nausea, vomiting, lack of appetite, metallic taste in the mouth.
Nervous system: headache, disturbances of consciousness, irritability, sleep disturbances, dizziness, ataxia, confusion, depression, peripheral neuropathy, convulsions.
Allergic reactions: skin rash, itching, urticaria.
Hemic and lymphatic: leukopenia.
Local reactions: irritation.
Other: arthralgia, burning sensation in the urethra.

Contraindications

Organic lesions of the central nervous system, blood diseases, abnormal liver function, I trimester of pregnancy, hypersensitivity to metronidazole.

Pregnancy and breastfeeding

Metronidazole quickly penetrates the placenta. In the II and III trimesters of pregnancy, metronidazole is used only for health reasons.
Metronidazole is excreted in breast milk. If necessary, use during lactation should decide on the termination of breastfeeding.

Metronidazole is used with caution in liver diseases.
In combination with amoxicillin is not recommended for use in patients younger than 18 years. In the process of treatment requires systematic monitoring of the pattern of peripheral blood.
During treatment of Trichomonas vaginitis in women and Trichomonas urethritis in men, it is recommended to abstain from sex; simultaneous treatment of both partners is mandatory.
During the application of metronidazole, a darker staining of urine is observed.
During treatment with metronidazole, alcohol should be avoided, since acetaldehyde accumulation may occur due to impaired alcohol oxidation.As a result, reactions similar to those characteristic of disulfiram (spastic abdominal pain, nausea, vomiting, headache, sudden flushing of the face) may develop.
Metronidazole in the form of tablets, solution for injection, suppositories are included in the List of VED.

Drug Interactions

With simultaneous use of metronidazole potentiates the action of Warfarin and other indirect anticoagulants.
With simultaneous use with cimetidine, the metabolism of metronidazole in the liver can be reduced, which can lead to slower excretion and an increase in plasma plasma metronidazole concentration.
With simultaneous use with metronidazole, phenobarbital accelerates its metabolism by inducing microsomal liver enzymes, as a result of which the half-life and concentration of metronidazole in the blood plasma decrease.

Storage conditions

Store in a dark, out of reach of children at a temperature of 15 ° to 25 ° C. Shelf life - 2 years.