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Metronidazole can be given via oral and parenteral routes.The drug is completely absorbed from the small intestine after oral administration, only small quantity of unabsorbed drug reaches the colon. Metronidazole is widely distributed in the body and reaches high concentration in vaginal secretion, saliva, semen and CSF. Metronidazole is metabolised in the liver through oxidation and glucuronide conjugation. The plasma t1/2 is about 8 hrs.
AMOEBIASIS: Adults: 400-800mg t.i.d. for 5-10 days. Children: 36-50mg/kg/day in 3 divided doses for 10 days.
TRICHOMONIASIS: 2g as a single dose/2 divided doses or 250mg t.i.d for 7 days. Treat sexual partner at same time.
GIARDIASIS: Adults : 2g once a daily for 3 days. Chidren: 25-35mg/kg/day in 2 divided doses for 5-10 days.
ANAEROBIC INFECTIONS: Adults: 15mg/kg infused over 1hr followed by 7.5mg/kg infused over 1hr every 6hrs. Max daily dose 4g.
PROPHYLAXIS AGAINST POST-OP INFECTIONS: 15mg/kg infused over 30-60 min, 1hr before surgery. 7.5mg/kg infused over 30-60 min 6 and 12 hrs after initial dose.
Effective against a wide range of organisms including E. histolytica, T.vaginalis, Giardia, anaerobes like Bacterioides spp, Fusobacterium spp, Clostriduim spp, Peptococcus and Streptopeptococcus, and moderately active against Gardnerella and Campylobacter.
Patients taking anticoagulants with Metronidazole may have an increased chance of bleeding. Patients taking Disulfiram with Metronidazole may have an increase in adverse effects affecting the central nervous system. When the drug is taken along with alcohol disufuram like reaction occurs. Metronidazole decrease the renal elimination of lithium.
Nausea, metallic taste, headache, dry mouth, abodominal distress, vomiting, diarrhoea, glossitis, stomatitis. Vertigo, dizziness, ataxia, thrombophlebitis and very rarely convulsions. It shows disufiram like effect. Urticaria, pruritus.
Precaution has to be taken in last two trimesters of pregnancy and in renal impairment.
Pregnancy: Use only if clearly needed.
Breast Feeding: Use with caution.
Man: May be used.