Metronidazole is a common drug with antiprotozoal and antibacterial properties. Its widespread use is explained by accessibility and a wide range of effects. But in order to understand why Metronidazole is prescribed, and under what conditions it is most effective, it is necessary to familiarize yourself with its features.
Material Content:
Release forms and composition
The active component of the drug is a substance of the same name metronidazole. Auxiliaries are also acceptable in the composition, such as stearic acid, polyethylene oxide 1500, carbomer (carbopol), sodium chloride, methoxybenzoate, polyethylene oxide 400, disodium edetate, stearic acid, purified water and others.
Form of drug release:
- 250 mg tablets;
- cream 30 g;
- vaginal suppositories of 0.1 g;
- infusion solution 0.5% in 100 ml;
- gel 30 g
Pharmacological properties and pharmacokinetics
Metronidazole belongs to the group of 5-nitroimidazole and is a synthetic analogue of the natural substance azomycin produced by Streptomyces spp.
Effective use of the drug from:
- anaerobic bacteroids (clostridia, peptococci, helicobacteria, gardnerella, fusobacteria);
- protozoa (trichomonas, amoeba, giardia, Leishmania);
- some types of gram-positive bacteria (eubacteria, bifidobacteria).
When a drug enters the body, it binds to the DNA of pathogens and blocks the formation of nucleic acids, which provokes their death.
Such strains of microorganisms as staphylococci and streptococci are immune to the action of metronidazole.
The active component is absorbed for 1 hour almost completely (80%). Moreover, its maximum concentration is achieved by intravenous administration and when taken orally, it is 10 μg / ml. Bioavailability is about 100% and does not decrease in combination with food.
Metronidazole metabolism occurs in the liver by oxidation.
As a result of this, the following metabolites are formed:
- alcohol (main) - provides about 30% antimicrobial action,
- acid (secondary) - 5% of the antibacterial properties of the active substance.
As a result, the resulting intermediate product has a targeted effect on bacteria.
The highest concentration of metronidazole is observed in saliva, liver, lungs, brain, vaginal secretion, kidneys, breast milk and seminal fluid. The active substance penetrates the placenta, and also overcomes the intercellular barrier.
From the body, the drug is excreted through the kidneys (80%) and the digestive tract (15%). After 7 hours, the concentration of metronidazole in the body is reduced to a minimum.
What is the drug Metronidazole prescribed for?
The medicine is intended for the treatment of infections caused by pathogens susceptible to its action.
Diseases to be treated with metronidazole:
- giardiasis;
- trichomoniasis;
- meningitis;
- intestinal and intestinal amoebiasis, including hepatic;
- pathologies of the oral cavity of an infectious property;
- pneumonia;
- lung or brain abscess;
- sepsis;
- balantidiosis;
- amoebiasis;
- inflammation of the ovaries, cervix;
- infectious skin lesions;
- bacterial vaginismus;
- acne;
- endometritis;
- duodenitis;
- gastritis;
- peptic ulcer;
- pseudomembranous colitis;
- cystitis;
- thrush;
- amoebiasis.
The use of metronidazole in gynecology allows you to fight with obstruction of the fallopian tubes, which provokes infertility.
It is acceptable to prescribe a drug to prevent the development of complications after a gynecological operation. In addition, its effectiveness in cancer has been proven, since the effect of the drug increases the sensitivity of tumor cells to therapeutic radiation, which improves the directed effect of radiation therapy.
The drug is recommended to be used in moderation and for the treatment of alcoholism. Studies have shown that over time, a person begins to feel an aversion to addiction and ceases to abuse.
Metronidazole does not treat colds and SARS.
Despite the prevailing opinion that the medicine is effective against worms, but this information is erroneous. Metronidazole is not able to exert a depressing effect on them. It helps only maintain the immune system and thereby acts as a prophylactic for pathologies caused by the activity of worms.
Instructions for use and dosage
It is necessary to take the drug as prescribed by the doctor. You can not interrupt treatment at the first sign of relief, as well as independently change the indicated dosage. Ignoring this rule leads to the fact that bacteria eventually become tolerant to its effects, which complicates further therapy.
The dosage of metronidazole depends on the type of disease, therefore, it is recommended to coordinate the course and regimen with the attending physician so as not to cause more serious health complications.
250 mg tablets
The drug is taken orally without damaging the integrity of the membrane after eating and or during taking it. You can drink it with milk. The dosage for children is calculated depending on the body weight of the child.
With trichomoniasis, a single course for an adult is 2 g or 8 tablets of metronidazole.They can be divided into 2 times. The same norm is acceptable for vaginitis, urethritis. Moreover, both sexual partners should undergo therapy.
With amoebiasis, the norm of the drug per day for an adult and a child over 10 years old is 750-1000 mg in 3 doses. For children aged 3 to 10 years, the required amount of the drug is calculated in the proportion of 35-50 mg per 1 kg of body weight. Take Metronidazole is necessary for a course of 5-7 days.
Giardiasis is treated for 5-10 days, and the daily dosage of the drug is 500 mg for adults and children over 10 years old, 375 mg for 6-10 years old, 250 mg for 3-6 years old.
In the case of other anaerobic infections, the drug is taken from 0.5 g to 1.5 g per day. But a more accurate dosage for each specific case is indicated by the doctor, after the diagnosis is made.
Vaginal suppositories 500 mg and 100 mg
According to the instructions for use, Metronidazole suppositories are effective against anaerobic infections in the genitals. For this, the medicine is injected directly into the vagina.
A single dosage is 2 g, or 500 mg each morning and evening for 10 consecutive days. In the case of using the drug, 100 mg should be administered 2 candles twice a day. Sexual intercourse during therapy is not recommended.
Cream for external use 1%
Metronidazole in this case allows you to treat skin infections, rosacea, burns, acne, eczema, trophic ulcers.
The cream is applied evenly to the skin. The procedure is carried out in the morning and at night before bedtime for 1-2 months, based on the form of the disease. The effectiveness of therapy becomes noticeable at 3 weeks of regular use.
Gel for external use 1%
The drug has a similar effect as the cream. The gel practically does not penetrate into the bloodstream, since the maximum amount of the active component varies within 70 ng / ml.
The product is applied to the skin in an even layer. It is important to treat all affected areas without gaps. If necessary, a dressing is applied on top. The procedure is performed twice a day. The duration of therapy is agreed with the doctor. A positive treatment result is noticeable at 2 weeks of regular use.
Gel for vaginal use 1%
The drug is effective for urogenital trichomoniasis, vaginitis of various etiologies and urethritis.
Gel Metronidazole is available in tubes weighing 30 g. Each of them is equipped with an applicator for the convenience of introducing the drug into the vagina. The procedure is carried out in the morning and in the evening. The course of treatment with Metronidazole gel is 5 days with a daily norm of 10 g, which equals 2 applicators.
Solution for infusions (injections) 0.5%
This release form is intended for intravenous administration. The main indication is the severe nature of the infection and the inability to take the medicine inside. A single norm for adults and children over 12 years old is 500 mg, but the maximum intake per day is 4 g. Continuous administration is carried out at a rate of 5 ml / min. The interval between injections is 8 hours.
For a child under 12 years of age, the amount of the drug is calculated based on body weight in the proportion of 7.5 mg / kg. The medicine is administered 3 times at the same rate. A more accurate dosage is established by the attending physician, given the criticality of the situation and the individual characteristics of the patient.
During pregnancy and lactation
The use of Metronidazole in the 1st trimester of pregnancy is unacceptable, since it penetrates the placenta into the bloodstream of the fetus.
It is permissible to use the fetus on life indicators at the 2nd and 3rd trimester, but at the same time the potential benefit should exceed the possible harm.
Lactation is a contraindication to the use of metronidazole, and if necessary, the appointment should be discontinued.
Drug interaction
Metronidazole solution cannot be used simultaneously with other drugs, as this increases the duration of prothrombin formation and activates the effect of warfarin, as well as ethyl rejection.
Interaction of metronidazole with other medicines:
| Name | Application result |
|---|---|
| Disulfiram | CNS function is disturbed, the interval between doses should be 14 days |
| Histodil, cimetidine | It disrupts the synthesis of metronidazole, which significantly increases its concentration in the body and provokes the development of side effects |
| Luminal, Phenobarbital, Diphenin, Phenytoin | Accelerates the natural excretion of the active substance from the body and thereby reduces its concentration |
| Lithium-based products | The concentration of lithium increases, which threatens intoxication |
| Sulfa drugs | Increase the antibacterial effect of metronidazole |
Combining metronidazole with non-depolarizing muscle relaxants is not recommended.
When using the cream, its activity with other types of drugs is minimal, but simultaneous use with Warfarex can increase the blood coagulation period.
Contraindications, side effects and overdose
Despite the therapeutic effect of the drug, it has certain limitations for use. Therefore, they must be studied before starting therapy.
The main contraindications of metronidazole:
- individual intolerance;
- age up to 3 years;
- lactation
- hepatic, renal failure;
- organic disorders of the central nervous system;
- pregnancy.
- leukopenia.
Self-medication and neglect of dosage standards threatens the development of side effects. You can not combine treatment with metronidazole with alcohol, as this leads to the opposite effect of therapy.
Possible consequences of an overdose:
- pancreatitis
- nausea;
- general weakness;
- depression;
- taste of metal in the mouth;
- runny nose
- dry mouth
- cystitis;
- lack of coordination;
- candidiasis;
- fever;
- leg cramps;
- decreased appetite;
- intestinal colic;
- hives;
- vomiting
- itching
- nervousness;
- thrombophlebitis.
If several side effects appear at the same time, it is necessary to stop treatment. And if you feel worse, call a doctor.
Metronidazole Analogs
Sometimes it is necessary to replace the drug with another drug, but with a similar effect.
List of Metronidazole analogues:
- Novizol;
- Ginalgin;
- Klion;
- Metrovit;
- Protozal;
- Tinidazole;
- Dasolik;
- Flagil;
- Trichopolum;
- Tagera;
- Efloran;
- Trichosept;
- Rosex
- Bacimex;
- Meratin;
- Triceside.
A distinctive feature of Metronidazole is its strong action and a high level of penetration into the blood. Therefore, do not self-medicate, as well as ignore the doctor's recommendations, as careless handling of the drug can negatively affect health.
