Metronidazole

Susp: Should be taken on an empty stomach. Take at least 1 hr before meals.
Tab: Should be taken with food.

Hypersensitivity to metronidazole and other nitroimidazoles. Concomitant use with disulfiram within the last 14 days. Coadministration with alcohol or propylene glycol-containing products during or within 3 days of therapy discontinuation. Pregnancy during the 1st trimester in the treatment of trichomoniasis.

Patient with active or chronic severe peripheral and CNS disease; current or history of seizure disorder, blood dyscrasias; Cockayne syndrome, hepatic encephalopathy. Renal and hepatic impairment. Neonates and children. Pregnancy and lactation. Patient Counselling This drug may cause drowsiness, confusion, dizziness, vertigo, hallucinations, convulsions, or transient visual disorders, if affected, do not drive or operate machinery. As an alternative option, nursing mothers may stop breastfeeding during and for 12-24 hours after stopping treatment. Topical: Avoid exposure of treated areas to ultraviolet or strong sunlight during treatment. Monitoring Parameters Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Monitor CBC with differential (baseline, during, and after repeated or prolonged treatment); LFTs before treatment initiation, during, and after treatment until liver function is within the normal range or until baseline values are reached (in patients with Cockayne syndrome). Assess for neurologic symptoms.

Significant: Bacterial or fungal superinfection (e.g. Clostridium difficile-associated diarrhoea and pseudomembranous colitis); gonococcal infection (after treatment of Trichomonas vaginalis); leucopenia; central, peripheral, or optic neuropathy; aseptic meningitis, ataxia, neurocerebellar toxicity, encephalopathy, seizures, confusion, dysarthria, vertigo; Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalised exanthematous pustulosis. Candida vaginitis (vaginal gel). Blood and lymphatic system disorders: Aplastic anaemia. Ear and labyrinth disorders: Hearing loss or impairment (including sensorineural), tinnitus. Gastrointestinal disorders: Nausea, vomiting, diarrhoea, taste disorders, furred tongue, glossitis, stomatitis, eructation with bitter taste, metallic taste, epigastric pain, dysphagia. General disorders and administration site conditions: Fever; vein irritations including thrombophlebitis (IV). Immune system disorders: Angioedema. Metabolism and nutrition disorders: Anorexia. Nervous system disorders: Headache. Psychiatric disorders: Depression, insomnia. Skin and subcutaneous tissue disorders: Erythema multiforme, urticaria. Pruritus, dry skin, burning or stinging of the skin, skin irritation, worsening of rosacea (topical).
Potentially Fatal: Severe hepatotoxicity/acute hepatic failure (patients with Cockayne syndrome).

Psychotic reactions with disulfiram. May potentiate the anticoagulant effects of warfarin. May retain lithium and increase the risk of renal damage. Decreased serum concentration with phenobarbital, phenytoin, or primidone. Increased serum concentration with cimetidine. May increase serum concentration and risk of toxicity of 5-fluorouracil. May increase the serum concentration of ciclosporin and busulfan. Increased risk of QT prolongation and torsades de pointes with amiodarone.

Antiamoebics / Other Antibiotics / Preparations for Vaginal Conditions / Topical Antibiotics

A01AB17 - metronidazole ; Belongs to the class of local antiinfective and antiseptic preparations. Used in the treatment of diseases of the mouth.
P01AB01 - metronidazole ; Belongs to the class of nitroimidazole derivatives antiprotozoals. Used in the treatment amoebiasis and other protozoal diseases.
J01XD01 - metronidazole ; Belongs to the class of imidazole derivative antibacterials. Used in the systemic treatment of infections.
D06BX01 - metronidazole ; Belongs to the class of other topical chemotherapeutics used in the treatment of dermatological diseases.
G01AF01 - metronidazole ; Belongs to the class of imidazole derivative antiinfectives. Used in the treatment of gynecological infections.