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Metronidazole

Aka: Metronidazole, Flagyl

I. Indications

  1. Protozoal Infection
    1. Trichomoniasis
    2. Amebiasis
    3. Giardiasis
  2. Anaerobic Bacteria infection
    1. Bacteroides fragilis
    2. Clostridium difficile
    3. Bacterial Vaginosis

II. Precautions

  1. Carcinogenic in mice and rats (FDA Black box warning)

III. Pharmacokinetics

  1. Half-life: 8 hours
  2. Renal excretion

IV. Dosing: Children

  1. Dose
    1. Load: Metronidazole 15 mg/kg IV
    2. Maintenance: Metronidazole 7.5 mg/kg/dose
  2. Interval
    1. First week of life: q12 hours
    2. After first week of life: q 8hours

V. Dosing: Adult

  1. Intravenous
    1. Loading dose: 15 mg/kg up to 1000 mg IV
    2. Maintenance dose: 7.5 mg/kg up to 500 mg IV q6-8 hour
  2. Oral dose: 250 to 750 mg PO tid

VI. Adverse Effects

  1. Antabuse like effect (Never use with Alcohol)
  2. Gastrointestinal intolerance
  3. Neurotoxicity (stop immediately if these occur)
    1. Seizures
    2. Encephalopathy
    3. Cerebellar dysfunction
    4. Peripheral Neuropathy (e.g. distal Paresthesias)

VII. Pregnancy

  1. Class B Medication (Avoid in first trimester pregnancy)

VIII. Directions

  1. Taking with food decreases gastric irritation

IX. References

  1. Burtin (1995) Am J Obstet Gynecol 172:525-9 [PubMed]

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Cost: Medications

metronidazole (on 10/21/2015 at Medicaid.Gov Survey of pharmacy drug pricing)
METRONIDAZOLE 0.75% CREAM Generic $2.20 per gram
METRONIDAZOLE 0.75% LOTION Generic $2.67 per ml
METRONIDAZOLE 250 MG TABLET Generic $0.25 each
METRONIDAZOLE 500 MG TABLET Generic $0.44 each
METRONIDAZOLE TOPICAL 0.75% GL Generic $2.10 per gram
METRONIDAZOLE TOPICAL 1% GEL Generic $3.64 per gram
METRONIDAZOLE VAGINAL 0.75% GL Generic $1.08 per gram
flagyl (on 6/1/2015 at Medicaid.Gov Survey of pharmacy drug pricing)
FLAGYL ER 750 MG TABLET $18.39 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Ontology: Metronidazole (C0025872)

Definition (CHV) a drug that treats bacterial and fungal infection
Definition (CHV) a drug that treats bacterial and fungal infection
Definition (NCI) A synthetic nitroimidazole derivative with antiprotozoal and antibacterial activities. Although its mechanism of action is not fully elucidated, un-ionized metronidazole is readily taken up by obligate anaerobic organisms and is subsequently reduced by low-redox potential electron-transport proteins to an active, intermediate product. Reduced metronidazole causes DNA strand breaks, thereby inhibiting DNA synthesis and bacterial cell growth.
Definition (NCI_NCI-GLOSS) A drug that is used to treat infection and is being studied in the treatment of cancer. It is a type of antibacterial, antiprotozoal, and anthelmintic.
Definition (MSH) A nitroimidazole used to treat AMEBIASIS; VAGINITIS; TRICHOMONAS INFECTIONS; GIARDIASIS; ANAEROBIC BACTERIA; and TREPONEMAL INFECTIONS. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed).
Definition (CSP) antiprotozoal and antibacterial effective against obligate anaerobes.
Definition (PDQ) A synthetic nitroimidazole derivative with antiprotozoal and antibacterial activities. Although its mechanism of action is not fully elucidated, un-ionized metronidazole is readily taken up by obligate anaerobic organisms and is subsequently reduced by low-redox potential electron-transport proteins to an active, intermediate product. Reduced metronidazole causes DNA strand breaks, thereby inhibiting DNA synthesis and bacterial cell growth. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39503&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39503&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C651" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D008795
SnomedCT 326285001, 332974000, 1222004, 372602008
LNC LP14997-8, MTHU002300
English 1H-Imidazole-1-ethanol, 2-methyl-5-nitro-, Metronidazole [skin], 2 Methyl 5 nitroimidazole 1 ethanol, 2-Methyl-5-nitroimidazole-1-ethanol, Metronidazole, metronidazole, Metronidazole [vaginal], METRONIDAZOLE, metronidazole (medication), Metronidazole [Chemical/Ingredient], metronidazole vaginal, metroNIDAZOLE, MetroNIDAZOLE, Metronidazole [vaginal] (product), Metronidazole [skin] (product), Metronidazole product, Metronidazole (product), Metronidazole (substance), METRO, Metronidazole [skin] (substance), Metronidazole [vaginal] (substance)
Swedish Metronidazol
Czech metronidazol
Finnish Metronidatsoli
Russian METRONIDAZOL, МЕТРО�ИД�ЗОЛ
Japanese フラジール, フラギル, 安�香酸メトロニダゾール, クロント, ダニゾール, メトロニダゾールホスファート, 塩酸メトロニダゾール, メトロニダゾール塩酸塩, メトロニダゾールベンゾアート, アスゾール, メトロニダゾール, メトロニダゾールリン酸, トリカゾール, ギ�フラビル, トリ�ゾール
Polish Metronidazol
Norwegian Metronidazol
Croatian Metronidazol
Spanish metronidazol [uso vaginal], metronidazol (uso dermatológico) (producto), metronidazol [uso vaginal] (producto), metronidazol (uso dermatológico), metronidazol (piel) (producto), metronidazol (piel), metronidazol (producto), metronidazol (sustancia), metronidazol, Metronidazol
French Métronidazole
German Metronidazol
Italian Metronidazolo
Portuguese Metronidazol
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Flagyl (C0699678)

Definition (CHV) brand name of an antibiotic
Definition (CHV) brand name of an antibiotic
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D008795
English flagyl, flagyl [brand name], Flagyl
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Pharmacology

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