Flagyl 400

Indications of Flagyl 400

Flagyl 400 is indicated in the treatment of the following diseases:

• The prevention of post-operative infections due to anaerobic bacteria.
• The treatment of septicemia, bacteremia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis, and post-operative wound infections caused by anaerobes.
• In the treatment of urogenital trichomoniasis.
• Bacterial vaginosis.
• All forms of amoebiasis.
• Acute ulcerative gingivitis.
• Anaerobically infected leg ulcers and pressure sores.
• Acute dental infections due to anaerobic organisms.
• Antibiotic associated pseudomembranus colitis.

 

Pharmacology

Flagyl 400 is an antibacterial medication that belongs to the imidazole class and is used as an antiprotozoal agent. Anaerobes decrease the 5-nitro group of Metronidazole metabolically. Studies have demonstrated that the reduced form of this drug interacts with DNA and gives bactericidal action of Metronidazole.

 

Dosage & Administration of Flagyl 400

Tablet and Suspension:

Trichomoniasis (Adults & Children over 10 yrs)-

• 200 mg tid or 400 mg bid for 7 days
• 800 mg in the morning and 1-2 gm at night for 2 days
• 2 gm as a single dose for 1 day

Trichomoniasis (Children)-

• Children 7-10 yrs: 100 mg bid
• Children 3-7 yrs: 100 mg bid
• Children 1-3 yrs: 50 mg bid

Intestinal amoebiasis (Adults & Children over 10 yrs)- 

• 800 mg bid for 5 days

Intestinal amoebiasis (Children)-

• Children 7-10 yrs: 400 mg bid
• Children 3-7 yrs: 200 mg bid
• Children 1-3 yrs: 200 mg bid

Extra-intestinal & Asymptomatic amoebiasis (Adults & Children over 10 yrs)-

• 400-800 mg tid for 5-10 days

Extra-intestinal & Asymptomatic amoebiasis (Children)-

• Children 7-10 yrs: 200-400 mg tid
• Children 3-7 yrs: 100-200 mg qid
• Children 1-3 yrs: 100-200 mg tid

Giardiasis (Adults & Children over 10 yrs)-

• 2 gm once daily for 3 days

Giardiasis (Children)-

• Children 7-10 yrs: 1 gm once daily
• Children 3-7 yrs: 600-800 mg once daily
• Children 1-3 yrs: 500 mg once daily

Acute ulcerative gingivitis (Adults & Children over 10 yrs)-

• 200 mg tid for 3 days

Acute ulcerative gingivitis (Children)-

• Children 7-10 yrs: 100 mg tid
• Children 3-7 yrs: 100 mg bid
• Children 1-3 yrs: 50 mg tid

Acute dental infections (Adults & Children over 10 yrs)-

• 200 mg tid for 3-7 days

Bacterial Vaginosis (Adults & Children over 10 yrs)-

• 400 mg bid for 7 days
• 2 gm as a single dose for 1 day

Leg ulcers and pressure sores (Adults & Children over 10 yrs)-

• 400 mg tid for 7 days

Anaerobic infections (Adults & Children over 10 yrs)-

• 800 mg initially and then 400 mg tid for 7 days

Anaerobic infections (Children)-

• Children 1-10 yrs: 7.5 mg/kg tid

Surgical prophylaxis (Adults & Children over 10 yrs)-

• 400 mg tid started 24  hours before  surgery for 1 day

Surgical prophylaxis (Children)-

• Children 1-10 yrs: 7.5 mg/kg tid

Vaginal Gel:

The recommended dose is one applicator full of Metronidazole gel (approximately 5 grams containing approximately 37.5 mg of Metronidazole) intravaginally once or twice a day for 5 days. For once-a-day dosing, Metronidazole gel should be administered at bedtime.

Suppository:

Anaerobic Infections-

• Adults: 1 g every 8 hours for 3 days, then 1 g every 12 hours.
• Children: 5-10 years: 500 mg every 8 hours for 3 days, then every 12 hours, Over 10 years adult dose.

Surgical Prophylaxis-

• Adults: 1 g 2 hours before surgery; up to 3 further doses of 1 g may be given every 8 hours for high-risk procedures.
• Children: 5-10 years: 500 mg 2 hours before surgery; up to 3 further doses of 500 mg may be given every 8 hours for high-risk procedures.

IV Infusion:

Metronidazole intravenous infusion requires no dilution and should not be mixed with any other drugs prior to administration.

• Adults and children over 12 years: Infuse 500 mg 8 hourly at a rate of 5 ml/minute and a maximum of 4 g should not be exceeded during a 24-hour period. Treatment for 7 days is sufficient for most patients, but treatment can be extended, especially for cases where reinfection is likely. For surgical prophylaxis, administration shortly before surgery should be followed by 8-hourly doses for the next 24 hours.
• Children under 12 years: 7.5 mg/kg body weight/day every 8 hours at a rate of 5 ml/minute.

 

Interaction of Flagyl 400

Disulfiram: Psychotic reactions have been reported in patients who were using metronidazole and disulfiram concurrently.

Alcohol: Alcoholic beverages and drugs containing alcohol should not be consumed during therapy and for at least one day afterward because of the possibility of a disulfiram-like (Antabuse effect) reaction (flushing, vomiting, tachycardia). Oral anticoagulant therapy (warfarin type): Potentiation of the anticoagulant effect and increased hemorrhagic risk caused by decreased hepatic catabolism. In the case of co-administration, prothrombin time should be more frequently monitored and anticoagulant therapy adjusted during treatment with metronidazole.

Lithium: Plasma levels of lithium may be increased by metronidazole.

Cyclosporin: Serum cyclosporin and serum creatinine should be closely monitored when co-administration is necessary.

Phenytoin or phenobarbital: increased elimination of metronidazole resulting in reduced plasma levels.

5-Fluorouracil: Reduced clearance of 5-fluorouracil resulting in increased toxicity of 5-fluorouracil.

Busulfan: Plasma levels of busulfan may be increased by metronidazole, which may lead to severe busulfan toxicity.

 

Contraindications

Patients having a history of hypersensitivity to Metronidazole or other Nitroimidazole derivatives should avoid taking it. 

 

Side Effects of Flagyl 400

During treatment, metallic taste, nausea, vomiting, diarrhoea, sleepiness, and rashes may occur.

 

Pregnancy & Lactation

US FDA Pregnancy Category of Metronidazole is B. There are, be that as it may, no satisfactory and well-controlled considers in pregnant ladies. Since creature propagation ponders are not continuously prescient of human reaction, this medicate ought to be utilized amid pregnancy as it were in the event that clearly required. Metronidazole has been appeared to be excreted in the human drain. So, caution ought to be worked out when Metronidazole is managed by a nursing woman.

 

Precautions & Warnings

• If for compelling reasons, metronidazole must be administered longer than the usually recommended duration, it is recommended that hematological tests, especially leucocyte count should be carried out regularly and that patients should be monitored for adverse reactions such as peripheral or central neuropathy (such as paresthesia, ataxia, dizziness, convulsive seizures).
• Metronidazole should be administered with caution to patients with hepatic encephalopathy.
• Patients should be warned that metronidazole may darken urine.

 

Therapeutic Class

Amoebicides, Anti-diarrhoeal Antiprotozoal.

 

Storage Conditions

Keep it below 30°C. Protect yourself from the sun. Medicines should be kept out of the reach of youngsters. Do not use it after the expiration date.

 

Pharmaceutical Name of Flagyl 400

Sanofi Bangladesh Ltd.

 

Generic Name of Flagyl 400

Metronidazole.

 

Related Products

• Metro 400
• Filmet 400