Metro 400

Indications of Metro 400

• All forms of amoebiasis (intestinal and extra-intestinal disease including liver abscess and that of symptomless cyst passers)
• Trichomoniasis
• Giardiasis
• Bacterial vaginosis
• Acute ulcerative gingivitis
• Anaerobic infections including septicaemia, bacteremia, peritonitis, brain abscess, necrotising pneumonia, osteomyelitis, pelvic abscess, pelvic cellulitis, etc
• Anaerobically-infected leg ulcers and pressure sores
• Acute dental infections (e.g., acute pericoronitis and acute apical infections)
• Surgical prophylaxis (prevention of postoperative infections due to anaerobic bacteria, particularly species of bacteroides and anaerobic streptococci)
• Chronic symptomatic peptic ulcer disease (as an agent of triple therapy to eradicate H. pylori-the most important etiological factor of peptic ulcer).

Pharmaceutical Name of Metro 400

Ziska Pharmaceuticals Limited.

Pharmacology

Metronidazole is an antimicrobial drug that is primarily active against obligate anaerobic microorganisms, both bacteria and protozoa. The 5-nitro group undergoes reductive transformation to an active intermediate which then exerts an inhibitory or lethal effect against DNA. Not only is DNA synthesis inhibited but the reduced metabolite also causes a loss of the helical structure of DNA with subsequent DNA strand breakage. In vitro, metronidazole demonstrates a consistently rapid bactericidal effect with the minimal bactericidal concentration approximating very closely to the minimal inhibitory concentration.

Dosage & Administration

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 days

Trichomoniasis (Children)-

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

Intestinal amoebiasis (Adults & Children over 10 yrs)-

• 800 mg tid for 5 days

Intestinal amoebiasis (Children)-

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

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 days

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 days

Surgical prophylaxis (Children)-

• Children 1-10 yrs: 7.5 mg/kg tid

Interaction of Metro 400

Metronidazole has been found to interact with alcohol, nicoumalone and warfarin, phenytoin, phenobarbitone, fluorouracil, disulfiram, lithium and cimetidine.

Contraindications

Side Effects of Metro 400

Metallic taste, furred tongue, nausea, vomiting, diarrhoea, drowsiness, rashes and mild reversible leukopenia may be observed during treatment. It is thus a relatively safe drug although when used in large doses over several months a few cases of severe peripheral neuropathy have occurred.

Pregnancy & Lactation

When metronidazole has been administered during pregnancy, no adverse effects have been noted in the mother or foetus. However, it is recommended that metronidazole not be given during the first trimester of pregnancy and avoided during the later trimesters if possible. If use is deemed necessary, short high-dose regimen is recommended. The efficacy of metronidazole in serious anaerobic infections has to be weighed against potential, but unproved, mutagenic and teratogenic effects. From limited data, metronidazole appears to cross the placenta, as would be expected from its lipid solubility. Metronidazole penetrates well into breast milk. If exposure of the neonates to metronidazole is to be avoided, breast-feeding should be delayed until 48 hours after discontinuing metronidazole in the mother.

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

Store in a cool (below 30 0c) & dry place (below 65% RH), protected from light.

Generic of Metro 400

Metronidazole