Expiration date: 05/2025
Active substance: Metronidazole
Pharmachologic effect
Antiprotozoal, and antimicrobial drug, a derivative of 5-nitroimidazole. The mechanism of action is in the biochemical reduction of 5-nitro intracellular transport proteins of anaerobic microorganisms and protozoa recovered nitro-5 interacts with deoxyribonucleic acid (DNA) microbial cells by inhibiting the synthesis of nucleic acids, which leads to the death of the bacteria.
Active against Trihomonas vaginalis, Entamoeba histolica, Gardnerella vaginalis, Giardia intestinalis, Lamblia spp., And obligate anaerobes Bacteroides spp. (Including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus), Fusobacterium spp., Veillonela spp., Prevotella (P. bivia, P. buccae, P. disiens), and some gram-positive bacteria ( Eubacterium spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp.). The minimum inhibitory concentration for these strains of 0.125-6.25 g / ml.
In combination with amoxicillin is active against Helicobacter pylori (Amoxicillin inhibits the development of resistance to metronidazole).
Not sensitive to metronidazole aerobic microorganisms and facultative anaerobes, but in the presence of mixed flora (aerobes and anaerobes) metronidazole acts synergistically with antibiotics effective against conventional aerobes.
Increases the sensitivity of tumors to radiation, causes sensitization on alcohol (disulfiramopodobnyh action), stimulates reparative processes.
Testimony
Protozoal infections: extra-intestinal amebiasis, including amebic liver abscess, intestinal amebiasis (amebic dysentery), trichomoniasis, giardiazis, balantidiasis, lyambliaz, cutaneous leishmaniasis, Trichomonas vaginitis, Trichomonas urethritis.
Infections caused by Bacteroides spp. (Including B.fragilis, B. distasonis, B.ovatus, B.thetaiotaomicron, B. vulgatus): infections of bones and joints, central nervous system infections (CNS), including: meningitis, brain abscess, bacterial endocarditis and pneumonia, empyema, lung abscess.
Infections caused by species of Bacteroides, including a group B.fragilis, species Clostridium: sepsis.
Pseudomembranous colitis (involving the use of antibiotics).
Gastritis or ulcer dvenedtsatiperstnoy ulcer associated with Helicobacter pylori, alcoholism.
Prevention of postoperative complications (especially interventions on the colon, okolorektalnoy area apendektomiya, gynecological operations).
Radiotherapy patients with tumors - as radiosensitizing agents in cases where the resistance of hypoxic tumor cells caused tumors.
Contraindications
Hypersensitivity, leukopenia (including in the anamnesis), organic lesions of the central nervous system (including epilepsy), hepatic failure (in the case of the appointment of large doses), pregnancy (I trimester), lactation.
With care - pregnancy (II-III trimesters), renal / hepatic failure.
Dosing and Administration
Inside, during or after eating (or drinking milk), not liquid.
Trichomoniasis - 250 mg 2 times a day for 10 days or 400 mg two times a day for 5-8 days. Women must also appoint metronidazole in the form of vaginal suppositories or tablets. If necessary, you can repeat the treatment or increase the dose to 0.75-1 g / day. Between courses should take a break of 3-4 weeks to conduct repeated control laboratory tests. An alternative regimen is the appointment of 2 g once a patient and his sexual partner. Children 2-5 years - 250 mg / day, 5-10 years - 250-375 mg / day over 10 years - 500 mg / day. The daily dose should be divided into 2 doses. The course of treatment - 10 days. Giardiasis - 500 mg 2 times a day for 5-7 days. Children under 1 year - 125 mg / day, 2-4 years - 250 mg / day, 5-8 years - 375 mg / day over 8 years - 500 mg / day (2 admission). The course of treatment - 5 days. When giardiazise - 15 mg / kg / day in 3 divided doses for 5 days. Adults: asymptomatic amoebiasis (the detection of cysts) daily dose - 1-1.5 g (500 mg 2-3 times a day) for 5-7 days. In chronic amoebiasis daily dose - 1.5 g in 3 divided doses for 5-10 days with acute amoebic dysentery - 2.25 g in 3 divided doses until the symptoms cease. When liver abscess - maximum daily dose - 2.5 g per 1 or 2-3 hours, 3-5 days, in combination with antibiotics (tetracycline) and other therapies.. Children 1-3 years old - 1/4 adult dose, 3-7 years - 1/3 of the adult dose, 7-10 years - half the adult dose. When balantidiasis - 750 mg 3 times a day for 5-6 days. In ulcerative stomatitis adults appoint 500 mg 2 times a day for 3-5 days, the children in this case, the drug is not shown. If pseudomembranous colitis - 500 mg 3-4 times a day. For eradication of Helicobacter pylori - 500 mg 3 times a day for 7 days (in a combination therapy, for example, a combination of amoxicillin with a 2.25 g / d). In the treatment of anaerobic infections maximum daily dose - 1.5-2 g In the treatment of chronic alcoholism appoint 500 mg / day for a period of up to 6 (not more) months. For the prevention of infectious complications - for 750-1500 mg / day in 3 divided doses for 3-4 days prior to surgery, or a single 1 g in the first day after surgery. After 1-2 days after the operation (when the reception is already enabled orally) - 750 mg / day for 7 days. When severe impaired renal function (creatinine clearance less than 10 ml / min) daily dose should be reduced by half.
