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Home / Drugs / Starting with M / Metronidazole
 
Metronidazole
 

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).
BrandsAcromona
Anagiardil
Apo-Metronidazole
Arilin
Atrivyl
Bayer 5360
Bexon
Clont
Cont
Danizol
Deflamon
Deflamon-Wirkstoff
Efloran
Elyzol
Entizol
Eumin
Flagemona
Flagesol
Flagil
Flagyl
Flagyl ER
Flagyl I.V.
Flegyl
Fossyol
Giatricol
Gineflavir
Klion
Klont
Meronidal
Metric 21
Metro Cream
Metro I.V.
Metro I.V. In Plastic Container
Metrocream
Metrogel
Metrogel-Vaginal
Metrolag
Metrolotion
Metrolyl
Metromidol
Metronidaz
Metrotop
Mexibol
Monagyl
Monasin
Nalox
Neo-Tric
Nida
Nidagel
Noritate
Novonidazol
Orvagil
Protostat
Rathimed
Sanatrichom
Satric
Takimetol
Trichazol
Trichex
Tricho Cordes
Tricho-Gynaedron
Trichocide
Trichomol
Trichopal
Trichopol
Tricocet
Tricom
Tricowas B
Trikacide
Trikamon
Trikojol
Trikozol
Trimeks
Trivazol
Vagilen
Vagimid
Vertisal
Wagitran
Zadstat
CategoriesAnti-Infective Agents
Anti-Infectives
Radiation-Sensitizing Agents
Antiprotozoals
Antiprotozoal Agents
ManufacturersGd searle llc
Able laboratories inc
Alembic ltd
Par pharmaceutical inc
Galderma laboratories lp
Altana inc
G and w laboratories inc
Sanofi aventis us llc
Taro pharmaceutical industries ltd
Tolmar inc
Graceway pharmaceuticals llc
Teva pharmaceuticals usa
Baxter healthcare corp
B braun medical inc
Abbott laboratories pharmaceutical products div
Abraxis pharmaceutical products
Elkins sinn div ah robins co inc
International medication systems ltd
Watson laboratories inc
Claris lifesciences ltd
Hospira inc
Laboratorios aplicaciones farmaceuticas sa de cv
Halsey drug co inc
Ivax pharmaceuticals inc sub teva pharmaceuticals usa
Lnk international inc
Mutual pharmaceutical co inc
Pliva inc
Sandoz inc
Superpharm corp
Teva pharmaceuticals usa inc
World gen llc
Ortho mcneil pharmaceutical inc
Savage laboratories inc div altana inc
PackagersActavis Group
Advanced Pharmaceutical Services Inc.
American Pharmaceutical Association
Ameri-Pac Inc.
Amerisource Health Services Corp.
Amneal Pharmaceuticals
Apace Packaging
Apotheca Inc.
A-S Medication Solutions LLC
Atlantic Biologicals Corporation
B. Braun Melsungen AG
Baxter International Inc.
Ben Venue Laboratories Inc.
Bryant Ranch Prepack
Cardinal Health
Carlisle Laboratories Inc.
Central Texas Community Health Centers
Claris Lifesciences Inc.
Community Action Inc. Community Health Services
Comprehensive Consultant Services Inc.
Contract Pharm
Darby Dental Supply Co. Inc.
Dept Health Central Pharmacy
Dermik Labs
DHHS Program Support Center Supply Service Center
Direct Dispensing Inc.
Dispensing Solutions
Diversified Healthcare Services Inc.
DPT Laboratories Ltd.
Dudley Corp.
E. Fougera and Co.
G & W Labs
Galderma Laboratories
GD Searle LLC
GlaxoSmithKline Inc.
Golden State Medical Supply Inc.
Graceway Pharmaceuticals
Group Health Cooperative
H and H Laboratories
H.J. Harkins Co. Inc.
Harris Pharmaceutical Inc.
Hawkins Inc.
Heartland Repack Services LLC
Hospira Inc.
Kaiser Foundation Hospital
Lake Erie Medical and Surgical Supply
Liberty Pharmaceuticals
Major Pharmaceuticals
Mckesson Corp.
Medisca Inc.
Medvantx Inc.
Mississippi State Dept Health
Murfreesboro Pharmaceutical Nursing Supply
Mutual Pharmaceutical Co.
Nord Ost Corp.
Nucare Pharmaceuticals Inc.
Nycomed Inc.
Obagi Medical Products Inc.
Palmetto Pharmaceuticals Inc.
Pangeo Pharma Quebec Inc.
Par Pharmaceuticals
Patheon Inc.
Patient First Corp.
PCA LLC
PD-Rx Pharmaceuticals Inc.
Pfizer Inc.
Pharmacia Inc.
Pharmedix
Pharmpak Inc.
Physicians Total Care Inc.
Pliva Inc.
Prasco Labs
Preferred Pharmaceuticals Inc.
Prepackage Specialists
Prepak Systems Inc.
Prescription Dispensing Service Inc.
Qualitest
Raz Co. Inc.
Rebel Distributors Corp.
Redpharm Drug
Remedy Repack
Rochester Pharmaceuticals
Sagent Pharmaceuticals
Sandhills Packaging Inc.
Sandoz
Sanofi-Aventis Inc.
SCS Pharmaceuticals
Southwood Pharmaceuticals
St Mary's Medical Park Pharmacy
Stat Rx Usa
Taro Pharmaceuticals USA
Teva Pharmaceutical Industries Ltd.
Tolmar Inc.
UDL Laboratories
Upsher Smith Laboratories
Vangard Labs Inc.
Veratex Corp.
Watson Pharmaceuticals
West-Ward Pharmaceuticals
SynonymsMethronidazole
Metronidazol
Metronidazole Benzoate
Metronidazole Hcl
Metronidazole in Plastic Container
Metronidazolo

indication

For the treatment of anaerobic infections and mixed infections, surgical prophylaxis requiring anaerobic coverage, Clostridium difficile-associated diarrhea and colitis, Helicobacter pylori infection and duodenal ulcer disease, bacterial vaginosis, Giardia lamblia gastro-enteritis, amebiasis caused by Entamoeba histolytica, acne rosacea (topical treatment), and Trichomonas infections.

pharmacology

Metronidazole, a synthetic antibacterial and antiprotozoal agent of the nitroimidazole class, is used against protozoa such as Trichomonas vaginalis, amebiasis, and giardiasis. Metronidazole is extremely effective against anaerobic bacterial infections and is also used to treat Crohn's disease, antibiotic-associated diarrhea, and rosacea.

mechanism of action

Metronidazole is a prodrug. Unionized metronidazole is selective for anaerobic bacteria due to their ability to intracellularly reduce metronidazole to its active form. This reduced metronidazole then covalently binds to DNA, disrupt its helical structure, inhibiting bacterial nucleic acid synthesis and resulting in bacterial cell death.

toxicity

LD50=500 mg/kg/day (orally in rat). Adverse effects include reversible peripheral neuropathy with prolonged therapy, CNS toxicity, disulfiram effect with alcohol, dark red-brown urine, metallic taste, nausea, epigastric distress, dizziness, vertigo and paresthesias associated with high doses, and neutropenia (reversible and mild).

biotransformation

Hepatic metabolism by hydroxylation, oxidation, and glucuronidation.

absorption

Well absorbed (at least 80%) with peak plasma concentrations achieved in 1-3 hours following oral administration of therapeutic doses of immediate release formulation.

half life

6-8 hours

drug interactions

Acenocoumarol: Metronidazole may increase the anticoagulant effect of acenocoumarol.

Amobarbital: The barbiturate, amobarbital, decreases the effect of metronidazole.

Amprenavir: Increased risk of side effects (oral solution)

Anisindione: Metronidazole may increase the anticoagulant effect of anisindione.

Aprobarbital: The barbiturate, aprobarbital, decreases the effect of metronidazole.

Busulfan: Metronidazole increases the effect/toxicity of busulfan

Butabarbital: The barbiturate, butabarbital, decreases the effect of metronidazole.

Butalbital: The barbiturate, butalbital, decreases the effect of metronidazole.

Butethal: The barbiturate, butethal, decreases the effect of metronidazole.

Carbamazepine: Metronidazole increases the effect of carbamazepine

Dicumarol: Metronidazole may increase the anticoagulant effect of dicumarol.

Dihydroquinidine barbiturate: The barbiturate, dihydroquinidine barbiturate, decreases the effect of metronidazole.

Disulfiram: Possible acute psychosis and confusion

Fluorouracil: Risk of 5-FU toxicity when associated with metronidazole

Heptabarbital: The barbiturate, heptabarbital, decreases the effect of metronidazole.

Hexobarbital: The barbiturate, hexobarbital, decreases the effect of metronidazole.

Lithium: Metronidazole increases the effect and toxicity of lithium

Methohexital: The barbiturate, methohexital, decreases the effect of metronidazole.

Methylphenobarbital: The barbiturate, methylphenobarbital, decreases the effect of metronidazole.

Pentobarbital: The barbiturate, pentobarbital, decreases the effect of metronidazole.

Phenobarbital: The barbiturate, phenobarbital, decreases the effect of metronidazole.

Primidone: The barbiturate, primidone, decreases the effect of metronidazole.

Quinidine barbiturate: The barbiturate, quinidine barbiturate, decreases the effect of metronidazole.

Secobarbital: The barbiturate, secobarbital, decreases the effect of metronidazole.

Tacrolimus: Metronidazole increases the levels/toxicity of tacrolimus

Talbutal: The barbiturate, talbutal, decreases the effect of metronidazole.

Tamsulosin: Metronidazole, a CYP3A4 inhibitor, may decrease the metabolism and clearance of Tamsulosin, a CYP3A4 substrate. Monitor for changes in therapeutic/adverse effects of Tamsulosin if Metronidazole is initiated, discontinued, or dose changed.

Tolterodine: Metronidazole may decrease the metabolism and clearance of Tolterodine. Adjust Tolterodine dose and monitor for efficacy and toxicity.

Tramadol: Metronidazole may increase Tramadol toxicity by decreasing Tramadol metabolism and clearance.

Trazodone: The CYP3A4 inhibitor, Metronidazole, may increase Trazodone efficacy/toxicity by decreasing Trazodone metabolism and clearance. Monitor for changes in Trazodone efficacy/toxicity if Metronidazole is initiated, discontinued or dose changed.

Warfarin: Metronidazole may increase the serum concentration of warfarin by decreasing its metabolism. Consider alternate therapy or a dose reduction in warfarin. Monitor for changes in prothrombin time and therapeutic and adverse effects of warfarin if metronidazole is initiated, discontinued or dose changed.