Metronidazole spectrum of action. Metronidazole tablets Belmed: instructions for use

From the article we learn to which pharmacological group "Metronidazole" belongs and which diseases can be cured with the help of this drug.

It is a medication that belongs to antiprotozoal agents with antibacterial functions. The trade name is Metronidazole. This medication is prescribed in which it is aimed at destroying the causative agent of the pathological infectious process) infectious pathologies of various localization, which are provoked by pathogens sensitive to the active element of the pharmacological agent.

Composition and form

Not everyone knows the pharmacological group "Metronidazole". This drug is available in the form of injection solutions and tablets. Solutions are poured into polyethylene bottles and 1 pc. packed in cardboard boxes. The medication contains metronidazole as the main substance.

The composition of the drug is described in detail in the instructions.

The tablets are white or white with a green-yellow tint, a flat cylindrical shape and a dividing line. The main active element of the tablets is metronidazole, the content of which in each of them is 250 mg. In addition, the composition includes additional components - talc, stearic acid, potato starch. Medicine tablets are packaged in blisters of 20 and 10 pieces. The cardboard package contains from 1 to 10 blisters and instructions for use of the drug.

What is the mechanism of action of "Metronidazole"?

Pharmacological properties

The active substance of this pharmaceutical preparation is a chemical derivative of 5-nitromidazole, which biochemically normalizes the 5-nitro group of transport intracellular proteins of anaerobic bacteria and unicellular protozoa microbes. The reduced 5-nitro group subsequently interacts with DNA, suppresses (inhibits) the synthesis of nucleic acid, which leads to the destruction of microorganisms. The medicine is highly active against a number of pathogenic microorganisms:

• Anaerobic bacteria that can only multiply and develop in the absence of oxygen: Bacteroides spp. (including Bacteroides distasonis, Bacteroides fragilis, Bacteroides ovatus, Bacteroides vulgatus, Bacteroides thetaiotaomicron,), Fusobacterium spp. and some gram-positive anaerobes (susceptible strains Peptococcus niger., Eubacterium spp., Clostridium spp., Peptostreptococcus spp.).
• Single-celled protozoan microorganisms sensitive to metronidazole - Entamoeba histolytica, Giardia intestinalis.
• When combined therapy with antibiotics, representatives of the class of semi-synthetic penicillins ("Amoxiclav"), tablets have a bactericidal effect against causative agents of gastritis and gastric ulcers, for example, Helicobacter pylori.

Aerobic bacteria (which develop only in the presence of oxygen) and optional (optional) anaerobes are not sensitive to the drug.

The mechanism of action of "Metronidazole" is quite simple. After taking this pharmacological drug inside, the main active element is quickly and almost completely absorbed into the systemic circulation from the small intestine and evenly penetrates into the tissues of the body and the structure of the central nervous system through the blood-brain barrier and breast milk during the lactation process. The process of metabolism in liver cells takes place to inactive decay products, which are excreted through the urinary system.

Indications for the use of the drug "Metronidazole"

The pharmacological agent is indicated for etiotropic therapy of infectious pathologies caused by pathogens sensitive to it:

• infectious protozoal diseases - trichomoniasis (an inflammatory process in the organs of the urogenital tract), extraintestinal amebiasis, including liver damage with the formation of abscesses in it (a limited cavity filled with pus), intestinal amebiasis (an inflammatory process affecting the large intestine);
• infectious processes provoked by anaerobic microbes, in particular, bacteroids - abscessing inflammation of the central nervous system structures, endocarditis (inflammation of the inner layer of bone cavities), meningitis (inflammation of the brain or spinal cord), pneumonia, lung abscess, sepsis;
• pathological processes caused by anaerobic peptostreptococci and clostridia - pathologies of internal organs, including liver abscess and peritonitis, damage to the pelvic organs (endometritis, abscesses of the fallopian tubes and ovaries, damage to the vaginal vault);
• in the complex therapy of peptic ulcer disease;
• elimination of the danger of infectious complications after the implementation of surgical interventions on the large intestine;
• pseudomembranous colitis, which is a specific inflammatory process affecting the colon wall, often triggered by prolonged antibiotic use.

In addition, the drug is used in the complex treatment of tumor pathologies requiring radiation.

Below we will consider the instructions for the use of "Metronidazole" in gynecology.

Application in gynecological practice

This tool is also available in the form of vaginal gels, which are widely used along with the systemic use of drugs in the field of gynecology. The drug is prescribed in the presence of the following pathological processes:

• abscess of the fallopian tubes or ovaries;
• infectious diseases of the vaginal vault and ovaries;
• trichomoniasis;
• endometritis;
• trichomonas or bacterial vaginitis;
• urethritis.

It is highly advisable to use the agent for the prevention of gynecological inflammation in the postoperative periods.

Are there any contraindications for Metronidazole?

Contraindications

Taking this drug is contraindicated in several physiological and pathological conditions, the list of which includes:

• intolerance to metronidazole or additional components of the drug in question;
• organic pathologies of the CNS structures associated with structural disorders in tissues, including epilepsy (the occurrence of tonic-clonic seizures in the form of seizures);
• liver failure, especially in the case of the appointment of high dosages of a medicine;
• I trimester of pregnancy, lactation period.

With some caution, the medication should be used in the II and III trimesters of bearing a child, as well as with an average degree of hepatic and renal failure. Contraindications "Metronidazole" must be taken into account.

Method of administration and dosage regimen

Injections of "Metronidazole" are indicated for severe stages of the infectious process, as well as the impossibility of taking the drug orally. The tablets are taken during or after meals, without chewing, with any liquid (preferably milk).

How to use according to the instructions for use "Metronidazole" in gynecology? Suppositories and vaginal gel are used once a day, usually at bedtime.

The average dose for trichomoniasis is 250 mg for 10 days or 400 mg 2 times a day for 5-7 days. In severe forms of the disease, the therapeutic course of tablets is recommended to be repeated, increasing the daily dosage to 1000 mg. The time interval between courses is 3-4 weeks.

The dosage of Metronidazole for adults and children is as follows:

• children under 1 year old are prescribed 125 mg per day;
• 2-4 years - 250 mg;
• 5-8 years old - 375 mg;
• over 8 years old and adults - 500 mg in two divided doses.

For the treatment of amebiasis, the dose of the drug can be increased to 3 g per day in three divided doses, the course of therapy is 5-7 days.

With liver abscesses - 2.5 g 2 times, 3-5 days with concomitant treatment with other antibacterial drugs (for example, tetracyclines).

In the treatment of pseudomembranous colitis, the dose of the drug is 500 mg 3 times a day. With a severe infectious process, the dosage can be increased to 2 g per day.

Treatment of gastric ulcer associated with Helicobacterpylori should include the use of this pharmacological drug in doses of 500 mg 3 times a day for one week. In the presence of liver or kidney failure, the dosage is usually reduced.

We have considered all methods of using "Metronidazole".

Side effects

Taking the drug can lead to the occurrence of some undesirable phenomena on the part of certain systems and organs:

1. Digestive system: dyspepsia, diarrhea or constipation, intestinal colic, dry mouth and "metallic" taste in the mouth, inflammatory reactions of the oral mucosa (stomatitis), tongue (glossitis) and gums (gingivitis).
2. Nervous system: cephalalgia, changes in coordination of movements, excessive excitability and irritability, depressive conditions (prolonged decrease in mood), general weakness, insomnia, decreased ability to work, hallucinations, confusion, convulsions.
3. Red bone marrow and blood: a decrease in the number of neutrophils and leukocytes.
4. Genitourinary organs: candidiasis (activation of a pathogenic infection in the body), inflammation of the bladder, (increased volumes of urine excreted), urinary incontinence, red and brown urine.
5. Allergic phenomena: skin rashes accompanied by itching, hives, nasal congestion, allergic fever (high temperature), arthralgia (joint pain),

If negative side symptoms occur, the medication can be canceled.

Drug interaction "Metronidazole"

The effect of indirect anticoagulants is enhanced by taking medication. Simultaneous reception with lithium preparations leads to an increase in the concentration of the latter in the blood and the development of intoxication. Phenytoin and phenobarbital reduce the effect of metronidazole, since the microsomal system of the liver is activated and metabolism and excretion are accelerated. Metronidazole metabolism is inhibited by cimetidine, which leads to an increase in its concentration in blood serum and the risk of side effects. Are Metronidazole tablets compatible with alcohol? The medication cannot be combined with alcohol (this will lead to antabuse syndrome). Simultaneous reception with disulfiram provokes the development of various neurological symptoms. It is not recommended to combine with non-depolarizing muscle relaxants (vecuronium bromide). Sulfonamides increase the antimicrobial effect of metronidazole.

Before taking this medication, you should carefully study the annotation to it. There is also a list of specific recommendations to look out for:

1. During the period of therapy, alcohol consumption is contraindicated, since ethanol can provoke the development of spastic abdominal pain, dyspeptic symptoms, flushing and cephalalgia.
2. It is not recommended to use the drug "Metronidazole" in combination with amoxicillin up to 18 years of age.
3. With a long therapeutic course, regular laboratory monitoring of the state of the blood should be carried out.
4. Ataxia, dizziness and other neurological disorders require discontinuation of this medication.
5. "Metronidazole" from the pharmacological group of antiprotozoal agents can provoke urine staining in a dark shade.
6. During the treatment of trichomoniasis of the urogenital tract, abstinence from sexual intercourse is recommended, as well as treatment with a sexual partner.
7. During the period of menstruation, the use of the medication is continued.
8. After the treatment of giardiasis, the symptoms of the pathological process can persist for a month, therefore, the effectiveness of the treatment process is monitored using laboratory tests.
9. When treating with this pharmacological agent, work that requires a high concentration of attention, as well as the speed of mental and motor reactions, should be abandoned.

Overdose symptoms

With a significant increase in the therapeutic recommended dosages of the drug, severe nausea, vomiting, impaired functioning of the nervous system, and epileptic seizures may develop. In such cases, symptomatic therapy is carried out.

The average cost of a pharmacological agent, depending on the form of release and dosage, may differ, and is approximately 10-130 rubles.

Analogs

The following drugs are similar for the drug "Metronidazole" in terms of the active element and therapeutic effect:

1. "Trichopol" is a medicine that is produced in tablet form and contains metronidazole as the main element of action. This pharmacological drug is prescribed to patients in the treatment of trichomoniasis, bacterial vaginosis, giardiasis, amebiasis (pathology of intestinal and other localization, including amoebic dysentery), ulcerative gingivitis, infectious periodontal pathologies, gynecological diseases provoked by anaerobic flora, sepsis, endocarditis .d.
2. "Klion" is a drug that belongs to the category of antimicrobial and antiprotozoal drugs, derivatives of 5-nitroimidazole. Its action is to restore the 5-nitro group of metronidazole by transport proteins inside the cells of the simplest microorganisms. The medicine can provoke disulfiram-like reactions. It is prescribed for a variety of infectious processes of internal organs, including the small pelvis.
3. "Metrogyl" is a medication that is an absolute analogue of the drug "Metronidazole", however, it is produced exclusively in the form of gels used intravaginally. This pharmacological agent is used in gynecological medical practice in the treatment of infectious processes of the female genital area.

Metronidazole is a drug (tablets) that belongs to the pharmacological group of antimicrobial drugs for systemic use. This medicinal product is characterized by the following application features:

• Sold by prescription only
• During pregnancy: contraindicated
• When breastfeeding: contraindicated
• In childhood: with caution
• In case of liver dysfunction: with caution
• In case of impaired renal function: with caution

Packaging

Composition

The tool is available in different forms, all forms include the active substance metronidazole.

The solution for infusion contains 5 mg of active ingredient.

Metronidazole tablets contain 0.25 g of the active ingredient.

Vaginal suppositories with metronidazole contain 0.125 g, 0.25 g or 0.5 g of the active ingredient. Also in the composition there are additional ingredients - polyethylene oxide 1500 and polyethylene oxide 400.

Metronidazole vaginal gel contains 1 g of metronidazole, as well as additional components: carbomer, propylene glycol, disodium edetate, propyl parahydroxybenzoate, sodium hydroxide, water.

Metronidazole cream contains 10 mg of metronidazole, as well as additional components: synthetic albrot, cetyl alcohol, sodium lauryl sulfate, glycerol, stearic acid, propyloxybenzoate, methyl hydroxybenzoate, water.

Metronidazole gel for external use contains 10 mg of the active ingredient, as well as additional components: ethanol, disodium EDTA salt, methyl oxybenzoate, carboxypolymethylene 940, propylene glycol, triethanolamine, propyloxybenzoate, water.

Release form

The drug is produced in several forms. A medicine in the form of a solution for infusion is a clear liquid that has a greenish tint. Fits in bottles of 100 ml, they are embedded in a cardboard box.

Vaginal suppositories are torpedo-shaped, white or yellowish in color. 10 pieces are put into a pack of cardboard.

The vaginal gel fits in a 30 g tube, the kit includes a special applicator for vaginal administration.

Also available are gel and cream for external use, these products are contained in tubes of 15 g, packed in cardboard boxes.

The medicine is produced in the form of a suspension for oral administration, vaginal tablets Metronidazole, the drug Metronidazole Lect, and others are also produced.

pharmachologic effect

Pharmacological group - antimicrobial drug, a group of antibiotics with high anaerobic activity.

When using Metronidazole for treatment, it should be borne in mind that this agent has an antimicrobial and antiprotozoal effect. Its mechanism of action is based on the biochemical reduction of the 5-nitro group of metronidazole by transport intracellular proteins of protozoa and anaerobic microorganisms.

Bacteria die due to the interaction of the reduced 5-nitro group of metronidazole with DNA cells of microorganisms and, as a consequence, inhibition of the synthesis of their nucleic acids.

The agent is active against Gardnerella vaginalis, Trichomonas vaginalis, Lamblia spp., Entamoeba histolytica, Giardia intestinalis, and the active ingredient is also active against obligate anaerobes Bacteroides spp., Prevotella, Veillonella spp., Fusobacterium spp. and in relation to individual gram-positive microbes (Clostridium spp., Eubacter spp., Peptostreptococcus spp., Peptococcus spp.).

If the drug is combined with amoxicillin, it is active against Helicobacter pylori.

At the same time, facultative anaerobes and aerobic microorganisms do not show sensitivity to metronidazole. But if mixed flora (i.e. aerobes and anaerobes) is present, it acts synergistically with antibiotics, which are effective against conventional aerobes.

The drug helps to increase the sensitivity of neoplasms to radiation, stimulates reparative processes, and promotes the manifestation of disulfiram-like reactions.

Pharmacokinetics and pharmacodynamics

Annotation on the drug indicates that after the application of the drug intravaginally, systemic absorption of the active substance occurs. Approximately 56% is absorbed.

There is a twice higher relative bioavailability of the drug used in the form of a vaginal gel, compared with vaginal tablets when using a single dose of 500 mg. The highest concentration when using a vaginal gel is achieved 6-12 hours after use.

Metronidazole binds to blood proteins by less than 20%. The substance passes through the placental barrier, the BBB, and enters all tissues in the body. Its excretion in breast milk is noted.

Metabolism takes place in the liver, excretion occurs mainly through the kidneys (approximately 60-80%, while about 20% is excreted from the body unchanged). Another 6-15% of the body is excreted through the intestines.

Indications for the use of Metronidazole

There are the following indications for the use of Metronidazole in suppositories:

• urethritis trichomonas vaginitis (for men and women);
• amoebic dysentery;
• giardiasis;
• the manifestation of anaerobic infections that develop as a result of the action of microorganisms sensitive to metronidazole;
• for the treatment of mixed severe aerobic-anaerobic infections;
• for the prevention of anaerobic infection in the case of surgery;
• with chronic alcoholism.

It is also prescribed for exacerbations of chronic gastritis; with an ulcer associated with Helicobacter pylori (combined with amoxicillin).

Ointment Metronidazole and other forms of the drug are prescribed for the following diseases and conditions:

• acne vulgaris and rosacea, bacterial vaginosis (applied externally);
• wounds and trophic ulcers that do not heal for a long time;
• with demodicosis;
• manifestation of protozoal infections (with extraintestinal amoebiasis, intestinal amebiasis, amoebic liver abscess, giardiasis, trichomoniasis, trichomonas vaginitis, giardiasis, balantidiasis, cutaneous leishmaniasis, trichomonas urethrallazitis);
• in the case of infections provoked by Bacteroides spp. (with infections of the central nervous system, with infections of the bones of the joints);
• with infections that provoke Clostridium spp., Peptococcus and Peptostreptococcus (with infections of the pelvic organs, abdominal cavity);
• pseudomembranous colitis (with the use of antibiotics);
• ulcer and gastritis, which are associated with Helicobacter pylori;
• in order to prevent complications after operations, in particular after interventions in the peri-rectal region, as well as after gynecological operations and appendectomy;
• as a radiosensitizing drug during radiation therapy for people with tumors, if resistance is associated with hypoxia in tumor cells.

More information about why the medicine helps, from which Metronidazole in tablets and in other forms, can be found from specialists.

Contraindications

The following contraindications are determined for the use of all forms of this medication:

• high sensitivity to the drug;
• lesions of the central nervous system of an organic nature (epilepsy, etc.);
• leukopenia (including a history);
• hepatic impairment (the dosage must be accurate, large doses of the drug cannot be used);
• breast-feeding.

Carefully prescribe a remedy during pregnancy, in case of renal failure. In such conditions, the dosage should only be prescribed by a physician.

Side effects of Metronidazole

In the process of taking the drug, side effects may develop:

• side effects in the functions of the gastrointestinal tract: nausea, vomiting, loss of appetite, diarrhea, constipation, manifestation of intestinal colic, dry mouth, pancreatitis, stomatitis;
• functions of the nervous system: impaired coordination, dizziness, ataxia, impaired consciousness, depression, irritability, hallucinations, high excitability, weakness, convulsions, headaches, insomnia, peripheral neuropathy;
• allergic manifestations: skin rash, urticaria, skin flushing, fever, arthralgia;
• urinary system: polyuria, candidiasis, dysuria, urinary incontinence, cystitis, red-brown urine;
• local manifestations: thrombophlebitis;
• other side effects: leukopenia, neutropenia, flattening of the T wave (manifested on the ECG).

Instructions for use of Metronidazole (Way and dosage)

The dosage and characteristics of the administration are determined by the form in which the drug is prescribed to the patient.

Metronidazole tablets, instructions for use

The medicine in tablets should be taken orally, with or after meals. No need to chew.

Patients with trichomoniasis are prescribed 250 mg twice a day, take 10 days. You can also use the drug at a dose of 400 mg twice a day for 5-8 days. Women during treatment should use additional vaginal tablets or suppositories.

A repeated course of treatment or dose escalation may be practiced. After the first course, it is important to take a break for about 1 month and conduct laboratory tests for control. As an alternative method of admission, 2 g of drugs are prescribed once to both sexual partners.

In the case of asymptomatic amebiasis (if a cyst is detected), adult patients are prescribed 500 mg of the drug 2-3 times a day, therapy lasts 5-7 days.

In the case of amebiasis in chronic form, the daily dose of 1.5 g is divided into three doses, the treatment lasts from 5 to 10 days.

In the case of acute amoebic dysentery, a dose of 2.25 g per day is prescribed, it must be divided into three doses, taken until the symptoms stop.

Patients with liver abscess are prescribed 2.5 g of the drug per day, it can be taken in one or 2-3 doses. Treatment lasts for 3-5 days, while a combination of metronidazole with tetracyclines is possible.

For ulcerative stomatitis, 500 mg of the drug is shown twice a day, take 3-5 days.

In the case of pseudomembranous colitis - 500 mg tablets 3-4 times a day.

In order to eradicate Helicobacter pylory, take 500 mg 3 times a day for seven days. Combined treatment is practiced with amoxicillin, etc.

In order to prevent complications of an infectious nature, 750-1500 mg of the drug per day is prescribed before surgery, 3-4 days before the manipulations. Also, a dose of 750 mg per day can be taken for 7 days after surgery.

For the treatment of anaerobic infection, 1.5-2 g of Metronidazole or Metronidazole LekT are prescribed per day.

Suppositories Metronidazole, instructions for use

Suppositories, vaginal gel, vaginal tablets are prescribed intravaginally in a dose of 500 mg, you need to put it once before bedtime or twice - in the morning and in the evening.

Typically, treatment lasts for 10 days. Depending on the diagnosis or course of the disease, the dosage and duration of therapy should be adjusted by the doctor. During the period of using vaginal drugs, you need to refrain from sexual intercourse.

Ointment Metronidazole, instructions for use

As a rule, topically and externally, ointment and gel should be applied twice a day, the dosage is set on an individual basis. The skin should be pre-cleaned, the layer of the product should be thin. If necessary, an occlusive dressing can be applied.

Typically, treatment lasts 3 to 9 weeks. You can alternate the use of gel and cream. The effect of the treatment is noted after 3 weeks.

Metronidazole veterinary

In veterinary medicine it is used in the form of tablets and granules. For animals, it is used internally to treat trichomoniasis of cattle, histomoniasis of ducks and geese, dysentery and balantidiosis of pigs.

Treatment in veterinary medicine is carried out according to the scheme prescribed by a specialist. For turkey poults, for chickens, the dose is calculated at the rate of 10 mg per 1 kg of poultry. You need to give the remedy three times a day for 10 days. How to give the agent to turkeys or other birds in the first days of life is determined by the veterinarian.

For the treatment of trichomoniasis in cattle, the agent is prescribed at a dose of 10 mg per 1 kg of body weight for 3-4 days. In veterinary medicine, there are certain treatment regimens that are applied after being prescribed by a specialist.

Metronidazole IV is prescribed for children after 12 years of age and for adults, the initial dose is 0.5-1 g. It is administered by drip, while the duration of the infusion is about 40 minutes.

If the drug is well tolerated, a dropper is later injected in a stream. As a rule, treatment is carried out within 1 week. If there is such a need, the duration of treatment can be extended.

Overdose

If an overdose of the drug occurs, the patient may experience ataxia, nausea, and vomiting. In case of severe overdose, peripheral neuropathy and seizures may occur.

In this case, symptomatic therapy is practiced, there is no specific antidote.

Interaction

You should know, using Metronidazole, that it is a drug that interacts in a certain way with other drugs.

The medicine enhances the effect of indirect anticoagulants on the body. As a result, the time of prothrombin formation increases.

When using this drug, ethanol intolerance is noted.

With the simultaneous administration of disulfiram, the patient may develop various neurological symptoms. It is important that at least two weeks pass between the appointment of these drugs.

Before taking Metronidazole intravenously, it should be borne in mind that such a drug should not be mixed with other medicines.

The metabolic process of metronidazole inhibits cimetidine. As a result, the concentration of metronidazole in the blood increases, and the likelihood of adverse reactions increases.

With the simultaneous use of drugs that stimulate enzymes of microsomal oxidation in the liver, the concentration of metronidazole in plasma may decrease.

When used at the same time with Li + preparations, an increase in the concentration of lithium is possible, which leads to the manifestation of signs of intoxication.

You should not practice in combination with non-depolarizing muscle relaxants.

The antimicrobial effect of metronidazole is stimulated by sulfonamides.

Terms of sale

Metronidazole can be purchased with a prescription, and a specialist will write a prescription in Latin.

Storage conditions

The medicine belongs to list B.

Shelf life

Metronidazole can be stored for 2 years

special instructions

It should be borne in mind that Metronidazole is an antibiotic that cannot be combined with ethanol. Otherwise, serious side effects can develop.

You should not combine metronidazole with amoxicillin when treating children and adolescents under 18 years of age.

If the treatment is carried out for a long time, it is important to carefully monitor the laboratory blood counts.

In patients with leukopenia, the likelihood of using the drug for treatment depends on whether there is a risk of infection.

It is important to immediately stop treatment, provided that the patient develops dizziness, ataxia, and worsens neurological status.

When taking the drug, a false positive Nelson test may be noted, which should be taken into account when using Metronidazole for thrush and other diseases.

It is important to give up sexual activity if Trichomonas vaginitis and urethritis are being treated. It is very important to treat both partners at the same time. You should not suspend treatment for the period of menstruation.

Applying the product externally, it should be noted that if it gets into the eyes, a gel or cream can provoke lacrimation. If this happens, it is important to immediately rinse your eyes with plenty of water.

When applied externally, it is important to apply the product completely to the entire area affected by the disease. The gel does not leave greasy stains on clothes and skin.

The use of this drug in horticulture and in the garden is also practiced. Metronidazole is used for plants against late blight. It is also used for onions to protect the plant from onion flies.

Many dermatologists use Metronidazole for acne. Acne gel effectively relieves inflammation and prevents scarring. In doing so, it also acts on the cause of the rash. However, the scheme of how to take any of the forms of Metronidazole for acne should be prescribed only by a doctor. Sometimes pills are also prescribed to the patient in order to eliminate the problems in the body that provoked the appearance of acne.

Before taking the drug, patients are often interested in: Metronidazole is an antibiotic or not. It should be borne in mind that this is an antibacterial agent, which is why these tablets and other forms of the drug should be prescribed only by a specialist after examination and analysis.

Analogues of Metronidazole

Analogs of Metronidazole are drugs in which a similar active substance is present in the composition. It should be borne in mind that a replacement drug can only be made after a doctor's approval.

Analogs of the drug are the drugs Deflamon, Batsimex, Metrogyl, Metron, Metronidal, Rozex, Orvagil, Cyptrogil, Trichopolum, Metronidazole-LekT, Trichosept, Metronidazole Nycomed, etc.

Metronidazole or Trichopolum - which is better?

For both drugs, the mechanism of action on the body is identical. Therefore, we can assume that Trichopolum and Metronidazole are one and the same.

Indications for use are also similar: drugs are prescribed for thrush, for other diseases of the genitourinary system. What treats one and the other medicine in gynecology is determined by a specialist, but, as a rule, these funds are interchangeable.

For children

The dosage and regimen for taking the drug for children should be prescribed only by a doctor. As a rule, children who are not yet 1 year old are prescribed 125 mg per day, children 2-4 years old should receive 250 mg of the drug per day, children 5-8 years old receive 375 mg of the drug per day.

Children after 8 years of age are prescribed 500 mg of the drug per day. What pills are prescribed for, and whether it is advisable, depends on the diagnosis. Means for external use are prescribed for children after reaching 12 years of age.

Metronidazole during pregnancy and lactation

Metronidazole during pregnancy is contraindicated in a woman in the first trimester; at a later date, the drug is prescribed according to indications and with caution, since the active substance passes through the placenta. When breastfeeding, it is impossible to practice drug treatment.

Metronidazole and alcohol

When discussing the compatibility of this medication with alcohol, it should be noted that in no case should you take alcoholic beverages during treatment. Reviews indicate that this combination significantly increases the severity of side effects.

In a person who has consumed even a small amount of alcohol during treatment with Metronidazole, blood pressure can significantly decrease. Therefore, taking the drug for thrush and other diseases, one should refrain from alcohol.

Instructions for use:

Metronidazole is an effective antibacterial and antiprotozoal synthetic drug with a broad spectrum of action.

pharmachologic effect

The active substance Metronidazole has antimicrobial and antiprotozoal effect against:

• Peptococcus niger .;
• Bacteroides spp., Including Bacteroides distasonis, Bacteroides thetaiotaomicron, Bacteroides fragilis, Fusobacterium spp., Bacteroides ovatus, Bacteroides vulgatus;
• Entamoeba histolytica;
• Clostridium spp .;
• Trichomonas vaginalis;
• Eubacterium spp .;
• Peptostreptococcus spp;

Metronidazole in combination with amoxicillin is also effective against Helicobacter pylori.

According to the instructions, Metronidazole causes sensitization to alcohol, increases the sensitivity of tumors to radiation and stimulates reparative processes.

Release form

Metronidazole is available in various dosage forms:

• Flat-cylindrical white tablets Metronidazole, 250 mg of active ingredient, 20 pieces in cans, 10 pieces in a blister;
• Suppositories Metronidazole containing 0.1 g of the drug in each suppository. 10 candles per pack;
• Yellowish transparent solution for infusion in polyethylene bottles containing 500 mg of active ingredient;
• Colorless 1% vaginal gel. 100 g of Metronidazole gel contains 1 g of active ingredient. In aluminum tubes of 30 g, complete with an applicator.

Indications for the use of Metronidazole

According to the instructions Metronidazole is used to treat:

• Infections caused by Bacteroides species - of the abdominal cavity, including peritonitis and abscess of the liver, pelvic organs, including endomyometritis, endometritis, infections of the vaginal vault after surgery, abscess of the fallopian tubes and ovaries, as well as infections of soft tissues and skin;
• Infections caused by Bacteroides and Clostridium species - sepsis;
• Gastritis or duodenal ulcers caused by Helicobacter pylori;
• Protozoal infections - intestinal amebiasis, balantidiasis, extraintestinal amebiasis, trichomoniasis, including amoebic liver abscess, trichomonas vaginitis, giardiasis, cutaneous leishmaniasis, trichomonas urethritis;
• Infections caused by Bacteroides spp., Including B. distasonis, B. fragilis, B. vulgalus B. ovatus, B. thetaiotaomicron - infections of the joints, bones, central nervous system, including brain abscess and meningitis, as well as pneumonia, bacterial endocarditis, empyema and lung abscess;
• Alcoholism;
• Pseudomembranous colitis, which is associated with the use of antibiotics.

Also, Metronidazole is used according to the instructions:

• For the prevention of postoperative complications in the peri-rectal region and colon, gynecological operations and appendectomy;
• For radiation therapy in oncology, as a radiosensitizing agent.

Suppositories Metronidazole are used for urogenital trichomoniasis and bacterial vaginitis, which cause microorganisms that are sensitive to the drug.

Contraindications

According to the instructions, Metronidazole is contraindicated for use with:

• Organic lesions of the central nervous system, including epilepsy;
• Leukopenia, incl. history;
• Hepatic failure if large doses are prescribed.

Reception of Metronidazole is contraindicated in case of hypersensitivity to the components of the drug, as well as in the first trimester of pregnancy and lactation.

Metronidazole is prescribed with caution in the second and third trimesters of pregnancy, as well as in renal or hepatic insufficiency.

Instructions for the use of Metronidazole

According to the description, Metronidazole tablets are taken after meals. The dosage and duration of treatment depends on the disease:

• With trichomoniasis - twice a day, 2 tablets of Metronidazole for 10 days. Also, during treatment, it is necessary to apply intravaginally Metronidazole suppositories, 2 suppositories twice a day - in the evening and in the morning. In this case, therapy with suppositories Metronidazole is recommended to start at the beginning of the menstrual cycle, and during this period to avoid douching. If necessary, the course of treatment for trichomoniasis can be repeated in a month. The dosage of the drug for children depends on age - at 2-5 years old, 250 mg per day is prescribed, at 5-10 years old - up to 375 mg, older - up to 500 mg per day;
• With giardiasis, Metronidazole is used for 5-7 days twice a day, 2 tablets;
• If a cyst is detected in asymptomatic amebiasis - within 5-7 days, 2 tablets of Metronidazole up to 3 times a day;
• In chronic amebiasis, the daily dose of Metronidazole is 1.5 g, which can be divided into three doses. Take within 5-10 days;
• In acute amoebic dysentery - until symptoms stop, take 2.25 g, divided into 3 doses;
• In case of liver abscess in combination with antibiotics of the tetracycline group and other methods of therapy - within 3-5 days a maximum of 2.5 g of Metronidazole;
• With balantidiasis - 750 mg 3 times a day for 5-6 days;
• For ulcerative stomatitis - 2 tablets of Metronidazole twice a day, up to 5 days;
• For the treatment of chronic alcoholism, take 2 tablets of Metronidazole per day for up to six months.

The daily dose for severe renal impairment should be halved.

If it is impossible to use Metronidazole inside, as well as in case of severe infection, the drug is used intravenously.

The usual dose is 500 mg, but not more than 4 g per day. With the onset of improvement, the transition to oral administration of the drug is carried out.

Side effects of Metronidazole

According to reviews, Metronidazole can cause the following side effects:

• Diarrhea, anorexia, constipation, nausea, glossitis, dry mouth, vomiting, metallic taste in the mouth, pancreatitis;
• Cystitis, dysuria, urinary incontinence, polyuria, candidiasis, red-brown urine staining;
• Dizziness and impaired coordination of movements, confusion, irritability, depression, hallucinations, increased irritability;
• Urticaria, fever, skin rash, flushing of the skin, nasal congestion, arthralgia;
• Neutropenia and leukopenia.

Metronidazole is described as the most common cause of insomnia, headache and weakness.

Colic, stomatitis, convulsions, ataxia and fever Metronidazole, according to reviews, causes much less often.

Care must be taken with the simultaneous use of Metronidazole with other drugs due to the possibility of developing unwanted side effects. During therapy with Metronidazole, according to reviews, it is not recommended to use alcohol because of the possibility of developing neurological symptoms and the appearance of abdominal pain of a spastic nature, vomiting and nausea.

Storage conditions

The drug is dispensed only with a doctor's prescription. The shelf life of Metronidazole tablets and suppositories is 2 years.

The product is available in different forms, all forms include an active substance metronidazole .

Solution for infusion contains 5 mg of active ingredient.

Metronidazole tablets contains 0.25 g of active ingredient.

Vaginal suppositories with metronidazolecontain 0.125 g, 0.25 g or 0.5 g of the active ingredient. Also in the composition there are additional ingredients - polyethylene oxide 1500 and polyethylene oxide 400.

Metronidazole vaginal gel contains 1 g of metronidazole, as well as additional components:, propylene glycol, disodium edetate, propyl parahydroxybenzoate, sodium hydroxide, water.

Metronidazole cream contains 10 mg of metronidazole, as well as additional components: synthetic albrot, cetyl alcohol, sodium lauryl sulfate, , stearic acid, propyloxybenzoate, methyl oxybenzoate, water.

Metronidazole gelfor external use, the composition contains 10 mg of the active ingredient, as well as additional components: ethanol, disodium EDTA salt, methyl oxybenzoate, carboxypolymethylene 940, propylene glycol, triethanolamine, propyloxybenzoate, water.

Release form

The drug is produced in several forms. A medicine in the form of a solution for infusion is a clear liquid that has a greenish tint. Fits in bottles of 100 ml, they are embedded in a cardboard box.

Vaginal suppositories are torpedo-shaped, white or yellowish in color. 10 pieces are put into a pack of cardboard.

The vaginal gel fits in a 30 g tube, the kit includes a special applicator for vaginal administration.

Also available are gel and cream for external use, these products are contained in tubes of 15 g, packed in cardboard boxes.

The medicine is produced in the form of a suspension for oral administration, vaginal tablets Metronidazole, the drug Metronidazole Lect, and others are also produced.

pharmachologic effect

Pharmacological group - antimicrobial drug, group with high anaerobic activity.

When using Metronidazole for treatment, it should be borne in mind that this agent has an antimicrobial and antiprotozoal effect. Its mechanism of action is based on the biochemical reduction of the 5-nitro group of metronidazole by transport intracellular proteins of protozoa and anaerobic microorganisms.

Bacteria die due to the interaction of the reduced 5-nitro group of metronidazole with DNA cells of microorganisms and, as a consequence, inhibition of the synthesis of their nucleic acids.

The agent is active in relation to Gardnerella vaginalis , Trichomonas vaginalis , Lamblia spp. , Entamoeba histolytica , Giardia intestinalis , also the active substance is active against obligate anaerobes Bacteroides spp. , Prevotella , Veillonella spp. , Fusobacterium spp ... and in relation to individual gram-positive microbes ( Clostridium spp. , Eubacter spp. , Peptostreptococcus spp. , Peptococcus spp. ).

If the drug is combined with , he is active in relation to Helicobacter pylori .

At the same time, facultative anaerobes and aerobic microorganisms do not show sensitivity to metronidazole. But if mixed flora (i.e. aerobes and anaerobes) is present, it acts synergistically with antibiotics, which are effective against conventional aerobes.

The drug helps to increase the sensitivity of neoplasms to radiation, stimulates reparative processes, and promotes the manifestation of disulfiram-like reactions.

Pharmacokinetics and pharmacodynamics

Annotation on the drug indicates that after the application of the drug intravaginally, systemic absorption of the active substance occurs. Approximately 56% is absorbed.

There is a twice higher relative bioavailability of the drug used in the form of a vaginal gel, compared with vaginal tablets when using a single dose of 500 mg. The highest concentration when using a vaginal gel is achieved 6-12 hours after use.

Metronidazole binds to blood proteins by less than 20%. The substance passes through the placental barrier, the BBB, and enters all tissues in the body. Its excretion in breast milk is noted.

Metabolism takes place in the liver, excretion occurs mainly through the kidneys (approximately 60-80%, while about 20% is excreted from the body unchanged). Another 6-15% of the body is excreted through the intestines.

Indications for the use of Metronidazole

There are the following indications for the use of Metronidazole in suppositories:

• and Trichomonas vaginitis (for men and women);
• amoebic dysentery;
• manifestation anaerobic infections that develop due to the action of microorganisms sensitive to metronidazole;
• for the treatment of mixed severe aerobic-anaerobic infections;
• for the prevention of anaerobic infection in the case of surgery;
• at in a chronic form.

Also prescribed for exacerbations of chronic ; with an ulcer associated with Helicobacter pylori (combined with amoxicillin).

Ointment Metronidazole and other forms of the drug are prescribed for the following diseases and conditions:

• acne vulgaris and rosacea , (applied externally);
• wounds and trophic ulcers that do not heal for a long time;
• at ;
• manifestation protozoal infections (with extraintestinal amebiasis, intestinal amebiasis, amoebic liver abscess, giardiasis, , trichomonas vaginitis, giardiasis, balantidiasis, trichomonas urethritis, with ureaplasma, with );
• in the case of infections provoked by Bacteroides spp. (with infections of the central nervous system, with infections of the bones of the joints);
• with infections that provoke Clostridium spp., Peptococcus and Peptostreptococcus (with infections of the pelvic organs, abdominal cavity);
• pseudomembranous colitis (against the background of the use of antibiotics);
• ulcer and gastritis, which are associated with Helicobacter pylori;
• in order to prevent complications after operations, in particular after interventions in the peri-rectal region, as well as after gynecological operations and appendectomy;
• as a radiosensitizing drug during radiation therapy for people with tumors, if resistance is associated with hypoxia in tumor cells.

More information about why the medicine helps, from which Metronidazole in tablets and in other forms, can be found from specialists.

Contraindications

The following contraindications are determined for the use of all forms of this medication:

• to the drug;
• lesions of the central nervous system of an organic nature ( and etc.);
• leukopenia (including history);
• hepatic impairment (the dosage must be accurate, large doses of the drug cannot be used);
• breast-feeding .

Carefully prescribe a remedy during pregnancy, in case of renal failure. In such conditions, the dosage should only be prescribed by a physician.

Side effects of Metronidazole

In the process of taking the drug, side effects may develop:

• side effects in the functions of the gastrointestinal tract : nausea, vomiting, loss of appetite, , constipation, manifestation of intestinal colic, dry mouth, , ;
• nervous system functions : impaired coordination, , ataxia, impaired consciousness, , irritability, hallucinations, high excitability, weakness, convulsions, , peripheral neuropathy;
• allergic manifestations : skin rash, , skin flushing, fever, arthralgia;
• urinary system : polyuria, , dysuria, urinary incontinence, cystitis, red-brown urine;
• local manifestations : ;
• other side effects : leukopenia, neutropenia, flattening of the T wave (manifested on the ECG).

Instructions for use of Metronidazole (Way and dosage)

The dosage and characteristics of the administration are determined by the form in which the drug is prescribed to the patient.

Metronidazole tablets, instructions for use

The medicine in tablets should be taken orally, with or after meals. No need to chew.

Sick trichomoniasis assigned to 250 mg twice a day, take 10 days. You can also use the drug at a dose of 400 mg twice a day for 5-8 days. Women during treatment should use additional vaginal tablets or suppositories.

A repeated course of treatment or dose escalation may be practiced. After the first course, it is important to take a break for about 1 month and conduct laboratory tests for control. As an alternative method of admission, 2 g of drugs are prescribed once to both sexual partners.

When asymptomatic amebiasis (if a cyst is detected), adult patients are prescribed 500 mg of the drug 2-3 times a day, therapy lasts 5-7 days.

When amoebiasis in the chronic form, the daily dose of 1.5 g is divided into three doses, the treatment lasts from 5 to 10 days.

In the case of system of amoebic dysentery a dose of 2.25 g per day is prescribed, it must be divided into three doses, taken until the symptoms stop.

Patients with liver abscess are prescribed 2.5 g of the drug per day, it can be taken in one or 2-3 doses. Treatment lasts for 3-5 days, while a combination of metronidazole with tetracyclines .

When ulcerative stomatitis shows the intake of 500 mg of the drug twice a day, take 3-5 days.

When pseudomembranous colitis - 500 mg tablets 3-4 times a day.

For the purpose of eradication Helicobacter pylory take 500 mg 3 times a day, this should be done for seven days. Combined treatment is practiced with amoxicillin, etc.

In order to prevent complications of an infectious nature, 750-1500 mg of the drug per day is prescribed before surgery, 3-4 days before the manipulations. Also, a dose of 750 mg per day can be taken for 7 days after surgery.

For treatment anaerobic infection per day, 1.5-2 g of Metronidazole or Metronidazole LekT are prescribed.

Suppositories Metronidazole, instructions for use

Suppositories, vaginal gel, vaginal tablets are prescribed intravaginally in a dose of 500 mg, you need to put it once before bedtime or twice - in the morning and in the evening.

Typically, treatment lasts for 10 days. Depending on the diagnosis or course of the disease, the dosage and duration of therapy should be adjusted by the doctor. During the period of using vaginal drugs, you need to refrain from sexual intercourse.

Ointment Metronidazole, instructions for use

As a rule, topically and externally, ointment and gel should be applied twice a day, the dosage is set on an individual basis. The skin should be pre-cleaned, the layer of the product should be thin. If necessary, an occlusive dressing can be applied.

Typically, treatment lasts 3 to 9 weeks. You can alternate the use of gel and cream. The effect of the treatment is noted after 3 weeks.

Metronidazole veterinary

In veterinary medicine it is used in the form of tablets and granules. For animals, it is used internally to treat trichomoniasis of cattle, histomoniasis of ducks and geese, dysentery and balantidiosis of pigs.

Treatment in veterinary medicine is carried out according to the scheme prescribed by a specialist. For turkey poults, for chickens, the dose is calculated at the rate of 10 mg per 1 kg of poultry. You need to give the remedy three times a day for 10 days. How to give the agent to turkeys or other birds in the first days of life is determined by the veterinarian.

For the treatment of trichomoniasis in cattle, the agent is prescribed at a dose of 10 mg per 1 kg of body weight for 3-4 days. In veterinary medicine, there are certain treatment regimens that are applied after being prescribed by a specialist.

Metronidazole IV is prescribed for children after 12 years of age and for adults, the initial dose is 0.5-1 g. It is administered by drip, while the duration of the infusion is about 40 minutes.

If the drug is well tolerated, a dropper is later injected in a stream. As a rule, treatment is carried out within 1 week. If there is such a need, the duration of treatment can be extended.

Overdose

If an overdose of the drug occurs, the patient may experience ataxia, nausea, and vomiting. In case of severe overdose, peripheral neuropathy and seizures may occur.

In this case, symptomatic therapy is practiced, there is no specific antidote.

Interaction

You should know, using Metronidazole, that it is a drug that interacts in a certain way with other drugs.

The medicine enhances the effect on the body indirect anticoagulants ... As a result, the time of prothrombin formation increases.

With the use of this drug, intolerance is noted ethanol .

While taking disulfiram the patient may develop a variety of neurological symptoms. It is important that at least two weeks pass between the appointment of these drugs.

Before taking Metronidazole intravenously, it should be borne in mind that such a drug should not be mixed with other medicines.

The metabolic process of metronidazole inhibits cimetidine ... As a result, the concentration of metronidazole in the blood increases, and the likelihood of adverse reactions increases.

With simultaneous use medicines that stimulate microsomal oxidation enzymes in the liver , the concentration of metronidazole in plasma may decrease.

When applied at the same time as li + preparations an increase in the concentration of lithium is possible, which leads to the manifestation of signs of intoxication.

You should not practice the combination with non-depolarizing muscle relaxants .

The antimicrobial effect of metronidazole stimulates sulfonamides .

Terms of sale

Metronidazole can be purchased with a prescription, and a specialist will write a prescription in Latin.

Storage conditions

The medicine belongs to list B.

Shelf life

Metronidazole can be stored for 2 years

special instructions

It should be borne in mind that Metronidazole is an antibiotic that cannot be combined with ethanol. Otherwise, serious side effects can develop.

You should not combine metronidazole with amoxicillin when treating children and adolescents under 18 years of age.

If the treatment is carried out for a long time, it is important to carefully monitor the laboratory blood counts.

In patients with leukopenia, the likelihood of using the drug for treatment depends on whether there is a risk of infection.

It is important to immediately stop treatment, provided that the patient develops dizziness, ataxia, and worsens neurological status.

When taking funds, it may be noted false positive Nelson test what should be considered when using Metronidazole for thrush and other diseases.

It is important to give up sexual activity if Trichomonas vaginitis and urethritis are being treated. It is very important to treat both partners at the same time. You should not suspend treatment for the period of menstruation.

Applying the product externally, it should be noted that if it gets into the eyes, a gel or cream can provoke lacrimation. If this happens, it is important to immediately rinse your eyes with plenty of water.

When applied externally, it is important to apply the product completely to the entire area affected by the disease. The gel does not leave greasy stains on clothes and skin.

The use of this drug in horticulture and in the garden is also practiced. Metronidazole is used for plants against late blight. It is also used for onions to protect the plant from onion flies.

Many experts in the field of dermatology apply Metronidazole for acne. Acne gel effectively relieves inflammation and prevents scarring. In doing so, it also acts on the cause of the rash. However, the scheme of how to take any of the forms of Metronidazole for acne should be prescribed only by a doctor. Sometimes the patient is also prescribed pills in order to eliminate the problems in the body that provoked the appearance of acne.

Metronidazole-LekT, Trichocept, Metronidazole Nycomed and etc.

Metronidazole or Trichopolum - which is better?

For both drugs, the mechanism of action on the body is identical. Therefore, we can assume that Trichopolum and Metronidazole are one and the same.

Indications for use are also similar: drugs are prescribed for thrush, for other diseases of the genitourinary system. What treats one and the other medicine in gynecology is determined by a specialist, but, as a rule, these funds are interchangeable.

For children

The dosage and regimen for taking the drug for children should be prescribed only by a doctor. As a rule, children who are not yet 1 year old are prescribed 125 mg per day, children 2-4 years old should receive 250 mg of the drug per day, children 5-8 years old receive 375 mg of the drug per day.

Children after 8 years of age are prescribed 500 mg of the drug per day. What pills are prescribed for, and whether it is advisable, depends on the diagnosis. Means for external use are prescribed for children after reaching 12 years of age.

Metronidazole during pregnancy and lactation

Metronidazole during pregnancy is contraindicated in a woman in the first trimester; at a later date, the drug is prescribed according to indications and with caution, since the active substance passes through the placenta. When breastfeeding, it is impossible to practice drug treatment.

Metronidazole and alcohol

When discussing the compatibility of this medication with alcohol, it should be noted that in no case should you take alcoholic beverages during treatment. Reviews indicate that this combination significantly increases the severity of side effects.

A person who has consumed even a small amount of alcohol during treatment with Metronidazole may significantly decrease ... Therefore, taking the drug for thrush and other diseases, one should refrain from alcohol.

Composition

1 tablet contains the active ingredient: metronidazole 500 mg or 250 mg.

Pharmacotherapeutic group

Antimicrobial and antiprotozoal agent

ATX code

pharmachologic effect

Antiprotozoal and antimicrobial drug, derivative of 5-nitroimidazole. The mechanism of action consists in the biochemical reduction of the 5-nitro group by intracellular transport proteins of anaerobic microorganisms and protozoa, the reduced 5-nitro group interacts with deoxyribonucleic acid (DNA) of the microbial cell, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria. Active against Trihomonas vaginalis, Entamoeba histolica, Gardnerella vaginalis, Giardia intestinalis, Lamblia spp., As well as 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 / disienism Eubacterium spp., Clotridium spp., Peptococcus spp., Peptostreptococcus spp.). The minimum inhibitory concentration for these strains is 0.125-6.25 μg / ml. In combination with amoxicillin, it is active against Helicobacter pylori (Amoxicillin inhibits the development of resistance to metronidazole). Aerobic microorganisms and facultative anaerobes are not sensitive to metronidazole, but in the presence of mixed flora (aerobes and anaerobes), Metronidazole acts synergistically with antibiotics that are effective against conventional aerobes. Increases the sensitivity of tumors to radiation, causes sensitization to alcohol (disulfiram-like action), stimulates reparative processes.

Indications for use

Protozoal infections: extraintestinal amebiasis, including amoebic liver abscess, intestinal amebiasis (amoebic dysentery), trichomoniasis, giardiasis, balantidiasis, giardiasis, 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, infections of the central nervous system (CNS), incl. meningitis, brain abscess, bacterial endocarditis, pneumonia, empyema and lung abscess. Infections caused by Bacteroides species, including the B. fragilis group, Clostridium, Peptococcus and Peptostreptococcus species: infections of the abdominal cavity (peritonitis, liver abscess), pelvic infections (endometritis, endomyometritis, abscess of the fallopian tubes and ovaries, infections of the vaginal vault after surgery) , infections of the skin and soft tissues. Infections caused by Bacteroides species, including the B. Fragilis group and Clostridium species: sepsis. Pseudomembranous colitis (associated with the use of antibiotics). Gastritis or duodenal ulcer associated with Helicobacter pylori, alcoholism. Prevention of postoperative complications (especially interventions on the colon, near-rectal region, apendectomy, gynecological operations). Radiation therapy for patients with tumors - as a radiosensitizing agent, in cases where tumor resistance is due to hypoxia in tumor cells.

Contraindications

Hypersensitivity, leukopenia (including history), organic lesions of the central nervous system (including epilepsy), liver failure (in the case of large doses), pregnancy (I trimester), lactation. With caution - pregnancy (II-III trimesters), renal / hepatic failure.

Method of administration and dosage

Inside, during or after meals, (or with milk), without chewing. With trichomoniasis - 250 mg 2 times a day for 10 days or 400 mg 2 times a day for 5-8 days. Women need to additionally prescribe metronidazole in the form of vaginal suppositories or tablets. If necessary, you can repeat the course of treatment or increase the dose to 0.75-1 g / day. Between courses, you should take a break of 3-4 weeks with repeated control laboratory tests. An alternative therapy regimen is the appointment of 2 g once to the patient and his sexual partner.

Release form

500 mg tablets. On 10, 20 tablets in a blister strip packaging from a film of polyvinyl chloride and printed aluminum foil varnished. 10, 20, 30, 40, 50, 60, 70, 80, 90 or 100 tablets in polymer jars for medicines. One jar or 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10 blisters along with instructions for use, place a cardboard package (pack).