Levomet
Generic Name
Metronidazole
Manufacturer
ACI Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| levomet 250 mg tablet | ৳ 8.00 | N/A |
Description
Overview of the medicine
Metronidazole is an antibiotic that fights bacteria in the body. It is used to treat bacterial infections of the vagina, stomach, liver, skin, joints, brain, and respiratory tract. It is also used to treat certain parasitic infections.
Uses & Indications
Dosage
Adults
For bacterial infections (e.g., anaerobic infections): 500 mg orally every 8 hours. For trichomoniasis: Single dose of 2g or 250mg three times daily for 7 days. For amoebiasis: 750mg three times daily for 5-10 days.
Elderly
Dosage adjustments may not be necessary unless there is severe hepatic impairment.
Renal_impairment
No dosage adjustment usually needed for patients on hemodialysis as it's largely removed during dialysis; for severe impairment not on dialysis, monitor closely.
How to Take
Oral administration. Can be taken with food to reduce stomach upset. Swallow whole, do not crush or chew.
Mechanism of Action
Metronidazole enters bacterial and parasitic cells and is reduced by anaerobic electron transport proteins to reactive intermediates. These intermediates then interact with DNA, causing strand breakage and inhibition of nucleic acid synthesis, leading to cell death.
Pharmacokinetics
Onset
Effects can be seen within hours to days depending on the infection.
Excretion
Primarily renal (60-80% as metabolites and unchanged drug); fecal excretion (6-15%).
Half life
Approximately 8 hours (range 6-12 hours).
Absorption
Rapid and extensive oral absorption (over 80%). Peak plasma concentrations occur within 1-2 hours.
Metabolism
Primarily hepatic (liver) by oxidation with hydroxylation and glucuronidation, forming active metabolites.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or other nitroimidazole derivatives.
- First trimester of pregnancy (relative contraindication for trichomoniasis).
- Alcohol consumption during and for at least 3 days after treatment due to disulfiram-like reaction.
Drug Interactions
Alcohol
Disulfiram-like reaction (nausea, vomiting, flushing, tachycardia).
Lithium
Increases serum lithium levels, potentially leading to toxicity.
Warfarin
Enhances anticoagulant effect, increasing risk of bleeding.
Cimetidine
May prolong metronidazole half-life.
Disulfiram
Psychotic reactions.
Phenobarbital/Phenytoin
May decrease metronidazole efficacy.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms may include nausea, vomiting, ataxia, and mild disorientation. Treatment is supportive and symptomatic; no specific antidote.
Pregnancy & Lactation
Pregnancy: Category B. Not recommended during the first trimester. Use in later trimesters only if clearly needed. Lactation: Excreted into breast milk. Advise temporary discontinuation of breastfeeding or express and discard milk during treatment and for 12-24 hours after the last dose.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or other nitroimidazole derivatives.
- First trimester of pregnancy (relative contraindication for trichomoniasis).
- Alcohol consumption during and for at least 3 days after treatment due to disulfiram-like reaction.
Drug Interactions
Alcohol
Disulfiram-like reaction (nausea, vomiting, flushing, tachycardia).
Lithium
Increases serum lithium levels, potentially leading to toxicity.
Warfarin
Enhances anticoagulant effect, increasing risk of bleeding.
Cimetidine
May prolong metronidazole half-life.
Disulfiram
Psychotic reactions.
Phenobarbital/Phenytoin
May decrease metronidazole efficacy.
Storage
Store below 30°C in a dry place, away from light. Keep out of reach of children.
Overdose
Symptoms may include nausea, vomiting, ataxia, and mild disorientation. Treatment is supportive and symptomatic; no specific antidote.
Pregnancy & Lactation
Pregnancy: Category B. Not recommended during the first trimester. Use in later trimesters only if clearly needed. Lactation: Excreted into breast milk. Advise temporary discontinuation of breastfeeding or express and discard milk during treatment and for 12-24 hours after the last dose.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24-36 months
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials since its discovery, demonstrating efficacy in various bacterial and parasitic infections.
Lab Monitoring
- Monitor CBC (complete blood count) for prolonged use.
- Liver function tests (LFTs) in patients with hepatic impairment.
Doctor Notes
- Counsel patients about strict alcohol avoidance.
- Be aware of potential drug interactions, especially with warfarin and lithium.
- Monitor for neurological symptoms.
Patient Guidelines
- Complete the full course of treatment, even if symptoms improve.
- Avoid alcohol during and for at least 3 days after treatment.
- Inform your doctor if you experience severe side effects or neurological symptoms.
- Take with food to minimize stomach upset.
Missed Dose Advice
If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and continue with the regular schedule. Do not double the dose.
Driving Precautions
May cause dizziness or lightheadedness; avoid driving or operating machinery if affected.
Lifestyle Advice
- Practice good hygiene to prevent reinfection, especially for STIs.
- Maintain adequate hydration.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.