Melagyl
Generic Name
Metronidazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| melagyl 400 mg tablet | ৳ 1.02 | N/A |
Description
Overview of the medicine
Melagyl 400 mg tablet contains Metronidazole, an antibiotic and antiprotozoal medication. It is used to treat a wide range of infections caused by anaerobic bacteria and certain parasites.
Uses & Indications
Dosage
Adults
Amoebiasis: 400-800 mg three times daily for 5-10 days. Giardiasis: 250 mg three times daily for 5-7 days or 2 g once daily for 3 days. Trichomoniasis: 200 mg three times daily for 7 days or 2 g as a single dose. Anaerobic infections: 400 mg three times daily.
Elderly
No specific dose adjustment is usually required, but caution is advised in patients with impaired liver function.
Renal_impairment
In severe renal impairment (CrCl <10 mL/min), the dose may need to be reduced by 50% or the dosing interval extended.
How to Take
Take the tablet orally with food or milk to minimize gastrointestinal upset. Swallow whole with water, do not chew or crush.
Mechanism of Action
Metronidazole is a nitroimidazole derivative. It enters bacterial and protozoal cells and is reduced to active metabolites by intracellular electron transport proteins. These metabolites bind to and damage DNA, inhibiting nucleic acid synthesis, which leads to cell death.
Pharmacokinetics
Onset
Therapeutic effects usually seen within 24-48 hours.
Excretion
Mainly excreted in urine (60-80%) as unchanged drug and metabolites; a small amount is excreted in feces.
Half life
Approximately 8 hours (range 6-12 hours).
Absorption
Well absorbed orally (over 80%) after administration. Peak plasma concentrations are achieved within 1-2 hours.
Metabolism
Extensively metabolized in the liver by hydroxylation, oxidation, and glucuronidation. Main metabolite (2-hydroxymethyl metronidazole) also has some antibacterial activity.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or other nitroimidazole derivatives.
- First trimester of pregnancy.
Drug Interactions
Alcohol
Disulfiram-like reaction (flushing, palpitations, nausea, vomiting, headache) may occur. Avoid alcohol during and for at least 48 hours after treatment.
Lithium
May increase serum lithium levels, leading to lithium toxicity.
Cimetidine
May prolong metronidazole half-life and decrease plasma clearance.
Phenobarbital/Phenytoin
May reduce metronidazole plasma levels by inducing hepatic enzyme activity.
Warfarin and other oral anticoagulants
Potentiates anticoagulant effect, leading to increased risk of bleeding. Monitor INR/PT.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, ataxia, and mild disorientation. There is no specific antidote. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Avoid during the first trimester. Use with caution in later trimesters only if clearly needed. Metronidazole is excreted in breast milk; a temporary discontinuation of breastfeeding may be advised during treatment or pumping and discarding milk for 12-24 hours after a single high dose.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or other nitroimidazole derivatives.
- First trimester of pregnancy.
Drug Interactions
Alcohol
Disulfiram-like reaction (flushing, palpitations, nausea, vomiting, headache) may occur. Avoid alcohol during and for at least 48 hours after treatment.
Lithium
May increase serum lithium levels, leading to lithium toxicity.
Cimetidine
May prolong metronidazole half-life and decrease plasma clearance.
Phenobarbital/Phenytoin
May reduce metronidazole plasma levels by inducing hepatic enzyme activity.
Warfarin and other oral anticoagulants
Potentiates anticoagulant effect, leading to increased risk of bleeding. Monitor INR/PT.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, ataxia, and mild disorientation. There is no specific antidote. Treatment is symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Avoid during the first trimester. Use with caution in later trimesters only if clearly needed. Metronidazole is excreted in breast milk; a temporary discontinuation of breastfeeding may be advised during treatment or pumping and discarding milk for 12-24 hours after a single high dose.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date
Availability
Available in pharmacies and hospitals nationwide
Approval Status
Approved by DGDA/FDA (well-established drug)
Patent Status
Off-patent (Generic available)
WHO Essential Medicine
YesClinical Trials
Metronidazole has been extensively studied since its introduction, with numerous clinical trials establishing its efficacy and safety profile for various indications. Ongoing research explores its role in emerging antimicrobial resistance and new therapeutic applications.
Lab Monitoring
- Liver function tests (for prolonged high-dose therapy)
- Complete blood count (CBC) to monitor for leukopenia (for prolonged therapy)
Doctor Notes
- Counsel patients thoroughly about the alcohol interaction.
- Monitor for signs of peripheral neuropathy, especially in patients on long-term therapy.
- Consider liver function monitoring in patients with hepatic impairment or prolonged treatment.
- Adjust dose in severe renal impairment (CrCl <10 mL/min).
Patient Guidelines
- Complete the full course of medication, even if symptoms improve, to prevent recurrence and resistance.
- Avoid alcohol during treatment and for at least 48 hours after your last dose.
- Take with food or milk to reduce stomach upset.
- Inform your doctor if you experience severe side effects or unusual symptoms.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
May cause dizziness or disorientation. Patients should be advised not to drive or operate machinery if affected.
Lifestyle Advice
- Maintain good hygiene practices to prevent parasitic infections.
- Drink plenty of fluids to stay hydrated, especially if experiencing diarrhea or vomiting.
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