Metco
Generic Name
Metronidazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metco 500 mg injection | ৳ 85.50 | N/A |
Description
Overview of the medicine
Metronidazole is an antibiotic and antiprotozoal medication used for a wide range of infections caused by susceptible anaerobic bacteria and protozoa.
Uses & Indications
Dosage
Adults
For most anaerobic infections, 500 mg IV infusion every 8 hours. Dosage may vary based on indication and severity. Surgical prophylaxis: 500 mg IV given shortly before surgery, followed by 500 mg IV every 8 hours for 24-48 hours.
Elderly
No specific dose adjustment for elderly patients unless there is significant renal or hepatic impairment.
Renal_impairment
For severe renal impairment (CrCl < 10 mL/min), dosage may need to be reduced, e.g., 50% of the usual dose. Hemodialysis removes metronidazole, so administer dose after dialysis.
How to Take
Administer by slow intravenous infusion over 30 to 60 minutes. Do not administer as an IV bolus.
Mechanism of Action
Metronidazole is a prodrug that is converted to active metabolites in anaerobic conditions. These metabolites disrupt DNA and inhibit nucleic acid synthesis in anaerobic bacteria and protozoa, leading to cell death.
Pharmacokinetics
Onset
Rapid onset of action after IV administration, typically within hours.
Excretion
Mainly renal excretion (60-80%) of the parent drug and its metabolites; some excretion occurs via feces.
Half life
Approximately 6-8 hours, slightly prolonged in patients with hepatic impairment.
Absorption
Rapid and complete absorption after intravenous administration, with peak plasma concentrations achieved quickly.
Metabolism
Primarily hepatic metabolism via hydroxylation and glucuronidation, forming active and inactive metabolites.
Side Effects
Contraindications
- Known hypersensitivity to metronidazole or other nitroimidazole derivatives.
- First trimester of pregnancy (relative contraindication).
Drug Interactions
Alcohol
Disulfiram-like reaction (nausea, vomiting, flushing, tachycardia, headache, abdominal cramps) due to inhibition of alcohol dehydrogenase.
Lithium
Increased plasma lithium concentrations, potentially leading to lithium toxicity. Monitor lithium levels.
Cimetidine
May prolong metronidazole half-life due to inhibition of hepatic metabolism.
Phenobarbital and Phenytoin
Decreased metronidazole plasma levels due to increased hepatic metabolism.
Warfarin and other oral anticoagulants
Enhanced anticoagulant effect, leading to increased risk of bleeding. Monitor INR/PT carefully.
Storage
Store below 25°C (77°F). Do not freeze. Protect from light. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, ataxia, and mild disorientation. Management is symptomatic and supportive; there is no specific antidote.
Pregnancy & Lactation
Metronidazole crosses the placenta and is secreted in breast milk. Generally avoided in the first trimester of pregnancy. Use in later trimesters and during lactation only if clearly needed and the potential benefits outweigh the risks. Consult a doctor.
Side Effects
Contraindications
- Known hypersensitivity to metronidazole or other nitroimidazole derivatives.
- First trimester of pregnancy (relative contraindication).
Drug Interactions
Alcohol
Disulfiram-like reaction (nausea, vomiting, flushing, tachycardia, headache, abdominal cramps) due to inhibition of alcohol dehydrogenase.
Lithium
Increased plasma lithium concentrations, potentially leading to lithium toxicity. Monitor lithium levels.
Cimetidine
May prolong metronidazole half-life due to inhibition of hepatic metabolism.
Phenobarbital and Phenytoin
Decreased metronidazole plasma levels due to increased hepatic metabolism.
Warfarin and other oral anticoagulants
Enhanced anticoagulant effect, leading to increased risk of bleeding. Monitor INR/PT carefully.
Storage
Store below 25°C (77°F). Do not freeze. Protect from light. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, ataxia, and mild disorientation. Management is symptomatic and supportive; there is no specific antidote.
Pregnancy & Lactation
Metronidazole crosses the placenta and is secreted in breast milk. Generally avoided in the first trimester of pregnancy. Use in later trimesters and during lactation only if clearly needed and the potential benefits outweigh the risks. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture, specific to lot.
Availability
Pharmacies, Hospitals
Approval Status
Approved by major regulatory bodies
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Metronidazole has undergone extensive clinical trials since its introduction, establishing its efficacy and safety profile across various infectious diseases over decades.
Lab Monitoring
- For prolonged therapy, periodic monitoring of complete blood count (CBC) should be performed.
- Liver function tests may be considered in patients with hepatic impairment.
Doctor Notes
- Ensure complete patient history, especially regarding neurological disorders and hepatic impairment, before initiating metronidazole therapy.
- Advise patients emphatically about the absolute contraindication of alcohol during and for several days post-treatment to avoid disulfiram-like reactions.
- Monitor for signs of peripheral neuropathy in patients on prolonged therapy; discontinue if symptoms appear.
Patient Guidelines
- Complete the full prescribed course of treatment, even if symptoms improve, to prevent recurrence and resistance.
- Strictly avoid alcohol during treatment and for at least 3 days after stopping the medication.
- Report any unusual side effects, especially numbness or tingling in hands or feet, or severe allergic reactions, to your doctor immediately.
Missed Dose Advice
If a dose is missed, it should be administered as soon as remembered, unless it is almost time for the next dose. Do not double the dose to catch up.
Driving Precautions
Metronidazole may cause dizziness, confusion, or visual disturbances. Patients should be advised not to drive or operate machinery if they experience these effects.
Lifestyle Advice
- Maintain good personal hygiene, especially in cases of sexually transmitted infections or amoebiasis, to prevent reinfection or spread.
- Drink plenty of fluids unless otherwise advised.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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