Metro
Generic Name
Metronidazole
Manufacturer
Various Generic Manufacturers
Country
Global (produced by various countries, e.g., Bangladesh, India)
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metro 400 mg tablet | ৳ 1.70 | ৳ 11.90 |
Description
Overview of the medicine
Metronidazole 400 mg tablet is an antibiotic and antiprotozoal medication used to treat a wide range of bacterial and parasitic infections. It is effective against anaerobic bacteria and certain parasites like amoebae and Giardia.
Uses & Indications
Dosage
Adults
Dosage varies by indication. For amoebiasis: 400-800 mg orally three times daily for 5-10 days. For trichomoniasis: 2 g orally as a single dose or 250 mg three times daily for 7 days. For anaerobic infections: 400-500 mg three times daily.
Elderly
No specific dose adjustment is generally required for elderly patients with normal renal and hepatic function, but caution is advised due to potential for decreased hepatic function.
Renal_impairment
No dosage adjustment needed for mild to moderate renal impairment. For severe renal impairment (CrCl < 10 mL/min), consider reducing the dose or extending the dosing interval, particularly for long-term use.
How to Take
Take orally, preferably with or after food, to minimize gastrointestinal upset. Swallow the tablet whole with water; do not crush, chew, or break it.
Mechanism of Action
Metronidazole acts by entering the cells of susceptible organisms, where it is reduced by anaerobic metabolism. The reduced form produces cytotoxic compounds that bind to DNA, inhibiting nucleic acid synthesis and causing DNA strand breakage, leading to cell death.
Pharmacokinetics
Onset
Therapeutic effects typically begin within hours to a few days, depending on the infection.
Excretion
Mainly excreted in the urine (60-80% as unchanged drug and metabolites); a small amount (6-15%) is excreted in the feces.
Half life
Approximately 6-12 hours in adults with normal renal and hepatic function.
Absorption
Rapidly and almost completely absorbed after oral administration, with peak plasma concentrations occurring within 1-2 hours.
Metabolism
Extensively metabolized in the liver, primarily by oxidation and glucuronidation, into several metabolites, including an active hydroxyl metabolite.
Side Effects
Contraindications
- •Hypersensitivity to metronidazole or other nitroimidazole derivatives.
- •First trimester of pregnancy (relative contraindication, generally avoided).
- •Concomitant use with disulfiram (within 14 days) or alcohol (due to disulfiram-like reaction).
Drug Interactions
Alcohol
Disulfiram-like reaction (abdominal cramps, nausea, vomiting, headaches, flushing). Avoid alcohol during and for at least 3 days after treatment.
Lithium
Increases plasma lithium levels, potentially leading to lithium toxicity. Monitor lithium levels.
Cimetidine
May increase metronidazole plasma levels by reducing its metabolism.
Phenytoin/Phenobarbital
Decrease metronidazole plasma levels by accelerating its metabolism.
Warfarin and other oral anticoagulants
Enhances anticoagulant effect, leading to increased risk of bleeding. Monitor INR/PT closely.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include nausea, vomiting, ataxia, and mild disorientation. There is no specific antidote. Management involves symptomatic and supportive treatment. Gastric lavage may be considered if recent ingestion.
Pregnancy & Lactation
Pregnancy Category B. While animal studies have shown no evidence of harm, metronidazole should be avoided during the first trimester of pregnancy. Use in second and third trimesters only if clearly needed. It is excreted in breast milk; a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
3 years from the date of manufacture when stored correctly.
Availability
Available in pharmacies, hospitals, and clinics worldwide
Approval Status
Widely approved (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesAlternative Medicines in Bangladesh
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Global Brand Names
International brand names for this medicine
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