Metsina
Generic Name
Metronidazole
Manufacturer
Generic Manufacturer (e.g., Square Pharmaceuticals Ltd.)
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| metsina 500 mg injection | ৳ 75.00 | N/A |
Description
Overview of the medicine
Metsina-500 mg Injection contains Metronidazole, an antibiotic and antiprotozoal medication. It is used to treat a variety of bacterial and parasitic infections in different parts of the body.
Uses & Indications
Dosage
Adults
For severe anaerobic infections: 500 mg intravenously every 8 hours. Max 4g/day. Duration 7-10 days or longer.
Elderly
No specific dose adjustment for elderly patients with normal renal and hepatic function. Monitor for adverse effects.
Renal_impairment
No dosage adjustment needed for mild to moderate renal impairment. For severe renal impairment/ESRD (CrCl <10 mL/min), consider a reduced dose (e.g., 50% of usual dose) or extended dosing interval. Hemodialysis removes metronidazole.
How to Take
Administer intravenously by slow infusion, usually over 30-60 minutes. Do not administer as an IV bolus. Dilution may be required based on formulation.
Mechanism of Action
Metronidazole is a nitroimidazole antimicrobial that enters the bacterial cell or protozoal cell, and its nitro group is reduced. This reduction forms reactive cytotoxic compounds that bind to DNA, proteins, and cell membranes, leading to cell death.
Pharmacokinetics
Onset
Rapid, typically within minutes after IV administration.
Excretion
Mainly renal (60-80% as metabolites), with a small amount excreted in feces (6-15%).
Half life
Approximately 6-8 hours.
Absorption
Well absorbed after IV administration, achieving peak plasma concentrations rapidly. Oral bioavailability is also high.
Metabolism
Primarily hepatic, via oxidation followed by glucuronidation, forming hydroxyl and carboxylic acid metabolites.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or other nitroimidazole derivatives
- First trimester of pregnancy (relative contraindication for trichomoniasis)
- Concurrent use of disulfiram within the last 2 weeks
- Concurrent use of alcohol or propylene glycol-containing products
Drug Interactions
Alcohol
Disulfiram-like reaction (nausea, vomiting, flushing, tachycardia, headache). Avoid alcohol during and for at least 3 days after treatment.
Lithium
Increases lithium plasma concentrations, leading to lithium toxicity. Monitor lithium levels.
Warfarin
May potentiate anticoagulant effect, increasing bleeding risk. Monitor INR closely.
Disulfiram
Concurrent use may cause psychotic reactions. Avoid within 2 weeks of disulfiram.
Storage
Store below 30°C. Protect from light. Do not freeze.
Overdose
Symptoms may include nausea, vomiting, ataxia, and mild disorientation. Management is symptomatic and supportive. There is no specific antidote.
Pregnancy & Lactation
Pregnancy: Category B. Generally considered safe for use in the 2nd and 3rd trimesters; use in 1st trimester should be avoided unless absolutely necessary. Lactation: Metronidazole is excreted in breast milk. A single large dose (e.g., 2g) may require temporary interruption of breastfeeding for 12-24 hours. For routine dosing, assess risk-benefit.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or other nitroimidazole derivatives
- First trimester of pregnancy (relative contraindication for trichomoniasis)
- Concurrent use of disulfiram within the last 2 weeks
- Concurrent use of alcohol or propylene glycol-containing products
Drug Interactions
Alcohol
Disulfiram-like reaction (nausea, vomiting, flushing, tachycardia, headache). Avoid alcohol during and for at least 3 days after treatment.
Lithium
Increases lithium plasma concentrations, leading to lithium toxicity. Monitor lithium levels.
Warfarin
May potentiate anticoagulant effect, increasing bleeding risk. Monitor INR closely.
Disulfiram
Concurrent use may cause psychotic reactions. Avoid within 2 weeks of disulfiram.
Storage
Store below 30°C. Protect from light. Do not freeze.
Overdose
Symptoms may include nausea, vomiting, ataxia, and mild disorientation. Management is symptomatic and supportive. There is no specific antidote.
Pregnancy & Lactation
Pregnancy: Category B. Generally considered safe for use in the 2nd and 3rd trimesters; use in 1st trimester should be avoided unless absolutely necessary. Lactation: Metronidazole is excreted in breast milk. A single large dose (e.g., 2g) may require temporary interruption of breastfeeding for 12-24 hours. For routine dosing, assess risk-benefit.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when stored under recommended conditions.
Availability
Hospitals, Clinics, Pharmacies
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensively studied and widely used for decades. Numerous clinical trials support its efficacy and safety for various bacterial and parasitic infections.
Lab Monitoring
- Liver function tests (especially with prolonged use or hepatic impairment)
- Complete blood count (CBC) (especially with prolonged use)
- INR for patients on warfarin
Doctor Notes
- Caution in patients with severe hepatic impairment, as metronidazole elimination may be prolonged.
- Monitor for signs of CNS toxicity (e.g., seizures, peripheral neuropathy) especially with prolonged or high-dose therapy.
- Advise patients about the disulfiram-like reaction with alcohol.
Patient Guidelines
- Complete the full course of treatment, even if symptoms improve.
- Avoid alcohol during treatment and for at least 3 days after.
- Report any new or worsening symptoms to your doctor.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If a dose is missed, administer it as soon as possible. If it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness or confusion. Patients should be advised to exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain good hygiene to prevent reinfection.
- Drink plenty of fluids to stay hydrated.
- Follow a balanced diet.
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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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