Monipro
Generic Name
Metronidazole 500 mg tablet
Manufacturer
Example Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| monipro 500 mg tablet | ৳ 14.00 | N/A |
Description
Overview of the medicine
Metronidazole is an antibiotic used to treat various bacterial and parasitic infections. It belongs to a class of drugs called nitroimidazole antimicrobials. It is effective against anaerobic bacteria and certain protozoa.
Uses & Indications
Dosage
Adults
For Amoebiasis: 500-750 mg three times daily for 5-10 days. For Anaerobic infections: 500 mg three times daily for 7-10 days. For Trichomoniasis: 2 g as a single dose or 250 mg three times daily for 7 days.
Elderly
Dosage adjustment may be needed based on hepatic and renal function, especially with impaired function.
Renal_impairment
For severe renal impairment (CrCl <10 mL/min), dose reduction may be considered, but generally no adjustment is required for mild to moderate impairment. Hemodialysis removes metronidazole, so administer dose after dialysis.
How to Take
Monipro 500 mg tablet should be taken orally. It can be taken with food or milk to minimize gastrointestinal upset. Swallow the tablet whole with a glass of water.
Mechanism of Action
Metronidazole is a prodrug that becomes active in anaerobic conditions. Its nitro group is reduced by electron transport proteins in anaerobic organisms, forming highly reactive nitro-free radicals. These free radicals disrupt DNA synthesis and damage other macromolecules, leading to bacterial and protozoal cell death.
Pharmacokinetics
Onset
Onset of action varies depending on the type and severity of infection, typically within days.
Excretion
Mainly renal (60-80%) in the urine as unchanged drug and metabolites, with a small amount excreted in feces.
Half life
Approximately 6-8 hours.
Absorption
Rapid and almost complete oral absorption. Peak plasma concentrations are achieved within 1-2 hours.
Metabolism
Primarily hepatic by oxidation and glucuronide conjugation. Major metabolites are active.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or any other nitroimidazole derivatives.
- First trimester of pregnancy (relative contraindication, use only if essential).
- Active central nervous system (CNS) disease.
Drug Interactions
Alcohol
Disulfiram-like reaction (nausea, vomiting, flushing, tachycardia, headache, abdominal cramps). Avoid alcohol during and for at least 3 days after treatment.
Lithium
May increase serum lithium levels, leading to toxicity. Monitor lithium levels.
Warfarin
Potentiates anticoagulant effect, increasing bleeding risk. Monitor INR closely.
Cimetidine
May decrease metronidazole clearance, leading to increased plasma levels and potential toxicity.
Disulfiram
Psychotic reactions have been reported when used concurrently or within 2 weeks of each other.
Phenobarbital/Phenytoin
May increase metronidazole metabolism, leading to decreased efficacy.
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, disorientation, and seizures. There is no specific antidote. Management is symptomatic and supportive, including gastric lavage or activated charcoal if ingestion was recent.
Pregnancy & Lactation
Pregnancy: Metronidazole crosses the placental barrier. It is generally avoided during the first trimester. Use in the second and third trimesters only if clearly needed and the benefits outweigh the risks. Lactation: Metronidazole is excreted into breast milk in concentrations similar to plasma. Discontinue breastfeeding during treatment and for 12-24 hours after the last dose, or use an alternative drug.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or any other nitroimidazole derivatives.
- First trimester of pregnancy (relative contraindication, use only if essential).
- Active central nervous system (CNS) disease.
Drug Interactions
Alcohol
Disulfiram-like reaction (nausea, vomiting, flushing, tachycardia, headache, abdominal cramps). Avoid alcohol during and for at least 3 days after treatment.
Lithium
May increase serum lithium levels, leading to toxicity. Monitor lithium levels.
Warfarin
Potentiates anticoagulant effect, increasing bleeding risk. Monitor INR closely.
Cimetidine
May decrease metronidazole clearance, leading to increased plasma levels and potential toxicity.
Disulfiram
Psychotic reactions have been reported when used concurrently or within 2 weeks of each other.
Phenobarbital/Phenytoin
May increase metronidazole metabolism, leading to decreased efficacy.
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, disorientation, and seizures. There is no specific antidote. Management is symptomatic and supportive, including gastric lavage or activated charcoal if ingestion was recent.
Pregnancy & Lactation
Pregnancy: Metronidazole crosses the placental barrier. It is generally avoided during the first trimester. Use in the second and third trimesters only if clearly needed and the benefits outweigh the risks. Lactation: Metronidazole is excreted into breast milk in concentrations similar to plasma. Discontinue breastfeeding during treatment and for 12-24 hours after the last dose, or use an alternative drug.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from the date of manufacture when stored under recommended conditions.
Availability
Pharmacies, Hospitals
Approval Status
Approved by FDA/DGDA
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Metronidazole has been extensively studied in numerous clinical trials since its introduction in the 1960s. These trials have established its efficacy and safety profile across a wide range of bacterial and parasitic infections. Ongoing research continues to explore its use and resistance patterns.
Lab Monitoring
- Liver function tests (for prolonged high-dose therapy or patients with hepatic impairment).
- Complete blood count (CBC) for patients on prolonged therapy (more than 10 days) to monitor for leukopenia or thrombocytopenia.
Doctor Notes
- Crucial to counsel patients on strict alcohol avoidance during and for at least 3 days post-treatment.
- Monitor patients for neurological adverse effects with prolonged or high-dose therapy.
- Consider alternative agents or defer treatment in the first trimester of pregnancy if possible.
- May interfere with certain lab tests (e.g., AST, ALT, LDH, triglycerides), causing falsely low or zero values.
Patient Guidelines
- Complete the entire prescribed course of medication, even if symptoms improve before the course is finished.
- Avoid alcohol and alcohol-containing products during treatment and for at least 3 days after stopping Monipro 500 mg tablet.
- Inform your doctor if you experience any severe or persistent side effects, especially neurological symptoms.
- Take with food to minimize stomach upset.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Monipro 500 mg tablet may cause dizziness, drowsiness, or visual disturbances in some individuals. Patients should be cautioned about operating machinery or driving until they know how the medication affects them.
Lifestyle Advice
- Maintain good personal hygiene to prevent reinfection, especially for sexually transmitted infections.
- Drink plenty of fluids to stay hydrated, particularly if experiencing diarrhea.
- Avoid unprotected sexual contact if treating an STI.
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