Sodal
Generic Name
Metronidazole
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
Variant | Unit Price | Strip Price |
---|---|---|
sodal 500 mg suspension | ৳ 150.00 | N/A |
Description
Overview of the medicine
Sodal 500 mg Suspension contains Metronidazole, an antibiotic effective against various bacterial and protozoal infections. It is used to treat infections of the gastrointestinal tract, skin, joints, respiratory tract, and reproductive system caused by susceptible anaerobic bacteria and protozoa.
Uses & Indications
Dosage
Adults
Amoebiasis: 400-800 mg 3 times daily for 5-10 days. Giardiasis: 200 mg 3 times daily for 5-7 days or 2 g once daily for 3 days. Trichomoniasis: 200 mg 3 times daily for 7 days or 2 g single dose. Anaerobic infections: 400-800 mg 2-3 times daily for 7-10 days.
Elderly
No specific dose adjustment is usually required, but caution is advised due to potential for decreased hepatic function.
Renal_impairment
In severe renal impairment (CrCl <10 mL/min), the dose should be reduced by 50% or the dosing interval extended.
How to Take
Take orally, preferably with or after food, to minimize gastrointestinal upset. Shake the suspension well before use. Use a calibrated measuring device for accurate dosing.
Mechanism of Action
Metronidazole is a nitroimidazole antimicrobial that enters the cell and is then reduced by electron transport proteins (ferredoxin, flavodoxin). This reduction generates reactive cytotoxic compounds that bind to DNA, causing DNA strand breakage and inhibition of nucleic acid synthesis, leading to cell death of anaerobic bacteria and protozoa.
Pharmacokinetics
Onset
Clinical effects may be observed within 1-2 hours, depending on the infection type.
Excretion
Approximately 60-80% of the dose is excreted in the urine, mainly as metabolites, and 6-15% in the feces.
Half life
The elimination half-life is approximately 6-12 hours in adults.
Absorption
Well absorbed orally, with bioavailability typically exceeding 80%. Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Extensively metabolized in the liver by oxidation and glucuronidation. The main metabolite, 2-hydroxymethylmetronidazole, also has antimicrobial activity.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or other nitroimidazole derivatives.
- First trimester of pregnancy (relative contraindication, use only if clearly needed).
Drug Interactions
Alcohol
Disulfiram-like reaction (flushing, palpitations, nausea, vomiting, headache) due to inhibition of alcohol dehydrogenase.
Lithium
Increased plasma lithium levels, leading to toxicity. Monitor lithium levels.
Cimetidine
May increase metronidazole levels by inhibiting its metabolism.
Phenytoin, Phenobarbital
May decrease metronidazole levels by increasing its metabolism.
Warfarin and other oral anticoagulants
Potentiation of anticoagulant effect, increasing risk of bleeding. Monitor INR closely.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children. Do not freeze.
Overdose
Symptoms of overdose include nausea, vomiting, ataxia, and mild disorientation. There is no specific antidote for metronidazole overdose. Management is supportive and symptomatic, including gastric lavage or induced emesis, and monitoring of vital signs.
Pregnancy & Lactation
Pregnancy Category B. Metronidazole should be avoided during the first trimester of pregnancy unless absolutely necessary. In the second and third trimesters, it can be used if the potential benefits outweigh the risks. Metronidazole is excreted into breast milk; therefore, breastfeeding should be discontinued during treatment and for 12-24 hours after the last dose, or an alternative medicine should be considered.
Side Effects
Contraindications
- Hypersensitivity to metronidazole or other nitroimidazole derivatives.
- First trimester of pregnancy (relative contraindication, use only if clearly needed).
Drug Interactions
Alcohol
Disulfiram-like reaction (flushing, palpitations, nausea, vomiting, headache) due to inhibition of alcohol dehydrogenase.
Lithium
Increased plasma lithium levels, leading to toxicity. Monitor lithium levels.
Cimetidine
May increase metronidazole levels by inhibiting its metabolism.
Phenytoin, Phenobarbital
May decrease metronidazole levels by increasing its metabolism.
Warfarin and other oral anticoagulants
Potentiation of anticoagulant effect, increasing risk of bleeding. Monitor INR closely.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children. Do not freeze.
Overdose
Symptoms of overdose include nausea, vomiting, ataxia, and mild disorientation. There is no specific antidote for metronidazole overdose. Management is supportive and symptomatic, including gastric lavage or induced emesis, and monitoring of vital signs.
Pregnancy & Lactation
Pregnancy Category B. Metronidazole should be avoided during the first trimester of pregnancy unless absolutely necessary. In the second and third trimesters, it can be used if the potential benefits outweigh the risks. Metronidazole is excreted into breast milk; therefore, breastfeeding should be discontinued during treatment and for 12-24 hours after the last dose, or an alternative medicine should be considered.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture when stored correctly. Refer to the packaging for the exact expiry date.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Expired
WHO Essential Medicine
YesClinical Trials
Metronidazole has undergone extensive clinical trials since its discovery, establishing its efficacy and safety for a wide range of anaerobic bacterial and protozoal infections. Ongoing research continues to explore its role in new indications and resistance patterns.
Lab Monitoring
- Liver function tests (especially with prolonged therapy or in patients with hepatic impairment)
- Complete blood count (especially with prolonged therapy, due to risk of leukopenia)
Doctor Notes
- Counsel patients strictly on alcohol avoidance to prevent disulfiram-like reactions.
- Monitor for neurological symptoms (e.g., peripheral neuropathy, seizures) especially with prolonged or high-dose therapy; discontinue if symptoms worsen.
- Consider liver function tests and CBC for patients on long-term treatment.
- Advise patients to complete the full course of treatment to minimize resistance.
Patient Guidelines
- Complete the entire course of medication, even if symptoms improve, to prevent recurrence and resistance.
- Avoid alcohol during treatment and for at least 3 days after stopping the medication.
- Take the medicine with food to reduce stomach upset.
- Inform your doctor if you experience any unusual symptoms, especially neurological effects like numbness or tingling.
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
Metronidazole may cause dizziness, confusion, or visual disturbances in some patients. Patients should be advised to exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain good personal hygiene, especially when treating parasitic infections, to prevent re-infection and spread to others.
- Stay hydrated by drinking plenty of fluids.
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Global Brand Names
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