Metronidazole
- Atc Codes:A01AB17#D06BX01#G01AF01#J01XD01#P01AB01
- CAS Codes:443-48-1#13182-89-3#69198-10-3
- PHARMGKB ID:443-48-1#13182-89-3#69198-10-3
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Anaerobex, Ariline, Metronidazol, Nidazea, Rozex, Trichex; Belgium: Flagyl, Nidazea, Rosaced, Rozex; Bulgaria: Arilin, Efloran, Flagyl, Metris, Metronidazol, Trichomonacid; Cyprus: Anabact, Colpocin-T, Dumozol, Elyzol, Flagyl, Klont, Metronidazole, Nidagyl, Norzol, Zidoval; Czech Republic: Efloran, Entizol, Metronidazol, Rosalox, Rozex; Denmark: Flagyl, Metronidazol, Rozex, Zidoval; Estonia: Arilin, Metronidazol, Metrosa, Rozex; Finland: Flagyl, Metronidazol, Rosazol, Rozex, Trikozol, Zidoval; France: Flagyl, Grinazole, Imizine, Metrocol, Metrogene, Metronidazole, Rosiced, Rozacreme, Rozagel, Rozex; Germany: Arilin, Clont, Elyzol, Flagyl, Infectoclont, Lindoplus, Macoflex, Metrobac, Metrocreme, Metronid, Metronidazol, Metronour, Metrosa, Rosiced, Rozex, Vagimid; Greece: Colpocin, Emedal, Flagolin, Flagyl, Gnostol, Metrazol, Metrogyl, Metronidazole, Robaz, Rosiced, Trichovagil, Tricodazol, Unitrim; Hungary: Klion, Metronidazol, Metrosa, Rozex, Supplin; Ireland: Flagyl, Metrogel, Metronidazole, Rozex; Italy: Deflamon, Flagyl, Metronid, Metronidazolo, Rosiced, Rozex, Vagilen, Zidoval; Latvia: Arilin, Efloran, Flazole, Klion, Metrogyl, Metronidazol, Metrosa, Rozex, Trichopol; Lithuania: Metronidazole; Luxembourg: Anaeromet, Flagyl, Metronidazole, Pharmaflex, Rozex; Malta: Colpocin, Flagyl, Klont, Meclon, Metronidazole, Rozex, Zyomet; Netherlands: Flagyl, Metronidazol, Nidazea, Rosiced, Rozex; Poland: Arilin, Grinazole, Metronidazol, Rozex; Portugal: Dumozol, Elyzol, Flagyl, Metroderme, Metronidazol, Norstene, Rodermil, Roseless, Rosiced; Romania: Flagyl, Grinazole, Metrogene, Metronidazol; Slovakia: Efloran, Entizol, Metronidazol, Metronidazole, Rozex; Slovenia: Efloran, Metronidazol, Rozamet; Spain: Flagyl, Metronidazol, Rozex; Sweden: Flagyl, Metronidazol, Robaz, Rozex, Zidoval; UK: Flagyl, Metrogel, Metrolyl, Metronidazole, Metrotop, Norzol, Rosiced, Rozex, Zidoval, Zyomet.
North America
Canada: Flagyl, Florazole, Metrogel, Metronidazole, Nidagel, Noritate, Novo-Nidazol, Rosasol; USA: Flagyl, Metrocream, Metronidazole, Noritate, Vandazole.
Latin America
Argentina: Bexón, Colpofilín, Dazotron, Etronil, Flagyl, Ginkan, Metral, Metrocev, Metrodermic, Metrolocal, Metronidazol, Nalox, Ovufem, Padet, Repligen, Rozex, Taremis, Tolbín, Tricofín; Brazil: Canderm, Candifen, Dalzolston, Flagyl, Flanizol, Helmizol, Metronidazol, Metronide, Metroniflex, Metronin, Metronix, Metroval, Metrozol, Neo Metrodazol, Odonid, Rozex; Mexico: Ameblín, Biomona, Biotazol, Dasmetrol, Dualizol, Elyzol, Epaq-Graceway, Fagizol, Fartricon, Flagenase, Flagenol, Flagepat, Flagyl, Flaxtec, Fresenizol, Lagylan, Lamblit, Messeldazol, Metricom, Metrizol, Metrobendizol, Metrocream, Metrogel, Metronidazol, Metroson, Milezzol, Nidralon, Nidrozol, Nitromidager, Ortrizol, Otrozol, Planizol, Prozolin, Samonil, Stomffler, Valpar, Vanestrín, Vertisal.
Asia
Japan: Asuzol, Flagyl.
Drug combinations
Metronidazole and Chlorquinaldol
Metronidazole and Clotrimazole
Metronidazole and Iodoquinol
Metronidazole and Miconazole
Metronidazole and Neomycin
Metronidazole and Nystatin
Metronidazole and Spiramycin
Metronidazole, Amoxicillin, and Lansoprazole
Metronidazole, Bismuth, and Tetracycline
Metronidazole, Dexamethasone, and Nystatin
Metronidazole, Lansoprazole, and Tetracycline
Metronidazole, Neomycin, and Nystatin
Metronidazole, Boric Acid, Hydrocortisone, and Nystatin
Metronidazole, Miconazole, Neomycin, and Polymyxin B
Metronidazole, Dexamethasone, Lidocaine, Neomycin, and Nystatin
Metronidazole, Gotu Kola, Hydrocortisone, Miconazole, Neomycin, and Polymyxin B
Chemistry
Metronidazole: C~6~H~9~N~3~O~3~. Mw: 171.15. 1H-Imidazole-1-ethanol, 2-methyl-5-nitro-. CAS-443-48-1; CAS-13182-89-3 (benzoate)(1962).
Metronidazole Hydrochloride: C~6~H~9~N~3~O~3~.HCl. Mw: 207.61. (1) 1H-Imidazole-1-ethanol, 2-methyl-5-nitro-, hydrochloride; (2) 2-Methyl-5-nitroimidazole-1-ethanol monohydrochloride. CAS-69198-10-3 (1980).
Pharmacologic Category
Amebicides. Miscellanous Antiprotozoals. Antiulcer Agents and Acid Suppressants. Skin and Mucous Membrane Agents; Antibacterials. (ATC-Code: A01AB17; D06BX01; G01AF01; J01XD01; P01AB01).
Mechanism of action
After diffusing into organism, interacts with DNA to cause loss of helical DNA structure and strand breakage resulting in inhibition of protein synthesis and cell death in susceptible organisms.
Therapeutic use
Treatment of susceptible anaerobic bacterial and protozoal infections in the following conditions: Amebiasis, symptomatic and asymptomatic trichomoniasis. Skin and skin structure infections. CNS infections. Intra-abdominal infections (as part of combination regimen). Systemic anaerobic infections. Treatment of antibiotic-associated pseudomembranous colitis, bacterial vaginosis. As part of multidrug regimen for H. pylori eradication to reduce risk of duodenal ulcer recurrence. Treatment of inflammatory lesions and erythema of rosacea.
Pregnancy and lactiation implications
Crosses placenta (carcinogenic in rats). Contraindicated for treatment of trichomoniasis during 1^st^ trimester of pregnancy, unless alternative treatment inadequate. Use only during pregnancy when benefit to mother outweighs potential risk to fetus. It is suggested to stop breast-feeding for 12-24 hours following single-dose therapy to allow excretion of dose.
Unlabeled use
Crohn’s disease.
Contraindications
Hypersensitivity to metronidazole, nitroimidazole derivatives, or any component of the formulation. Pregnancy (1^st^ trimester; found to be carcinogenic in rats).
Warnings and precautions
Possibly carcinogenic based on animal data. Seizures and neuropathies reported, especially with increased doses and chronic treatment (use with caution in history of seizure disorder). Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Use with caution in blood dyscrasias, in heart failure or other sodium-retaining states; also in liver impairment (potential accumulation), and in renal impairment (CrCl <10 mL/minute).