Flagyl

Drugs

Generic Name: Metronidazole
Product Name: Flagyl

Indication of Flagyl
Action of Flagyl
Dose Advice of Flagyl
Schedule of Flagyl
Common side effects of Flagyl
Uncommon side effects of Flagyl

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Indication of Flagyl:

Used for the treatment of infections suspected or proven to be caused by anaerobic bacteria which are susceptible to Metronidazole.
Including: septicaemia; bacteremia; brain abscess; necrotising pneumoniae; osteomyelitis; puerperal sepsis; pelvic abscess; pelvic cellulitis; post-operative wound infections.

Used for the prevention of anaerobic infections in high risk situations.
Including: intra-abdominal surgery and surgery involving the bowel, vaginal hysterectomy, and surgery in the presence of anaerobic septicaemia.

Used for the treatment of urogenital trichonomoniasis, bacterial vaginosis, amoebiasis, giardiasis, acute ulcerative gingivitis.

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Action of Flagyl:

Microbiology:
Metronidazole has bactericidal activity against important species of obligate anaerobic bacteria and other micro-organisms. The process by which it reduces papules and pustules in rosacea is unknown.

Pharmacokinetics:
Maximum concentrations occur within 1-2 hours after oral administration, and at the end of an intravenous infusion, with biological half lives of 6 and 7.3 hours respectively.

The suppository form is more slowly and less completely absorbed than the oral form, with maximum concentrations after 8 hours, though with a comparable half life of about 7 hours.

Metronidazole is widely distributed to body tissues and fluids, it cross the blood brain barrier and the placenta, and is found in breast milk.

Metronidazole and its metabolites are excreted primarily in the urine.

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Dose Advice of Flagyl:

Gel, cream:
Apply a thin layer of gel/cream to the affected area, twice daily (morning and night).
A dosage of 4 g should not be exceeded during any 24 hour period.

Oral:
Anaerobic infections: 400 mg, three times daily, for 7 days. (Children 7-12 yrs: 200 mg three times daily; 3-7 yrs: 100 mg three times daily; 1-3 yrs: 100 mg three times daily).

Urogenital trichomoniasis: 200 mg, three times daily, for 7 days OR 2 g stat. (Sexual partners should also be treated).

Bacterial Vaginosis: 400 mg, three times daily, for 7 days OR 2 g stat.

Amoebiasis:
Invasive intestinal disease in susceptible patients: 800 mg, three times daily, for 5 days. (Children 7-12 yrs: 400 mg three times daily; 1-7 yrs 200 mg three times daily).

Intestinal disease in less susceptible patients; chronic amoebic hepatitis: 400 mg, three times daily, for 5-10 days (Children 7-12 yrs: 200 mg three times daily; 1-7 yrs: 100 mg three times daily).

Amoebic liver abscess, extra-intestinal amoebiasis: 400-800 mg, three times daily, for 5-10 days (Children 7-12 yrs: 200-400 mg, three times daily; 1-7 yrs: 100-200 mg three times daily).

Asymptomatic cyst passes: 400-800 mg, three times daily, for 5-10 days (Children 7-12 yrs: 200-400 mg three times daily; 1-7 yrs: 100-200 mg three times daily).

Giardiasis: 2 g, once daily, for 3 days. (Children 7-12 yrs: 1 g once daily; 3-7 yrs: 600 mg; 1-3 yrs: 400 mg).

Acute ulcerative gingivitis: 200 mg, three times daily, for 3 days (Children 3-12 yrs: 100 mg three times daily; 1-3 yrs: 50 mg three times daily).

Surgical prophylaxis: 400 mg (taken 1-2 hours before surgery & repeated every 8 hours for 24 hours) (Children: 7-12 yrs 200-400 mg; 1-7 yrs: 100-200 mg).

Suppositories:
Anaerobic infections: 1 g suppository, every 8 hours, for 3 days. (Children 5-12 yrs: 500 mg).

Surgical prophylaxis:
Appendicectomy: 1 g suppository (At diagnosis/before surgery and every 8 hours for 48 hours after surgery). (Children 5-12 yrs: 500 mg).

Elective colonic surgery: 1 g suppository, every 8 hours for 48 hours before AND after surgery. (Children 5-12 yrs: 500 mg).

Elderly patients:
Pharmacokinetics may be disturbed, therefore monitoring of serum levels should guide dose adjustment.

Hepatic Disease:
Dosages should be decreased in patients with severe hepatic disease.

Pregnant and breastfeeding women:
Metronidazole should be avoided by such patients.

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