Flagyl ER
Flagyl ER (Metronidazole)Pharmacological action
Believe, that the action mechanism is bound to disturbance of structure of DNA of sensitive microorganisms. It is active concerning Trichomonas vaginalis, Gardnerella vaginalis, Giardia intestinalis, Entamoeba histolytica, Lamblia, in particular Bacteroides spp., Fusobacterium spp. And some other microorganisms. Aerobic microorganisms are steady against metronidazole.
Pharmacokinetics
It is well soaked up after intake. Bioavailability makes 80 %. It is distributed in tissues and organism liquids. Gets through a placenta. Linkage with fibers of a blood plasma - 20 %. It is metabolized in a liver by oxidation and linkage with glucuronic acid. The semideducing period makes 8 h. It is deduced with urine (60-80 %) and a feces (6-15 %).
Indications
Mecotic vaginitis and urethritis at women, a mecotic urethritis at men, a lambliasis, an amebic dysentery, the mephitic gangrenes caused by microorganisms sensitive to metronidazole, the combined therapy serious admixed aerobically-mephitic gangrenes. Mephitic gangrene preventive maintenance at surgical interventions (especially on organs of an abdominal cavity, urinary ways). The Alcoholism.
For external and local application: treatment of pink and vulgar eels, treatment is long not healing wounds, trophic ulcers.
Dosage regimen
Inside to adults and children is more senior 12 years - on 7.5 mg/kg everyone 6 h or on 250-750 mg 3-4 times/days to Children till 12 years - on 5-16.7 mg/kg 3 times/days
At i.v. introduction by the adult and to children the initial dose is more senior 12 years makes 15 mg/kg, then on 7.5 mg/kg everyone 6 h or depending on a disease aetiology - on 500-750 mg everyone 8 h. Duration of courses of treatment and frequency of their carrying out is defined individually.
Side effect
From the alimentary system: a nausea, vomiting, absence of appetite, metal smack in a mouth.
From party TSNS and peripheric nervous system: a headache, consciousness disturbances, hypererethism, dream disturbances, giddiness, confusion of consciousness, depression, a peripheric neuropathy, cramps.
Allergic reactions: a dermal eruption, an itch, an urticaria.
From hemopoiesis system: a leukopenia.
Local reactions: a boring.
Contraindications
Iillnesses of blood, disturbance of function of a liver, I trimester of pregnancy, a hypersensibility to metronidazole.
Pregnancy and lactemia
Metronidazole quickly gets through a placenta. In II and III trimesters of pregnancy metronidazole apply only under vital indications.
Metronidazole is allocated with thoracal milk. In need of application in a lactemia it is necessary to solve a question on the termination of thoracal feeding.
Special indicatings
With care apply metronidazole at liver diseases.
In a combination with Aximocilin do not recommend to apply at patients more youngly 18 years. In the course of treatment the regular control of a picture of peripheric blood is necessary.
During treatment of a mecotic vaginitis at women and a mecotic urethritis at men it is recommended to abstain from a sexual life; simultaneous treatment of both partners is obligatory.
During metronidazole application more dark staining of urine is observed.
In treatment by metronidazole it is necessary to avoid alcohol reception since owing to disturbance of oxidation of alcohol there can be an acetaldehyde accumulation. The reactions similar to what are characteristic for Disulfiramum (spastic abdominal pains, a nausea, vomiting, a headache, a sudden rush of blood to the person) as a result can develop.
Medicinal interaction
At simultaneous application with Cimetidinum metronidazole metabolism in a liver can be lowered, that can lead to the slowed down deducing and rising of concentration of metronidazole in a blood plasma.
At simultaneous application with metronidazole phenobarbital accelerates its metabolism, as a result of it the period of semideducing and concentration of metronidazole in a blood plasma decrease..
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