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Flagyl

Flagyl
Flagil is prescribed during amoebiasis, urogenital trichomoniasis, nonspecific vaginitis, giardiasis (intestinal and hepatic), surgical infections caused by anaerobes.

Brand: Metronidazole

Availability: In Stock
Average Delivery Time: 9 Days
Exp. Date: December 2023
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Flagyl 400 mg
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Product description

Pharmacological action of Flagyl 

Buy Flagyl in Canada

Metronidazole belongs to nitro-5-imidazoles. The mechanism of action of metronidazole is the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitro group of metronidazole interacts with the DNA of the cell of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of microorganisms. The main metabolite (2-oxymetronidazole) also has antiprotozoal and antimicrobial effects.

Metronidazole is an effective broad-spectrum antimicrobial and antiprotozoal agent. The drug is highly active against Trichomonas vaginalis, Giardia intestinalis, Entamoeba histolytica, Lamblia intestinalis, as well as against obligate anaerobes (spore- and non-spore-forming) - Bacteroides spp. (B.fragilis, B.ovatus, B.distasonis, B.thetaiotaomicron, B.vulgatus), Fusobacterium spp., Clostridium spp., Peptostreptococcus spp., Peptococcus spp., Sensitive Eubacterium strains.

Aerobic microorganisms and facultative anaerobes are not sensitive to metronidazole.

Pharmacokinetics

When taken orally, Flagyl is rapidly and almost completely absorbed (approximately 80% in 1 hour). Food intake does not affect the absorption of the drug. Bioavailability is approximately 100%.

After oral administration of 500 mg of the drug, the plasma concentration after 1 hour is 10 μg / ml, and after 3 hours - 13.5 μg / ml.

T1/2 is 8-10 hours, the connection with blood proteins is insignificant and does not exceed 10-20%. The drug quickly penetrates into tissues (lungs, kidneys, liver, skin, bile, cerebrospinal fluid, saliva, seminal fluid, vaginal secretions), into breast milk and passes through the placental barrier.

About 30-60% of metronidazole is metabolized by hydroxylation, oxidation and glucuronidation. The main metabolite (2-oxymetronidazole) also has antiprotozoal and antimicrobial effects.

The drug is excreted by 40-70% through the kidneys (in unchanged form - about 35% of the dose taken).

In patients with impaired renal function, after repeated administration, accumulation of metronidazole in the blood serum may be observed.

Indications for Flagyl®

Treatment of giardiasis with Flagyl

  • protozoal infections: extraintestinal amebiasis, including amoebic liver abscess, intestinal amebiasis (amoebic dysentery), trichomoniasis, balantidiasis, giardiasis, cutaneous leishmaniasis, trichomonas vaginitis, trichomonas urethritis;

  • infections caused by Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus): infections of bones and joints, CNS infections, incl. meningitis, brain abscess, bacterial endocarditis, pneumonia, empyema and lung abscess, sepsis;

  • infections caused by Clostridium spp., Peptococcus and Peptostreptococcus species: infections of the abdominal cavity (peritonitis, liver abscess), infections of the pelvic organs (endometritis, abscess of the fallopian tubes and ovaries, infections of the vaginal vault);

  • pseudomembranous colitis (associated with the use of antibiotics);

  • gastritis or duodenal ulcer associated with Helicobacter pylori (combination therapy);

  • prevention of postoperative complications (especially interventions on the colon, pararectal region, appendectomy, gynecological operations).

Dosing regimen of Flagyl 

Inside. For amoebiasis, Flagyl is administered orally for 7 days at 1.5 g / day for 3 doses (adults).

Giardiasis is treated for 5 days: adults are prescribed 750-1000 mg / day, children 6-10 years old - 375 mg / day (1.5 tab.) And children 10-15 years old - 500 mg / day (2 tab.) ... For children under 6 years of age , the use of metronidazole suspension is preferable.

With trichomoniasis in women (urethritis and vaginitis) Flagyl is prescribed once in a dose of 2 g or as a course of treatment for 10 days: 1 tab. (250 mg) 2 times / day.

In case of trichomoniasis in men (urethritis) Flagyl is prescribed once in a dose of 2 g or as a course of treatment for 10 days, 1 tab. (250 mg) 2 times / day.

For nonspecific vaginitis, 500 mg of Flagyl is used 2 times / day for 7 days.

In the treatment of anaerobic infections adults are prescribed Flagyl at 1-1.5 g / day.

In case of severe impaired renal function (CC less than 10 ml / min), it is recommended to reduce the daily dose of the drug by 2 times.

Contraindications to the use of

  • organic lesions of the central nervous system;

  • blood diseases, incl. a history of leukopenia;

  • hepatic impairment (in the case of large doses);

  • pregnancy;

  • breast-feeding;

  • children under 6 years old;

  • hypersensitivity to imidazoles.

Application during pregnancy and breastfeeding

Contraindications: pregnancy and breastfeeding.

Application for violations of liver function

Contraindication: liver failure (in the case of large doses).

Application for impaired renal function

In case of severe impaired renal function (CC less than 10 ml / min), it is recommended to reduce the daily dose of the drug by 2 times.

Use in children

Contraindication: children under 6 years of age. Giardiasis is treated for 5 days: children 6-10 years old - 375 mg / day (1.5 tab.) And children 10-15 years old - 500 mg / day (2 tab.). For children under 6 years of age , the use of metronidazole suspension is preferable.

Special instructions

Since the simultaneous administration of the drug with alcohol can have an effect similar to the effect of disulfiram (feeling of fever, vomiting, tachycardia), patients should be warned that during treatment with Flagyl, one should not consume alcoholic beverages or medications containing alcohol.

Long-term administration of the drug is desirable under the control of the blood count. With leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process.

When treating Trichomonas vaginitis in women and Trichomonas urethritis in men, it is necessary to refrain from sexual activity. Simultaneous treatment of sexual partners is mandatory. Treatment does not stop during menses. After trichomoniasis therapy, control tests should be carried out for 3 successive cycles before and after menstruation.

After treatment of giardiasis, if symptoms persist, after 3-4 weeks, carry out 3 fecal analyzes at intervals of several days (in some successfully treated patients, lactose intolerance caused by invasion may persist for several weeks or months, resembling the symptoms of giardiasis).

Treatment should be discontinued if ataxia, dizziness, hallucinations develop, and the neurological status of patients worsens.

It must be borne in mind that metronidazole can immobilize treponemas, which leads to a false positive Nelson's test.

Influence on the ability to drive vehicles and control mechanisms

Due to the possibility of dizziness and other side effects associated with taking the drug, it is recommended to refrain from driving and other mechanisms.

Drug interactions

Similar to disulfiram, causes intolerance to ethanol.

Simultaneous use with disulfiram can lead to the development of various neurological symptoms (the interval between appointments is at least 2 weeks).

Strengthens the action of indirect anticoagulants, which leads to an increase in the time of prothrombin formation.

Cimetidine inhibits the metabolism of metronidazole, which can lead to an increase in its concentration in the blood serum and an increased risk of side effects.

Simultaneous administration of drugs that stimulate microsomal oxidation enzymes in the liver (phenobarbital, phenytoin) can accelerate the elimination of metronidazole, resulting in a decrease in its concentration in plasma.


Side effect

From the gastrointestinal tract: nausea, metallic taste in the mouth, dry mouth, loss of appetite, glossitis, stomatitis, pancreatitis, anorexia, epigastric pain, vomiting, diarrhea, constipation.

From the nervous system: headache, dizziness, impaired coordination of movements, ataxia, confusion, irritability, depression, increased excitability, weakness, insomnia, convulsions, confusion, hallucinations, peripheral neuropathy (especially with prolonged use).

Allergic reactions: urticaria, skin rash, skin flushing, nasal congestion, fever, arthralgia.

From the urinary system: dysuria, polyuria, cystitis, urinary incontinence, candidiasis, urine staining is possible in a brownish-reddish color.

Others: neutropenia, leukopenia, flattening of the T wave on the ECG.