Metrogyl - official* instructions for use. Metrogyl, solution for intravenous administration Metrogyl solution for infusion

For serious infections, the doctor may prescribe the drug Metrogyl in droppers. Metrogyl solution has a number of contraindications and is prescribed for very limited indications.

Metrogyl - medicine and its action

Metrogyl solution is used for intravenous administration and belongs to the group of antiprotozoal and antibacterial agents. Available in 100 ml bottles, the cost per package is about 150 rubles. The solution is transparent, colorless or light yellow. Manufacturers: Sintez, Unique and others.

The active substance is metronidazole (5 mg/ml), an antiprotozoal agent, a derivative of 5-nitroimidazole.

The drug contains a number of excipients - citric acid, water, sodium hydrogen phosphate, saline solution.

The mechanism of action of the drug has not been reliably studied; it is assumed that the substance disrupts the DNA structure of microorganisms that are sensitive to it. Metronidazole is most effective in diseases caused by:

The drug can be used in second-line regimens for the treatment of Helicobacter pylori in combination with penicillins. Many anaerobes are not sensitive to the drug. Additionally, it has a regenerating effect, accelerates tissue repair, and increases the effectiveness of radiation therapy against tumors.

Indications and contraindications

Most often, as an indication for use, Metrogyl in droppers is prescribed against genital infections.

In women, this is vaginitis caused by Trichomonas and other microbes, as well as endometritis, damage to the vaginal vault and other organs during surgical interventions, endomyometritis, giardiasis of the genital organs.

The administration of the solution is practiced for ulcers, purulent cavities in the area of ​​the ovaries, and fallopian tubes.

Dermatological diseases can also be treated with this drug, as well as infectious diseases of soft tissues. Thus, treatment is prescribed for tetanus and other diseases caused by anaerobes, and for cutaneous leishmaniasis. Infections of internal organs are treated using drips for:

Protozoal intestinal infections are treated with a course of droppers with the drug, we are talking about balantidiasis, amoebic dysentery. Treatment is carried out for damage to the organs of the urinary system, bones, joints, brain, heart. For pneumonia, abscess and empyema of the lungs, which are caused by microbes sensitive to Metrogyl, treatment will also bring positive results.

Contraindications include leukopenia, epilepsy, other organic diseases of the nervous system, severe pathologies of the blood, bone marrow, and the last stages of renal failure. In the first trimester of gestation, during lactation, treatment is prohibited; women in the 2-3 trimesters of gestation are treated carefully and according to strict indications.

How to use Metrogyl correctly?

In childhood, therapy is carried out only in a hospital. In adults, due to the seriousness of the indications for using the solution, therapy is also performed mainly in a medical facility. Dosages and recommendations are as follows:

Usually, droppers are prescribed for only 2-3 days, then they switch to injecting the medicine into a vein. The general course of therapy is a week, the course can be extended individually

Instead of jet administration, metronidazole tablets may be prescribed.

In case of renal or liver failure, the dosage of the drug is selected by the doctor. They will depend on the severity of the disease and the parameters of the biochemical blood test.

Analogues and important information about Metrogil

Metrogyl should not be mixed with other medications in the same dropper. It is strictly forbidden to use while intoxicated - this leads to the appearance of neurological symptoms.

The drug "Metrogyl" (intravenous) is an antimicrobial and antiprotozoal agent. The active substance of the drug is metronidazole. The drug exhibits activity against a number of obligate anaerobes. In combination with amoxicillin, it acts against Helicobacter pylori. Facultative anaerobes and aerobic microorganisms exhibit resistance to the drug. The drug increases the sensitivity to radiation of tumors, provokes disulfiram-like manifestations, and stimulates repair processes.

Medicine "Metrogil" (for intravenous administration). Pharmacokinetics

When 500 mg is infused over 20 minutes, the maximum level of the drug in the blood is observed after an hour. About 30-60% of the product is metabolized. The main metabolite has antimicrobial and antiprotozoal effects. About 60-80% is excreted in urine, and up to 15% of the drug is excreted in feces.

Purpose

The drug is indicated for the treatment and prevention of infectious lesions caused by sensitive microbes. In particular, the medicine is recommended for surgical interventions in the urinary tract and abdominal organs. Indications include sepsis, severe hepatic and intestinal amebiasis, osteomyelitis, brain and pelvic abscesses. The drug "Metrogyl" is prescribed (intravenously) for lesions of soft tissues, skin, bones, joint infections, and gynecological pathologies. The drug is recommended for tumors (as a radiosensitizing agent in cases of tumor resistance caused by hypoxia in its cells).

Application diagram

The initial dosage for patients over 12 years of age is from half to one gram dropwise. The duration of the infusion is thirty to forty minutes. Every next 8 hours the medicine is administered at a dose of 500 mg. The infusion rate is 5 ml/min. With satisfactory tolerability, after the first 2-3 infusions, jet administration is used. Duration of therapy is a week. No more than 4 g per day is allowed. For patients under 12 years of age, the drug “Metrogyl” (intravenously) is prescribed according to the indicated regimen in a single dosage of seven and a half milligrams/kg. To prevent complications during surgical interventions, patients over 12 years of age are prescribed 0.5 to 1 g per day before surgery and 1.5 g/day the next day. (0.5 mg every 8 hours). When used as a radiosensitizing agent, administration is carried out dropwise at 160 mg/kg or from 4 to 6 g/m2 of body surface. The infusion is made half an hour to an hour before irradiation.

Side effects of the drug "Metrogyl" (intravenously). Reviews

As practice shows, if the infusion rate and dosage schedule are observed, undesirable consequences rarely develop. According to the observations of specialists, patients tolerate the therapy satisfactorily. Rarely, disturbances in the activity of the gastrointestinal tract and nervous system may occur. Due to hypersensitivity, an allergic reaction is likely to develop. Some patients experienced convulsions, hallucinations, loss of appetite, and a metallic taste in the mouth.

According to the instructions for use, Metrogyl (it is prescribed intravenously quite often) is a very effective broad-spectrum antiprotozoal and antibacterial drug. The main active ingredient is metronidazole; it also contains auxiliary components:

• citric acid (monohydrate);
• sodium chloride;
• anhydrous sodium hydrogen phosphate;
• water for infusion.

Metrogyl droppers are available in 2 types - glass ampoules and polyethylene bottles. 20 ml ampoules are placed in special thermal containers, which are then packaged in cardboard boxes. The number of ampoules in the package is 5 pieces. There are 5 mg of active ingredient per 1 ml, the total volume per ampoule is 100 mg.

"Metrogyl" in a 1 ml polyethylene bottle contains 5 mg of metronidazole, the total volume of the main component per bottle is 500 mg. The bottle is wrapped in cellophane and placed in a cardboard package. The number of bottles in one package is 1 piece. It is a clear liquid, most often colorless, but can sometimes have a yellowish tint. There is a faint characteristic odor.

Pharmacological properties

Instructions for use of Metrogyl (intravenous) inform consumers that the drug is a derivative of 5-nitroimidazole. The essence of the activity of this drug is the biochemical reconstruction of the 5-nitro group of metronidazole by intracellular transport proteins of protozoa and anaerobic microorganisms. The regenerated 5-nitro group of metronidazole interacts with the DNA of microorganisms and, by inhibiting the synthesis of their nucleic acids, leads to the destruction of bacteria.

Solution for intravenous administration "Metrogyl" is active against:

• to gram-positive anaerobes;
• gram-negative anaerobes.

The following strains are particularly sensitive to the action of metronidazole:

• Trichomonas vaginalis.
• Gardenella vaginalization.
• Guinardia intestinalis, etc.

Aerobic microorganisms and facultative anaerobes are insensitive to Metrogyl. Therefore, infectious diseases provoked by a combination of aerobic and anaerobic flora require the combination of Metrogyl with antibiotics that are active against aerobic microorganisms. The combined actions of metronidazole and the antibiotic give a stronger effect than their separate use.

Metrogyl, administered intravenously (dropwise), has the ability to increase the sensitivity of cancer tumors to radiation and stimulate the resistance of body cells to various DNA damage.

Mechanism of action

Once inside, the drug is perfectly absorbed from the gastrointestinal tract, its maximum level in the blood plasma is reached within two hours. The highest concentrations of the drug are found in the lungs, kidneys, liver, brain and skin. The therapeutic dosage of metronidazole is found in saliva, cerebrospinal fluid, amniotic and seminal fluid, breast milk and vaginal secretions. This is explained by the special ability of metronidazole to penetrate into all tissues and fluids of the human body. The binding rate to plasma proteins of this drug is quite low, the maximum level reaches 18-20%. Most of the medicine is excreted from the body in the urine, only a small amount is excreted in the feces.

Its half-life takes about 6-8 hours; if the patient suffers from impaired liver function, this period may increase. If renal impairment is observed, the drug will not be eliminated with repeated doses, but will accumulate.

Indications for use

This medication has a fairly wide spectrum of action. Due to its properties, it is prescribed for treatment and preventive measures that are aimed at infections caused by pathogenic microorganisms that are particularly sensitive to metronidazole. This applies to a greater extent to anaerobic bacteria.

The indications for Metrogil (administered intravenously) are as follows:

The instructions were compiled for self-treatment. It is strongly recommended that you pay attention to all the information provided.

Contraindications

There are a number of contraindications for Metrogil (administered intravenously). Like any drug, it is contraindicated for people with individual intolerance to the components. In addition, the following is prohibited:

• with organic damage to the central nervous system;
• Prescribing large dosages is not recommended for people with liver disease;
• blood diseases;
• period of gestation;
• breastfeeding period.

Methods of application

According to the instructions for use, Metrogyl is prescribed intravenously for severe infectious diseases. For each age category there is a specific treatment regimen:

1. Adults and children over 12 years old. The initial amount is 0.5-1 g intravenously. The duration of one procedure should not exceed 40 minutes. After which the solution is administered every 8 hours, 500 mg, the injection rate is 5 ml per minute. If there is no intolerance to the drug, after the second procedure they switch to jet administration. The therapeutic course is a week. If there is a need, intravenous treatment is extended, the decision on the extension is made by the doctor. The daily dosage is 4 g. If indicated, a transition to maintenance therapy can be made; the dosage is 400 mg three times a day.

2. Children under 12 years old. The treatment regimen is similar, a single dosage is 7.5 mg per kilogram of body weight.

3. Purulent-septic diseases are treated with one course.

4. Preventive measures for adults and children over 12 years of age before surgery are prescribed as follows: 0.5-1 g intravenously in the evening, before surgery, on the day of surgery and the next day after surgery. The instructions for using Metrogyl intravenously advise sticking to this regimen for two days, then transferring the patient to maintenance treatment by taking the drug orally.

5. For patients with chronic renal or liver failure, the daily dosage does not exceed 1 g, the number of doses is twice a day.

All other appointments are made on an individual basis. The specialist will be guided by the diagnosis, course of the disease, dynamics and condition of the patient.

Pregnancy and lactation

The drug is prohibited for the first 3 months; for the next 2 trimesters, prescriptions can only be made for health reasons. Women who are breastfeeding are not recommended to take Metrogyl; it is allowed only after the end of the lactation period.

Adverse reaction

Sometimes side effects may occur. Metrogyl, administered intravenously, can provoke the following reaction:

• from the digestive tract - loss of appetite, constipation, diarrhea, nausea, vomiting, metallic taste in the mouth, constant thirst, exacerbation of pancreatitis, stomatitis, intestinal colic;
• from the central nervous system - sleep disturbance, dizziness, loss of orientation, poor coordination, confusion, hyperactivity, nervousness, hallucinations, fatigue, headaches, muscle cramps, depression;
• from the genitourinary organs - cystitis, enuresis, candidiasis, change in urine color, dysuria, polyuria.

Symptoms unrelated to the diagnosis may also appear:

• skin itching;
• hives;
• runny nose;
• arthralgia;
• increased body temperature;
• pain or swelling at the injection site;
• neuropenia;
• leukopenia.

If such signs occur, treatment should be stopped and consult a specialist.

Application in gynecology

The drug has also found its use in gynecology. Metrogyl is prescribed intravenously if it is not possible to use its other forms - suppositories, gel or tablets. Prescribed for the following diseases:

• endometritis;
• cystitis;
• urethritis;
• abscess of the fallopian tubes and ovaries;
• trichomoniasis;
• venereal diseases;
• infectious lesions of the vaginal vault;
• bacterial or trichomonas vaginitis;
• infections that provoke ovarian diseases.

Also in gynecology, this drug is used as a prophylactic postoperative agent.

The duration of treatment with intravenous solution lasts 4-5 days. The drug is administered twice a day, the time interval between doses is 8 hours. Single dose - 500-1000 mg, depending on the diagnosis.

Shelf life and storage

The drug "Metrogil" belongs to class B. It must be kept in an inaccessible place, where neither children nor sunlight can reach it, the room temperature should be no more than 30 degrees. The drug cannot be frozen, the shelf life is 3 years, after which it must be disposed of.

Interaction with other drugs

Clinical studies have proven that the drug Metrogyl (it is often prescribed intravenously) is prohibited from being combined with many medications. Otherwise, the following reactions occur:

• simultaneous use of Disulfiram leads to the appearance of neurological signs, so the interval between doses should be at least 14 days;
• drugs that stimulate enzymes in the liver can accelerate the elimination of metronidazole, which will provoke a decrease in its level in the blood plasma;
• Cimetidine reduces the metabolism of metronidazole, which is fraught with side effects;
• drugs containing lithium cause its increase in the blood plasma, and this, in turn, develops signs of poisoning;
• sulfonamides can enhance the antimicrobial properties of Metrogyl;
• Experts also do not recommend combining metronidazole with muscle relaxants (vecuronium bromide).

additional information

During treatment with Metrogyl drips, it is strictly forbidden to drink alcohol, as this can cause nausea, vomiting, hot flashes and headaches. If the drug is used for a long time, it is necessary to regularly take blood tests to monitor the indicators. As a result of taking the drug, urine may become dark in color.

An intravenous overdose of Metrogyl has the following symptoms:

• vomit;
• dizziness or headache;
• ataxia.

Acute overdose is fraught with the development of epileptic seizures and neuropathy. In such cases, gastric lavage and treatment of symptoms are indicated, which is usually carried out in a hospital setting.

Broad-spectrum bactericidal drug Metrogil effective against protozoa and some gram-positive bacteria. Active substance Metrogyla- metronidazole – belongs to the group of nitroimidazole derivatives. After the reduction reaction of the 5-nitro group, which occurs when interacting with intracellular proteins of bacteria, the drug is able to inhibit the synthesis of certain nucleic acids, which are the basis of bacterial DNA. Due to this effect on DNA, microbial cells die. Metrogil effective in the treatment of bacterial infections caused by anaerobic microorganisms Veillonela spp., Fusobacterium spp., Bacteroides spp., Clostridium spp., Eubacterium spp., Peptostreptococcus spp., Peptococcus spp. Strains of Trichomonas vaginalis, Gardnerella vaginalis, Entamoeba histolytica, and Giardia intestinalis are sensitive to the action of metronidazole. Metronidazole has a bactericidal effect against Helicobacter pylori, however, with monotherapy with the drug, resistance quickly develops, therefore, in the treatment of diseases caused by Helicobacter pylori, Metrogyl is used in combination with amoxicillin, which suppresses the development of resistance.

For infectious diseases caused by mixed aerobic and anaerobic flora, use Metrogyl in combination with antibiotics active against aerobes, and mutual synergism between antibiotics and metronidazole is noted.
Metronidazole increases the sensitivity of tumors to radiation. Has an effect similar to disulfiram. Stimulates repair processes in the body.

When taken orally, the drug is well absorbed from the gastrointestinal tract. Maximum plasma concentrations after oral administration are achieved within 2 hours. Metronidazole penetrates well into all biological fluids and tissues of the body. High concentrations of metronidazole are observed in organs such as lungs, kidneys, liver, brain, skin. An amount of metronidazole capable of exerting a therapeutic effect is isolated in saliva, cerebrospinal fluid, abscess cavities, amniotic fluid, vaginal secretions, seminal fluid, and breast milk.
The degree of binding to plasma proteins is low and reaches a maximum of 18-20%.

It is excreted primarily by the kidneys, however, a small amount of metronidazole is excreted in the feces. The half-life is 6-8 hours and increases with impaired liver function.

With repeated administration of the drug in patients with severe renal impairment, metronidazole may accumulate; this should be taken into account when prescribing the drug.

Indications for use

Mode of application

Usually Metrogil prescribe:
For trichomonas infections: in women they are used in combination with local therapy, while metronidazole tablets are prescribed 200 mg (1 tablet Metrogyl 200 mg) 3 times a day. Men are prescribed 200-400 mg 3 times a day. The course of treatment is usually 7 days. If necessary, a repeat course is carried out after 3-4 weeks. For severe trichomonas infections, the dose of the drug may be increased by the attending physician. An alternative to this method of administration is to prescribe 2 g of metronidazole to both partners once.
For Trichomonas infections, it is necessary to treat both sexual partners.
Children under 10 years of age are prescribed 200-400 mg per day, depending on the severity of the disease and age. Children over 10 years old are prescribed 400-500 mg per day. The daily dose is usually divided into 2 doses.
For amoebic infections: adults are usually prescribed 400 mg 3 times a day. Children are prescribed 30-40 mg/kg body weight, the resulting dose is divided into three doses. The course of treatment is usually about 7-10 days. For severe amoebic infections, such as amoebic liver abscess, the dose can be doubled for adults, then the patient takes 800 mg of metronidazole 3 times a day.
For infections caused by anaerobic microorganisms sensitive to metronidazole, adults are usually prescribed 200-400 mg 2-3 times a day. Children are usually prescribed 7 mg/kg body weight 3 times a day with an interval of 8 hours between doses. The duration of treatment is usually 7-10 days.
To prevent the development of postoperative infections caused by microorganisms sensitive to metronidazole, a single dose of 1000 mg is prescribed, after which it is switched to 200 mg 3 times a day.
The drug is taken by children under the supervision of parents and strictly as prescribed by the attending physician.
In case of impaired renal function, the dose is reduced by 2 times.

Metrogyl solution for intravenous administration:
For adults and children over the age of 12 years, the initial dose is 0.5-1 g, after which 500 mg is administered every 8 hours. The rate of administration during the first infusions should not exceed 5 ml per minute. If the drug is well tolerated by the patient, then after 2-3 infusions the speed can be increased up to a jet injection of the drug.

Typically, the duration of treatment is 6-7 days, however, if necessary, the infusion of the drug can be extended. If necessary, after the course of treatment, you can continue therapy with oral tablets.
The maximum daily dose is 4 g.
For children under 12 years of age, a single dose is calculated using the formula 7.5 mg/kg body weight.
Usually, for infectious and inflammatory diseases, a repeated course of treatment is not required.
To prevent infections after surgery, children over 12 years of age and adults are prescribed 0.5-1 g intravenously per day before surgery. Next, the drug is prescribed according to the following scheme: on the day of surgery and the next day, 1.5 g per day is prescribed, dividing the dose into 3 doses with an interval of 8 hours. After this, they switch to maintenance therapy with the drug in tablet form.
Patients with severe renal impairment should not be prescribed more than 1 g per day.

Side effects

Contraindications

Pregnancy

Interaction with other drugs

Overdose

Release form

Storage conditions

Synonyms

Compound

1 film-coated tablet Metrogyl 400 mg contains:
Metronidazole – 400 mg;
Excipients.

1 ml solution for intravenous administration Metrogil contains:
Metronidazole – 5 mg;
Excipients.

Main settings

Metrogyl is an antiprotozoal drug with antibacterial activity.

Release form and composition

Metrogyl is available in the following dosage forms:

• Tablets: biconvex, round, pink (200 mg each) or orange (400 mg each) film coated (in blister packs of 10 pcs., 2 or 10 packs in a cardboard box);
• colorless or pale yellow, transparent (in polyethylene bottles of 100 ml, 1 bottle in a cardboard box; in ampoules of 20 ml, 5 ampoules in a cardboard box; in ampoules of 20 ml, 5 ampoules in a thermal container, 1 thermal container in cardboard box);
• Gel for external use: yellow to colorless, homogeneous (in aluminum tubes of 30 g, 1 tube in a cardboard box);
• Vaginal gel: from light yellow to colorless, homogeneous (in tubes of 30 g with an applicator included, 1 set in a cardboard box);
• Suspension for oral use (in bottles of 60 or 100 ml, 1 bottle in a cardboard box).

1 tablet contains:

• Active substance: metronidazole – 200 or 400 mg;
• Auxiliary components: purified water, colloidal silicon dioxide, magnesium stearate, corn starch; 200 mg tablets – hydrogenated castor oil and Opadry II pink dye 85G54815, 400 mg tablets – povidone and Opadry II orange dye 85G53070.

The composition of 1 ml of solution includes:

• Active substance: metronidazole – 5 mg;
• Auxiliary components: citric acid (monohydrate), water for injection, sodium hydrogen phosphate (anhydrous), sodium chloride.

The composition of 100 mg gel for external use includes:

• Auxiliary components: propylene glycol, methyl parahydroxybenzoate, purified water, propyl parahydroxybenzoate, sodium hydroxide, carbomer 940, disodium edetate.

Composition of 100 mg vaginal gel:

• Active substance: metronidazole – 1 mg;
• Auxiliary components: sodium hydroxide, propyl hydroxybenzoate, purified water, propylene glycol, disodium edetate, carbomer-940.

5 ml of oral suspension contains the active substance: metronidazole – 200 mg.

Indications for use

Metrogyl in tablet form is used to treat the following diseases/conditions:

• Brain abscess, meningitis;
• Anaerobic infections, the causative agents of which are Bacteroides fragilis and other bacteroids, fusobacteria, eubacteria, clostridia, anaerobic cocci;
• Gas gangrene;
• Septicemia;
• Protozoal infections: amoebic dysentery, trichomonas vaginitis and urethritis, balantidiasis, giardiasis, trichomoniasis, amoebiasis;
• Osteomyelitis;
• After surgical interventions on the abdominal organs and urinary tract: pelvic abscesses, postpartum sepsis, liver abscess, appendicitis, intraperitoneal infections, postoperative wound infections, cholecystitis, peritonitis; for the prevention of postoperative anaerobic infections;
• Tetanus;
• Respiratory tract infections (necrotizing pneumonia, lung abscess).

Metrogyl in the form of a solution for intravenous administration is used to treat the following diseases/conditions:

• Alcoholism;
• Protozoal infections: extraintestinal amebiasis, including amoebic liver abscess, giardiasis, intestinal amebiasis, trichomonas urethritis, trichomoniasis, balantidiasis, giardiasis, cutaneous leishmaniasis, trichomonas vaginitis;
• Infections caused by Bacteroides spp. (including Bacteroides vulgatus, Bacteroides thetaiotaomicron, Bacteroides ovatus, Bacteroides distasonis, Bacteroides fragilis): infections of bones and joints, central nervous system, including pneumonia, meningitis, brain abscess, bacterial endocarditis, empyema and lung abscess;
• Pseudomembranous colitis caused by the use of antibacterial drugs;
• Infections caused by Bacteroides spp., including the B. fragilis group, Clostridium spp.: sepsis;
• Gastritis or duodenal ulcer caused by Helicobacter pylori;
• Infections caused by Bacteroides spp., including the B. fragilis group, Clostridium spp., Peptococcus spp. and Peptostreptococcus spp.: infections of the skin and soft tissues, abdominal cavity (liver abscess, peritonitis), pelvic organs (infections of the vaginal vault after surgery, abscess of the fallopian tubes and ovaries, endomyometritis, endometritis);
• Prevention of postoperative complications (especially during gynecological operations, interventions on the colon, perirectal area, appendectomy).

Metrogyl in the form of a gel for external use is used to treat the following diseases/conditions:

• Trophic ulcers of the lower extremities (due to diabetes mellitus, varicose veins);
• Rosacea (including post-steroid acne);
• Poorly healing wounds;
• Vulgar acne;
• Anal fissures, hemorrhoids;
• Bedsores;
• Seborrheic dermatitis, oily seborrhea.

Metrogyl in the form of a vaginal gel is used for the treatment of urogenital trichomoniasis, bacterial vaginosis of various etiologies, confirmed by clinical and microbiological data.

Metrogyl in the form of a suspension is used to treat anaerobic bacterial infections, amoebic liver abscess, amebiasis, giardiasis.

Contraindications

Pills:

• Blood diseases (including indications in medical history);
• Age up to 12 years;
• First trimester of pregnancy;

Solution for intravenous administration:

• Blood diseases;
• Organic lesions of the central nervous system (including epilepsy);
• Liver failure (when prescribing large doses);
• Hypersensitivity to the components of the drug.

Suspension:

• Blood diseases;
• First trimester of pregnancy and lactation period;
• Hypersensitivity to the components of the drug.

Vaginal gel:

• Impaired coordination of movements;
• Liver failure;
• Leukopenia (including history);
• Organic lesions of the central nervous system;
• First trimester of pregnancy;

• Hypersensitivity to the components of the drug.

Metrogyl gel for external use is contraindicated for use in case of hypersensitivity to the components of the drug.

The drug in tablet form is used with caution in the presence of kidney and liver diseases (renal and hepatic failure); in the form of a solution – for renal failure.

Directions for use and dosage

The tablets are taken orally during or after meals, without chewing or washed down with milk.

Children over 15 years of age and adults are prescribed 200-400 mg of the drug 2-3 times a day. The dosage of Metrogyl and the duration of therapy are determined depending on the nature of the infection.

Dosage regimen:

• Trichomoniasis: 1 tablet (200 mg) 3 times a day for 7 days; Women need to additionally use metronidazole in the form of vaginal gel or suppositories. It is possible to repeat the course of therapy if necessary, or increase the dose to 750-1000 mg per day. Between courses, a break of 21-28 days is required with repeated control laboratory tests. An alternative treatment regimen is a single dose of 2000 mg of the drug to the patient and his sexual partner;
• Amebiasis: children - 30-40 mg per 1 kg of body weight, divided into 3 doses; adults – 1 tablet (400 mg) 3 times a day. Duration of therapy – 7-10 days;
• Amoebic liver abscess: children – 30-35 mg per 1 kg of body weight, divided into 3 doses; adults – 1-2 tablets (400 mg) 3 times a day in combination with tetracycline antibacterial drugs or other methods. Duration of therapy – 5-10 days;
• Anaerobic bacterial infections: children – 7 mg per 1 kg of body weight every 8 hours; adults – 1-2 tablets (200 mg) 2-3 times a day. Duration of therapy – 7-10 days;
• Prevention of anaerobic infection before surgical interventions performed on the pelvic organs and large intestine: 5 tablets (200 mg each) once, then 1 tablet 3 times a day.

When Metrogyl is prescribed in combination with amoxicillin (2250 mg per day), the daily dose of metronidazole is 1500 mg. The frequency of administration is 3 times a day.

For severe functional disorders of the liver and kidneys, the daily dose of metronidazole is 1000 mg, amoxicillin – 1500 mg. The frequency of administration is 2 times a day.

Metrogyl solution is administered intravenously. Its use is indicated for severe infections, as well as in the absence of the possibility of taking the drug orally.

The dosage of the drug for children over 12 years of age and adults is 500-1000 mg intravenously at a rate of 30-40 minutes, then 500 mg every 8 hours at a rate of 5 ml per 1 minute. If well tolerated, after the first 2-3 infusions the solution should be administered as a stream. Duration of therapy is 7 days, with a possible increase for a longer period if necessary. The maximum daily dose is 4000 mg. According to indications, it is recommended to switch to taking the drug orally at a maintenance dose of 400 mg 3 times a day.

For children under 12 years of age, Metrogyl is prescribed according to a similar regimen in a single dose of 7.5 mg per 1 kg of body weight.

In cases of purulent-septic diseases, 1 course of therapy is usually carried out.

For the purpose of prevention, children over 12 years of age and adults are prescribed 500-1000 mg intravenously on the eve of surgery, on the day of surgery and the next day - 1500 mg per day (500 mg every 8 hours). After 1-2 days, it is recommended to switch to oral maintenance therapy.

The maximum daily dose for chronic renal failure and creatinine clearance less than 30 ml per minute and/or liver failure is no more than 1000 mg, the frequency of administration is 2 times a day.

Metrogyl gel for external use is applied in a thin layer to previously cleansed affected areas of the skin 2 times a day (morning and evening) for 21-63 days.

The duration of therapy is 3-4 months, in most cases the therapeutic effect is observed after 21 days of use.

Metrogyl vaginal gel is used intravaginally at a dose of 5000 mg (1 full applicator) 2 times a day (morning and evening). Duration of therapy – 5 days.

Metrogyl suspension is taken orally.

Dosage regimen:

• Trichomoniasis: 200 mg 3 times a day for 1 week;

• Amebiasis: children - 30-40 mg per 1 kg of body weight per day, divided into 3 doses; adults – 400 mg 3 times a day. Duration of therapy – 7-10 days;
• Amoebic liver abscess: children – 30-35 mg per 1 kg of body weight per day, divided into 3 doses; adults – 400-800 mg 3 times a day. Duration of therapy – 5-10 days;
• Anaerobic bacterial infections: children – 7 mg per 1 kg of body weight every 8 hours; adults – 200-400 mg 2-3 times a day. Duration of therapy – 7-10 days;
• Giardiasis: children 2-5 years old - 200 mg per day, 5-10 years old - 300 mg per day, 10-15 years old - 400 mg per day for 5 days. The course of therapy can be repeated after 10-15 days;
• Prevention of anaerobic infection before a planned operation: once 1000 mg, then 200 mg 3 times a day; in cases of emergency surgery - 1000 mg once.

Side effects

During Metrogyl therapy, side effects from certain body systems may occur.

Pills:

• Digestive system: dry mouth, unpleasant metallic taste in the mouth, nausea, diarrhea, vomiting, constipation, lack of appetite, pancreatitis, pseudomembranous colitis, stomatitis, intestinal colic, glossitis, increased levels of liver enzymes, hepatitis, cholestatic jaundice;
• Nervous system: headache, ataxia, dizziness, weakness, sleep disturbance, hallucinations, impaired coordination of movements, impaired consciousness, peripheral neuropathy, increased excitability, epileptic seizures, depression;
• Genitourinary system: urinary incontinence, polyuria, dysuria, red-brown urine, vaginal candidiasis, burning sensation in the urethra;
• Allergic reactions: itching, skin rash, skin hyperemia, nasal congestion, fever, arthralgia, anaphylactic shock;
• Hematopoietic system: thrombocytopenia, leukopenia;
• Other: flattening of the T wave on the electrocardiogram, neutropenia.

Solution for intravenous administration:

• Digestive system: dry mouth, metallic taste in the mouth, constipation, stomatitis, glossitis, intestinal colic, nausea, diarrhea, vomiting, loss of appetite, pancreatitis;
• Nervous system: peripheral neuropathy, hallucinations, convulsions, headache, insomnia, weakness, increased excitability, depression, irritability, confusion, ataxia, impaired coordination of movements, dizziness;
• Allergic reactions: arthralgia, fever, nasal congestion, skin flushing, skin rash, urticaria;
• Urinary system: red-brown urine color, candidiasis, urinary incontinence, polyuria, cystitis, dysuria;
• Local reactions: thrombophlebitis;
• Other: flattening of the T wave on the electrocardiogram, leukopenia, neutropenia.

When using the gel for external use, in rare cases, the following may occur: lacrimation (when applying the drug close to the eyes), mild dryness, peeling and burning of the skin, hyperemia, allergic reactions (skin rash, urticaria).

Vaginal gel:

• Systemic effects: leukopenia or leukocytosis, dark urine color, constipation or diarrhea, cramping abdominal pain, decreased appetite, nausea, vomiting, changes in taste, including a metallic taste, dry mouth, headache, dizziness;
• Allergic reactions: urticaria;
• Local reactions: vulvitis, burning sensation or increased urination; in the sexual partner - a burning sensation or irritation of the penis. After discontinuation of the gel, vaginal candidiasis develops.

special instructions

During Metrogyl therapy, you should not drink alcohol (a disulfiram-like reaction may develop).

Patients under 18 years of age are not recommended to use the drug in combination with amoxicillin.

In cases of leukopenia, the possibility of continuing therapy directly depends on the risk of developing an infectious process.

With long-term use of tablets, suspension or solution, peripheral blood parameters should be monitored.

Discontinuation of the drug is required if ataxia, dizziness or any other deterioration in neurological status occurs.

It should be borne in mind that Metrogyl can immobilize treponemes and lead to a false-positive Nelson test.

During therapy for trichomonas urethritis and trichomonas vaginitis (in men and women, respectively), you should abstain from sexual activity. Simultaneous treatment of both sexual partners is mandatory. Therapy should not be stopped during menstruation. Upon completion of treatment for trichomoniasis, it is necessary to carry out control tests during 3 consecutive cycles before and after menstruation.

If after treatment of giardiasis the symptoms of the disease persist, after 21-28 days it is necessary to conduct 3 stool tests at intervals of several days.

During the period of use of Metrogyl solution, urine may turn dark.

When using the gel for external use and vaginal gel, avoid contact with the eyes. If the gel gets into your eyes, they should be rinsed immediately with plenty of water.

Drug interactions

When Metrogyl is used simultaneously with certain medications, undesirable effects may occur:

• Indirect anticoagulants: strengthening their action, which leads to an increase in the time of prothrombin formation;
• Sulfonamides: enhancing the antimicrobial effect of metronidazole;
• Cimetidine: inhibition of the metabolism of metronidazole, which may lead to an increase in its concentration in the blood serum and the risk of side effects;
• Drugs that stimulate microsomal oxidation enzymes in the liver (phenytoin, phenobarbital): acceleration of the elimination of metronidazole, which reduces its concentration in plasma.
• Lithium preparations (in high doses): an increase in the concentration of lithium in the blood plasma and the development of signs of intoxication.
• Taking Metrogyl can lead to ethanol intolerance.

When Metrogyl is used topically, the interaction with other drugs is negligible, but caution must be exercised when administered concomitantly with warfarin and other indirect anticoagulants.

Metrogyl for intravenous administration is not recommended to be mixed with other medications.

Terms and conditions of storage

Keep out of reach of children and protected from light; tablets, solution and gel for external use - at temperatures up to 30 °C, vaginal gel and suspension - up to 25 °C.

Best before date:

• Gel for external use, suspension, solution for intravenous administration – 3 years;
• Vaginal gel – 2 years.

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