Metrogyl (metronidazole) solution for infusions 5 mg/ml. 100 ml.

Description

Metrogyl composition
active substance: metronidazole;
1 ml of solution contains 5 mg of metronidazole;
Excipients: sodium chloride, disodium edetate, water for injections.

Dosage form
Solution for infusion.

Pharmacological properties
It is an antiprotozoal and antibacterial medicine. The active substance interacts with the DNA of microbial cells, inhibiting the production of nucleic acids, causing the death of the bacteria. In combination with amoxicillin, it is effective against Helicobacter pylori. Not used against aerobes, facultative anaerobes.

Indications
Metrogyl is prescribed:

• with trichomoniasis with clinical manifestations, if the presence of Trichomonas was confirmed by appropriate laboratory tests;
• for the treatment of a sexual partner with an asymptomatic course of trichomoniasis (T.vaginalis) or if the pathogen is not isolated;
• with asymptomatic trichomoniasis (cervicitis, endocervicitis, cervical erosion);
• with amoebic dysentery (acute amebiasis), liver abscess provoked by amoebae;
• with anaerobic bacterial infection (intra-abdominal abscess, peritonitis, liver abscess provoked by Bacteroides);
• with gynecological infections (tubo-ovarian abscess, endometritis, endomyometritis, infection during gynecological operations), provoked by Bacteroides, Clostridium, Peptococcusniger, Peptostreptococcus;
• for skin infections caused by Bacteroides, Peptococcusniger, Clostridium, Peptostreptococcus, Fusobacterium;
• with infections of the lower respiratory tract (pneumonia, empyema, lung abscess) provoked by Bacteroides;
• for infections of joints, bones caused by Bacteroides species;
• with bacterial septicemia caused by Bacteroides, Clostridium;
• with infections of the nervous system (meningitis, brain abscess), provoked by Bacteroides;
• with endocarditis – inflammation of the inner wall of the heart, provoked by Bacteroides.

Contraindications:

• in case of allergy to components (active or auxiliary);
• with leukopenia;
• with organic (non-infectious) changes in the brain (including epilepsy);
• children under 2 years old;
• with liver failure;
• with Crohn’s disease (granulomatous enteritis);
• in the first trimester of pregnancy.

With caution, Metrogyl is prescribed in the II – III trimesters of pregnancy, in case of impaired renal / liver function.

Children
Apply to children from the first days of life.

Application during pregnancy and lactation
Only as prescribed by a doctor and under his supervision.

Method of application and dosage
Metrogyl should be administered intravenously only at a rate of 5 ml / min.
Pre- and postoperative prevention of infections: mainly in abdominal (especially colorectal) and gynecological surgery:

• Adults: 500 mg immediately before surgery, complete the injection approximately 1 hour before surgery. Re-enter the dose every 8 hours.
• Children:
  Children <12 years: a single dose of 20-30 mg / kg, the injection should be completed approximately 1 hour before surgery.
  Newborns with gestational age <40 weeks: 10 mg / kg body weight once before surgery.

Anaerobic infections. The duration of treatment depends on its effectiveness. In most cases, a seven-day course will suffice. In the presence of clinical indications (eg, eradication of infection from organs inaccessible to drainage, with a tendency to endogenous contamination by aerobic pathogens from the intestine, oropharynx or genitals), treatment can be continued.
Treatment of established anaerobic infections:

• Adults: 500 mg every 8 hours.
• Children:
  Children aged 8 weeks to 12 years: the usual daily dose is 20-30 mg / kg / day once or 7.5 mg / kg every 8 hours. The daily dose can be increased to 40 mg / kg depending on the severity of the infection. The duration of treatment is usually 7 days.
  Children <8 weeks of age: 15 mg / kg once daily or 7.5 mg / kg every 12 hours. Metronidazole may accumulate in infants <40 weeks of gestation during the first week of life, so serum concentrations of metronidazole should be monitored after a few days of treatment.

Bacterial vaginosis:
Adolescents: 400 mg twice daily for 5-7 days or 2000 mg once.

Urogenital trichomoniasis:

• Adults and adolescents: 2000 mg once or 200 mg three times a day for 7 days, or 400 mg twice a day for 5-7 days.
• Children <10 years of age: 40 mg / kg once or 15-30 mg / kg / day, divided into 2-3 doses, for 7 days; not to exceed 2000 mg / dose.

Giardiasis:

• Patients> 10 years of age: 2000 mg once daily for 3 days or 400 mg three times daily for 5 days, or 500 mg twice daily for 7 to 10 days.
• Children aged 7 to 10 years: 1000 mg once a day for 3 days.
• Children aged 3 to 7 years: 600 to 800 mg once a day for 3 days.
• Children aged 1 to 3 years: 500 mg once daily for 3 days.
• Alternatively, prescribe 15-40 mg / kg / day, divided into 2-3 doses.

Amoebiasis:

• Patients aged> 10 years: from 400 to 800 mg 3 times a day for 5-10 days.
• Children aged 7 to 10 years: from 200 to 400 mg 3 times a day for 5-10 days.
• Children aged 3 to 7 years: from 100 to 200 mg 4 times a day for 5-10 days.
• Children aged 1 to 3 years: 100 to 200 mg 3 times a day for 5-10 days.

Alternatively, apply from 35 to 50 mg / kg per day, divided into 3 doses for 5 to 10 days, not exceeding 2400 mg / day.
Eradication of Helicobacter pylori in pediatric patients. Use as part of combination therapy at 20 mg / kg per day, not exceeding the maximum daily dose of 1000 mg, divided by 2, for 7-14 days. Before starting treatment, it is necessary to read the official recommendations.

Overdose
Overdose symptoms: vomiting, convulsions, lack of appetite.
Overdose treatment: symptomatic therapy. There is no special antidote, active molecules are removed from the body by hemodialysis.

Side effects
Possible lack of appetite, nausea, loose stools, discomfort in the supragastric region, abdominal cramps, constipation, intestinal colic, headache, digestive disorders (stomatitis, metallic taste, feeling of unevenness of the tongue, dry mouth, inflammation of the tongue), changes in the blood test ( persistent thrombocytopenia, reversible neutropenia), cardiovascular disorders (flattening of the T wave on the ECG), neurological disorders (aseptic meningitis, seizures, encephalopathy, impaired coordination, optic neuropathy, dizziness, peripheral neuropathy, excitability, confusion, impairment of consciousness, hallucinations insomnia, irritability, depression), urinary disorders (dyspareunia, urinary disorders, dark urine, cystitis, urinary incontinence, vaginal candidiasis), allergic reactions (skin redness, urticaria, joint pain, Stevens-Johnson syndrome, erythematous rash, hot flashes , nasal congestion, toxic epidermal th necrolysis), fever, dryness in the vagina, vulva, decreased sex drive, proctitis, dry mouth.

Storage conditions and periods
Store Metrogyl for no more than 2 years in its original packaging at 15–25 ° C.