Adult Dosing
Trichomoniasis
- 2 g PO x 1 or 1 g bid x 1 day
- Alt: 250 mg PO tid x 7 days or 375 mg PO bid x 7 days
Note:
- Treat asymptomatic sex partners along the same guidelines. Do not use in first trimester of pregnancy
Amebic liver abscess
- 750 mg PO tid x 5-10 days
Intestinal amebiasis
- 500-750 mg PO tid x 5-10 days
Anaerobic Bacterial infections
- Usual dose: 7.5 mg/kg every six hours x 7-14 days (approx. 500 mg for a 70-kg adult)
- Max: 4 g/day
Bacterial vaginosis (Flagyl ER)
- 750 mg PO Daily ER tabs x 7 days
Peritonsillar abscess [Non-FDA Approved]
Crohn's Disease [Non-FDA approved]
Notes:- Dose should be taken under fasting conditions, at-least one hour before or two hours after meals
- Avoid giving dose during the first trimester in pregnant patients
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
Amebiasis
- 35-50 mg/kg/day PO divided tid x 10 days
Cellulitis [Non-FDA Approved]
- <7 days:
- <1.2 kg: 7.5 mg/kg/dose q48 hr
- 1.2-2 kg: 7.5 mg/kg/dose q24 hr
2 kg: 15 mg/kg/24 hr divided q12 hr
- 7 days:
- <1.2 kg: 7.5 mg/kg/dose q24 hr
- 1.2-2 kg: 15 mg/kg/24 hr divided q12 hr
- 2 kg: 30 mg/kg/24 hr divided q12 hr
- Infant/child:
- 30 mg/kg/24 hr divided q6 hr
- Max. dose: 4 g/24 hr
Peritonsillar abscess [Non-FDA Approved]
Crohn's Disease [Non-FDA approved]
[Outline]
Renal Dose Adjustment (Based on CrCl)
- <10 mL/min: Adjust dose amount
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined; caution advised
See Supplemental Patient Information
- Metronidazole has been shown to be carcinogenic in mice and rats. Reserve use for approved conditions [US Black Box Warning]
- Convulsive seizures, encephalopathy, aseptic meningitis, optic and peripheral neuropathy have been reported in patients treated with metronidazole. Discontinue the therapy in case abnormal neurologic signs, metronidazole should be use cautiously in central nervous system diseases
- Mild leukopenia has been observed during administration of metronidazole
- Decrease infant exposure by withholding breastfeeding for 12-24 hrs after maternal single dose
- Avoid concomitant alcohol, 1 day after discontinuing and 3 days for extended release tab, due to the risk of disulfiram-like reaction
- Monitor serum creatinine at baseline; WBC with differential count at baseline and after completion of therapy
- Examine total and differential leukocyte counts before and after therapy for trichomoniasis, amebiasis, and anaerobic infections
Cautions: Use cautiously in
- Severe hepatic impairment
- Hx of blood dyscrasias
- CNS disorder
Supplemental Patient Information
- Advise patient not to consume alcoholic beverages while taking metronidazole
- Counsel patient that use of this drug is only to treat bacterial infections
Pregnancy Category:B
Breastfeeding: Metronidazole is excreted in breastmilk. With maternal intravenous and oral therapy, breastfed infants receive metronidazole in doses that are less than those used to treat infections in infants. Candidal infections and diarrhea have been reported in breastfed infants. Oral and rectal colonization might be more common in infants exposed to metronidazole. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 18 April 2011). Due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of drug, taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- MetroNIDAZOLE 250 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
90 mg = $38.99
180 mg = $64.97 - Flagyl ER 750 MG TB24 [Bottle] (PFIZER U.S.)
30 mg = $384.28
90 mg = $1119.3 - Flagyl 375 MG CAPS [Bottle] (PFIZER U.S.)
30 mg = $142.8
90 mg = $410.51 - Flagyl 250 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $112.99
90 mg = $295.96 - MetroNIDAZOLE 0.75 % GEL [Tube] (SANDOZ)
70 % = $59.99
210 % = $174.96 - MetroNIDAZOLE 500 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
30 mg = $25.99
90 mg = $63.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
