II. Precautions

  1. Carcinogenic in mice and rats (FDA Black box warning)

III. Pharmacokinetics

  1. Half-life: 8 hours
  2. Renal excretion

IV. Dosing: Children

  1. Dose
    1. Load: Metronidazole 15 mg/kg IV
    2. Maintenance: Metronidazole 7.5 mg/kg/dose
  2. Interval
    1. First week of life: q12 hours
    2. After first week of life: q 8hours

V. Dosing: Adult

  1. Intravenous
    1. Loading dose: 15 mg/kg up to 1000 mg IV
    2. Maintenance dose: 7.5 mg/kg up to 500 mg IV q6-8 hour
  2. Oral dose: 250 to 750 mg PO tid

VI. Adverse Effects

  1. Antabuse like effect (Never use with Alcohol)
  2. Gastrointestinal intolerance
  3. Neurotoxicity (stop immediately if these occur)
    1. Seizures
    2. Encephalopathy
    3. Cerebellar dysfunction
    4. Peripheral Neuropathy (e.g. distal Paresthesias)

VII. Pregnancy

  1. Class B Medication (Avoid in first trimester pregnancy)

VIII. Directions

  1. Taking with food decreases gastric irritation

Images: Related links to external sites (from Google)

Cost: Medications

MetroNIDAZOLE (on 2/9/2012 at DrugStore.com)
MetroNIDAZOLE 0.75% Gel 45gm Tube #1 for $49.99 ($49.99/unit)
MetroNIDAZOLE 0.75% Cream 45gm Tube #1 for $175.98 ($175.98/unit)
MetroNIDAZOLE 0.75% Lotion 59ml Bottle #1 for $240.00 ($240.00/unit)
MetroNIDAZOLE 0.75% Gel 70gm Tube #1 for $59.99 ($59.99/unit)
MetroNIDAZOLE 250mg Tablets #90 for $38.99 ($0.43/unit)
MetroNIDAZOLE 500mg Tablets #30 for $25.99 ($0.87/unit)
Flagyl (on 2/9/2012 at DrugStore.com)
Flagyl 500mg Tablets #30 for $189.00 ($6.30/unit)
Flagyl 250mg Tablets #30 for $112.99 ($3.77/unit)
Flagyl 375mg Capsules #30 for $142.80 ($4.76/unit)
Flagyl ER (on 2/9/2012 at DrugStore.com)
Flagyl ER 750mg 24 Hour Tablets #30 for $384.28 ($12.81/unit)

Ontology: Metronidazole (C0025872)

Definition (CHV) a drug that treats bacterial and fungal infection
Definition (CHV) a drug that treats bacterial and fungal infection
Definition (NCI) A drug that is used to treat infection and is being studied in the treatment of cancer. It is a type of antibacterial, antiprotozoal, and anthelmintic.
Definition (MSH) A nitroimidazole used to treat AMEBIASIS; VAGINITIS; TRICHOMONAS INFECTIONS; GIARDIASIS; ANAEROBIC BACTERIA; and TREPONEMAL INFECTIONS. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed).
Definition (CSP) antiprotozoal and antibacterial effective against obligate anaerobes.
Definition (PDQ) A synthetic nitroimidazole derivative with antiprotozoal and antibacterial activities. Although its mechanism of action is not fully elucidated, un-ionized metronidazole is readily taken up by obligate anaerobic organisms and is subsequently reduced by low-redox potential electron-transport proteins to an active, intermediate product. Reduced metronidazole causes DNA strand breaks, thereby inhibiting DNA synthesis and bacterial cell growth. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39503&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39503&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C651" NCI Thesaurus)
Definition (NCI) A synthetic nitroimidazole derivative with antiprotozoal and antibacterial activities. Although its mechanism of action is not fully elucidated, un-ionized metronidazole is readily taken up by obligate anaerobic organisms and is subsequently reduced by low-redox potential electron-transport proteins to an active, intermediate product. Reduced metronidazole causes DNA strand breaks, thereby inhibiting DNA synthesis and bacterial cell growth.
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH D008795
SnomedCT 326285001, 332974000, 1222004, 372602008
English 1H-Imidazole-1-ethanol, 2-methyl-5-nitro-, Metronidazole [skin], 2 Methyl 5 nitroimidazole 1 ethanol, 2-Methyl-5-nitroimidazole-1-ethanol, Metronidazole, metronidazole, Metronizole, Metronidazole [vaginal], METRONIDAZOLE, Metronidazole [skin] (product), Metronidazole [vaginal] (product), metronidazole (medication), Metronidazole [Chemical/Ingredient], metronidazole vaginal, metroNIDAZOLE, Metronidazole product, Metronidazole (product), Metronidazole (substance), METRO, Metronidazole [skin] (substance), Metronidazole [vaginal] (substance)
Swedish Metronidazol
Czech metronidazol
Finnish Metronidatsoli
Russian METRONIDAZOL, МЕТРОНИДАЗОЛ
Spanish metronidazol [uso vaginal], metronidazol (uso dermatológico) (producto), metronidazol [uso vaginal] (producto), metronidazol (uso dermatológico), metronidazol (piel) (producto), metronidazol (piel), metronidazol (producto), metronidazol (sustancia), metronidazol, Metronidazol
Japanese フラジール, フラギル, 安息香酸メトロニダゾール, クロント, ダニゾール, メトロニダゾールホスファート, 塩酸メトロニダゾール, メトロニダゾール塩酸塩, メトロニダゾールベンゾアート, アスゾール, メトロニダゾール, メトロニダゾールリン酸, トリカゾール, ギネフラビル, トリバゾール
Polish Metronidazol
French Métronidazole
German Metronidazol
Italian Metronidazolo
Portuguese Metronidazol

Ontology: Flagyl (C0699678)

Definition (CHV) brand name of an antibiotic
Definition (CHV) brand name of an antibiotic
Definition (NCI) A drug that is used to treat infection and is being studied in the treatment of cancer. It is type of antibacterial, antiprotozoal, and anthelmintic.
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH D008795
English flagyl, flagyl [brand name], Flagyl