Metronidazol Artesan-Drossapharm (Metronidazole)

Metronidazole is indicated for infections caused by anaerobic bacteria and susceptible protozoa. It is employed across several clinical pathways:

• Bacterial vaginosis: eliminates the anaerobic flora responsible for the condition.
• Trichomoniasis: eradicates Trichomonas vaginalis, relieving symptoms.
• Amoebiasis: treats intestinal infection caused by Entamoeba histolytica.
• Giardiasis: clears Giardia lamblia from the gastrointestinal tract.
• Anaerobic bacterial infections: manages intra‑abdominal, pelvic, skin and soft‑tissue infections caused by anaerobes.
• Clostridioides difficile‑associated diarrhea (adjunct): reduces toxin‑producing bacterial load when used with standard therapy.

• Metronidazole is taken up by anaerobic microorganisms and reduced by intracellular electron‑transport proteins to reactive nitro radicals. These radicals damage DNA, inhibit nucleic acid synthesis and disrupt vital metabolic pathways, ultimately leading to cell death of susceptible bacteria and protozoa.

Metronidazole may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Metallic taste: transient metallic sensation in the mouth.
• Headache: occasional mild headache.
• Diarrhea: loose stools during therapy.
• Abdominal pain: cramping or discomfort.
• Loss of appetite: reduced desire to eat.

Serious or Rare Side Effects

• Seizures: rare neurologic events.
• Peripheral neuropathy: tingling or numbness in extremities.
• Severe allergic reactions: anaphylaxis, rash, or swelling.
• Stevens‑Johnson syndrome: severe skin reactions.
• Hepatic toxicity: elevated liver enzymes or hepatitis.
• Neutropenia: reduced white blood cell count.

Before initiating therapy, consider the following safety measures:

• Assess renal function: adjust use in patients with impaired kidney function.
• Avoid alcohol: risk of disulfiram‑like reaction.
• Monitor for allergic reactions: discontinue if severe rash or swelling occurs.
• Use caution in pregnancy: discuss risks with a healthcare provider.
• Contraindicated in known hypersensitivity: do not administer to patients with documented allergy to metronidazole.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture.

Metronidazole can interact with several medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Alcohol: may cause severe flushing, tachycardia, and hypotension.
• Warfarin: potentiates anticoagulant effect, increasing bleeding risk.
• Lithium: may raise lithium serum concentrations, risking toxicity.

Moderate Interactions (Monitor Closely)

• Carbamazepine: may lower metronidazole levels, reducing effectiveness.
• Cimetidine: can increase metronidazole plasma concentration.
• Phenytoin: may decrease metronidazole exposure, requiring monitoring.