Metronidazole Accord-Uk (Metronidazole)

Metronidazole is a nitroimidazole antibiotic used to treat infections caused by anaerobic bacteria and certain protozoa.

• Bacterial vaginosis: eradicates the anaerobic bacteria responsible for the condition.
• Trichomoniasis: eliminates the protozoan parasite causing the infection.
• Amoebiasis: clears intestinal Entamoeba histolytica infection.
• Anaerobic infections: treats a broad range of anaerobic bacterial infections.
• Clostridioides difficile infection: helps resolve toxin-mediated colitis.

• Metronidazole is reduced within anaerobic microorganisms to nitro radical anions that interact with DNA, causing strand breakage and inhibiting nucleic acid synthesis. This selective toxicity disrupts microbial replication and leads to cell death, while aerobic cells are largely unaffected due to limited reduction of the drug.

Metronidazole may cause a variety of adverse reactions.

Common Side Effects

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

Serious or Rare Side Effects

• Seizures: convulsions in susceptible individuals.
• Peripheral neuropathy: tingling or numbness in extremities.
• Severe allergic reactions: rash, swelling, or anaphylaxis.
• Stevens-Johnson syndrome: severe skin reactions.
• Pseudomembranous colitis: Clostridioides difficile overgrowth.
• Hepatic dysfunction: elevated liver enzymes or jaundice.

Before using Metronidazole, consider the following safety measures.

• Renal impairment: assess kidney function and adjust dose if needed.
• Hepatic disease: use with caution in patients with liver dysfunction.
• Alcohol consumption: avoid alcohol during treatment and for 48 hours after completion to prevent disulfiram-like reactions.
• Pregnancy: consult prescriber; safety data are limited.
• Concurrent warfarin therapy: monitor INR closely due to potential increased anticoagulant effect.
• Store at room temperature: keep in the original packaging, protect from moisture and direct sunlight.

Metronidazole can interact with several medicines, requiring attention to the level of risk.

Major Interactions (Avoid)

• Alcohol: may cause a disulfiram-like reaction.
• Warfarin: increased anticoagulant effect, risk of bleeding.
• Lithium: elevated lithium concentrations, risk of toxicity.

Moderate Interactions (Monitor Closely)

• Cimetidine: may raise metronidazole plasma levels.
• Phenobarbital: may reduce metronidazole efficacy.
• Oral contraceptives: may decrease hormonal effectiveness, consider additional contraception.