Metronidazole B.Braun (Metronidazole)

Metronidazole is an antibacterial and antiprotozoal agent used for infections caused by anaerobic organisms and certain parasites.

• Anaerobic bacterial infections: eradicates susceptible anaerobes and reduces infection severity.
• Clostridioides difficile infection: helps resolve toxin‑mediated colitis.
• Bacterial vaginosis: restores normal vaginal flora by targeting Gardnerella species.
• Trichomoniasis: eliminates Trichomonas vaginalis parasites.
• Amebic liver abscess: destroys Entamoeba histolytica in hepatic tissue.

• Metronidazole enters susceptible microorganisms and undergoes intracellular reduction of its nitro group, generating reactive nitro radicals. These radicals interact with DNA, causing strand breaks and inhibiting nucleic acid synthesis, which leads to cell death of anaerobic bacteria and protozoa.

Metronidazole may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Nausea: mild to moderate gastrointestinal upset.
• Metallic taste: transient alteration of taste perception.
• Headache: mild to moderate intensity.
• Diarrhea: loose stools, usually self‑limiting.
• Skin rash: mild erythema or pruritus.
• Dark urine: harmless discoloration due to metabolites.

Serious or Rare Side Effects

• Seizures: rare neurologic event requiring immediate attention.
• Peripheral neuropathy: tingling or numbness, potentially irreversible.
• Stevens‑Johnson syndrome: severe skin reaction with mucosal involvement.
• Hepatotoxicity: elevated liver enzymes or jaundice.
• Hemolytic anemia: especially in patients with G6PD deficiency.
• Hypersensitivity anaphylaxis: acute allergic response.

Before using Metronidazole B.Braun, consider the following safety measures.

• Assess renal function: adjust therapy if severe impairment is present.
• Monitor hepatic status: avoid use in patients with active liver disease.
• Evaluate for alcohol use: advise abstinence during treatment and 48 hours after.
• Pregnancy and lactation: use only if benefits outweigh potential risks.
• Concomitant CNS depressants: observe for enhanced sedation.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Metronidazole can interact with several drug classes; awareness helps prevent adverse outcomes.

Major Interactions (Avoid)

• Disulfiram: may cause severe flushing and tachycardia.
• Warfarin: potentiates anticoagulant effect, increasing bleeding risk.
• Lithium: can raise serum lithium levels, risking toxicity.

Moderate Interactions (Monitor Closely)

• Phenytoin: may reduce metronidazole levels, decreasing efficacy.
• Cimetidine: can increase metronidazole plasma concentration.
• Alcohol: may precipitate a disulfiram‑like reaction.