Metronidazole Basi (Metronidazole)

Metronidazole is a nitroimidazole antibiotic indicated for several anaerobic and protozoal infections.

• Anaerobic bacterial infections: effective in treating infections caused by anaerobic organisms such as Bacteroides and Clostridium species.
• Bacterial vaginosis: restores normal vaginal flora by eliminating anaerobic overgrowth.
• Trichomoniasis: eradicates Trichomonas vaginalis, relieving symptoms and preventing recurrence.
• Amebic liver abscess: targets Entamoeba histolytica in hepatic tissue.
• Clostridioides difficile infection: reduces toxin‑producing C. difficile bacteria in the colon.

• Metronidazole enters susceptible anaerobic bacteria and protozoa, where its nitro group is reduced to reactive intermediates. These free radicals damage DNA, inhibit nucleic acid synthesis, and disrupt essential metabolic pathways, leading to cell death of the targeted microorganisms.

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

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Metallic taste: transient alteration of taste perception.
• Headache: occasional mild headache.
• Diarrhea: loose stools during therapy.

Serious or Rare Side Effects

• Seizures: rare neurologic events.
• Peripheral neuropathy: tingling or numbness in extremities.
• Severe allergic reactions: anaphylaxis or skin rash requiring immediate medical attention.

Metronidazole should be used with caution in specific patient groups and clinical situations.

• Renal impairment: assess kidney function and adjust therapy if needed.
• Hepatic dysfunction: monitor liver enzymes during treatment.
• Alcohol consumption: avoid alcohol to prevent a disulfiram‑like reaction.
• Pregnancy: Category B; use only when benefits outweigh potential risks.
• Concurrent warfarin therapy: monitor INR closely for enhanced anticoagulant effect.
• Store at ambient temperature: keep in original container, protect from light and moisture.

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

Major Interactions (Avoid)

• Alcohol: may cause a severe disulfiram‑like reaction.
• Warfarin: can potentiate anticoagulant effect, increasing bleeding risk.
• Lithium: may raise lithium serum concentrations.

Moderate Interactions (Monitor Closely)

• Cimetidine: may increase metronidazole plasma levels.
• Phenobarbital: may reduce metronidazole effectiveness.
• Oral contraceptives: may diminish hormonal contraceptive efficacy.