Metronidazole Biogaran (Metronidazole)

Metronidazole is used to target anaerobic microorganisms and protozoa in several clinical settings.

• Bacterial vaginosis: restores normal vaginal flora by eliminating anaerobic bacteria.
• Trichomoniasis: eradicates Trichomonas vaginalis, relieving symptoms and preventing transmission.
• Amoebiasis: clears intestinal Entamoeba histolytica infection and associated dysentery.
• Giardiasis: eliminates Giardia lamblia, reducing diarrhea and malabsorption.
• Anaerobic bacterial infections: treats intra‑abdominal, pelvic, skin and soft‑tissue infections caused by susceptible anaerobes.

• Metronidazole enters anaerobic cells and is reduced by ferredoxin proteins to reactive nitro radical anions. These radicals damage DNA, inhibit nucleic acid synthesis and disrupt essential metabolic pathways, leading to irreversible bacterial and protozoal cell death while sparing aerobic organisms.

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

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Metallic taste: transient metallic sensation in the mouth.
• Headache: occasional dull or throbbing pain.
• Abdominal pain: cramping or discomfort.
• Diarrhea: loose stools during therapy.
• 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: rash, swelling, or anaphylaxis.
• Stevens‑Johnson syndrome: serious skin blistering.
• Clostridioides difficile infection: colitis risk.
• Hepatotoxicity: liver enzyme elevation or injury.

Before initiating Metronidazole therapy, consider the following safety measures.

• Pregnancy: consult a prescriber; data are limited and risk‑benefit must be evaluated.
• Alcohol: avoid consumption during treatment to prevent disulfiram‑like reactions.
• Liver disease: use with caution; monitor hepatic function.
• Renal impairment: dose adjustment may be required in severe dysfunction.
• Drug interactions: review all concomitant medications for potential interactions.
• Store at ambient temperature: keep in the original container, protect from moisture and light.

Metronidazole can interact with several medicines; some require avoidance while others need monitoring.

Major Interactions (Avoid)

• Alcohol: may cause severe flushing, tachycardia and nausea.
• Warfarin: can increase anticoagulant effect and bleeding risk.
• Lithium: may raise lithium levels, leading to toxicity.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: efficacy may be reduced; consider backup contraception.
• Phenytoin: may lower metronidazole plasma concentrations, reducing effectiveness.