Metronidazole Dawa (Metronidazole)

Metronidazole is indicated for a range of anaerobic bacterial and protozoal infections.

• Bacterial vaginosis: eradicates Gardnerella vaginalis and restores normal vaginal flora.
• Trichomoniasis: eliminates Trichomonas vaginalis and resolves genital symptoms.
• Amoebiasis: treats intestinal Entamoeba histolytica infection and prevents tissue invasion.
• Giardiasis: clears Giardia lamblia from the gastrointestinal tract.
• Anaerobic bacterial infections: combats susceptible anaerobes in intra‑abdominal, skin and dental infections.
• Clostridioides difficile infection: reduces toxin‑producing C. difficile and helps restore gut flora.

• Metronidazole is taken up by anaerobic microorganisms and reduced by intracellular electron transport proteins to form nitro radicals. These reactive intermediates damage DNA, inhibit nucleic acid synthesis, and disrupt essential metabolic pathways, leading to bacterial or protozoal cell death while sparing aerobic cells.

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 dull or throbbing pain.
• Diarrhea: loose stools that resolve after therapy.
• Abdominal pain: cramping or discomfort in the stomach area.
• Loss of appetite: reduced desire to eat.

Serious or Rare Side Effects

• Seizures: rare neurologic events requiring immediate attention.
• Peripheral neuropathy: tingling or numbness in extremities.
• Severe allergic reactions: rash, itching, swelling, or anaphylaxis.
• Stevens‑Johnson syndrome: serious skin blistering disorder.
• Liver toxicity: elevated liver enzymes or hepatitis.
• Pancytopenia: reduction in blood cell counts.

Before prescribing Metronidazole, clinicians should consider several safety factors.

• Pregnancy Category B: generally considered safe in pregnancy, but use only if clearly needed.
• Hepatic impairment: use with caution; monitor liver function tests.
• Renal impairment: dose adjustment may be required in severe kidney disease.
• Alcohol avoidance: advise patients to abstain from alcohol to prevent disulfiram‑like reactions.
• Neuropathy monitoring: discontinue if signs of peripheral neuropathy develop.
• Store at below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Metronidazole can interact with other medicines, affecting efficacy or safety.

Major Interactions (Avoid)

• Alcohol: may cause severe disulfiram‑like reaction.
• Warfarin: can enhance anticoagulant effect, increasing bleeding risk.
• Lithium: concurrent use may raise lithium levels and cause toxicity.

Moderate Interactions (Monitor Closely)

• Cimetidine: may increase metronidazole plasma concentrations.
• Oral contraceptives: efficacy may be reduced; consider alternative contraception.
• Theophylline: levels may rise, requiring monitoring for toxicity.