Indications
Metronidazole is indicated in:
- All forms of amoebiasis (intestinal and extra-intestinal disease including liver abscess and that of symptomless cyst passers)
- Trichomoniasis
- Giardiasis
- Bacterial vaginosis
- Acute ulcerative gingivitis
- Anaerobic infections including septicaemia, bacteraemia, peritonitis, brain abscess, necrotising pneumonia, osteomyelitis, puerperal sepsis, pelvic abscess, pelvic cellulitis etc.
- Anaerobically-infected leg ulcers and pressure sores
- Acute dental infections (e.g. acute pericoronitis and acute apical infections)
- Surgical prophylaxis (prevention of postoperative infections due to anaerobic bacteria, particularly species of bacteroides and anaerobic streptococci
- Chronic symptomatic peptic ulcer disease (as an agent of triple therapy to eradicate H. pylori-the most important aetiological factor of peptic ulcer)
Therapeutic Class
Pharmacology
Dosage & Administration
Tablet and Suspension:
Amoebic dysentery: Duration 5-10 Days;
- For Tablet: Adults- 750 mg t.i.d. Children- (7-10 years) 500 mg t.i.d. (3-7 years) 250 mg q.i.d. (1-3 years) 250 mg t.i.d.
- For Suspension: Adults- 800 mg t.i.d. Children- (7-10 years) 500 mg t.i.d. (3-7 years) 200 mg q.i.d. (1-3 years) 200 mg t.i.d.
Asymptomatic amoebiasis: Duration 5-10 Days;
- For Tablet: Adults- 500-750 mg t.i.d. Children- (7-10 years) 250-500 mg t.i.d. (3-7 years) 250 mg q.i.d. (1-3 years) 250 mg t.i.d.
- For Suspension: Adults- 500-800 mg t.i.d. Children- (7-10 years) 200-500 mg t.i.d.; (3-7 years) 200 mg q.i.d.; (1-3 years) 200 mg t.i.d.
Hepatic extraintestinal amoebiasis : Duration 5-10 Days (or 2days);
- For Tablet: Adults- 500-750 mg t.i.d.; Children- (7-10 years) 250-500 mg t.i.d.; (3-7 years) 250 mg q.i.d.; (1-3 years) 250 mg t.i.d.
- For Suspension: Adults- 500-800 mg t.i.d.; Children- (7-10 years) 200-500 mg t.i.d.; (3-7 years) 200 mg q.i.d.; (1-3 years) 200 mg t.i.d.
Giardiasis: Duration 3 Days;
- For Tablet: Adults- 2 g once daily; Children-(7-10 years) 1g once daily; (3-7 years) 750 mg once daily; (1-3 years) 500 mg once daily.
- For suspension: Adults- 2 g once daily; Children-(7-10 years) 1g once daily; (3-7 years) 800 mg once daily; (1-3 years) 500 mg once daily.
Trichomoniasis: Duration 7 Days;
- For Tablet: Adults- 250 mg t.i.d.; Children- (7-10 years) 100 mg t.i.d.; (3-7 years) 100 mg b.i.d.; (1-3 years) 50 mg t.i.d.
- For Suspension: Adults- 200 mg t.i.d.; Children- (7-10 years) 100 mg t.i.d.; (3-7 years) 100 mg b.i.d.; (1-3 years) 50 mg t.i.d.
Trichomoniasis: Duration 1 Day;
- For Tablet: Adults- 2 g single dose;
- For Suspension: Adults- 2 g single dose;
Vincent’s infection (Ulceration of mucous membrane of respiratory tract & mouth): Duration 3 Days;
- For Tablet: Adults- 250 mg t.i.d. or 500 mg b.i.d; Children- (7-10 years) 100 mg t.i.d.; (3-7 years) 100 mg b.i.d.; (1-3 years) 50 mg t.i.d.
- For Suspension: Adults- 200 mg t.i.d. or 500 mg b.i.d; Children- (7-10 years) 100 mg t.i.d.; (3-7 years) 100 mg b.i.d.; (1-3 years) 50 mg t.i.d.
Periodontal infection: Duration 3 Days;
- For Tablet: Adults- 250 mg t.i.d.; Children- (7-10 years) 100 mg t.i.d.; (3-7 years) 100 mg b.i.d.; (1-3 years) 50 mg t.i.d.
- For Suspension: Adults- 200 mg t.i.d.; Children- (7-10 years) 100 mg t.i.d.; (3-7 years) 100 mg b.i.d.; (1-3 years) 50 mg t.i.d.
Severe dental infection: Duration 3 Days;
- For Tablet: Adults- 500 mg t.i.d.; Children- (7-10 years) 100 mg t.i.d.; (3-7 years) 100 mg b.i.d.; (1-3 years) 50 mg t.i.d.
- For Suspension: Adults- 500 mg t.i.d.; Children- (7-10 years) 100 mg t.i.d.; (3-7 years) 100 mg b.i.d.; (1-3 years) 50 mg t.i.d.
Anaerobic infection: Duration 7 Days;
- For Tablet: Adults- 500 mg t.i.d.; Children- 7.5 mg/kg body weight t.i.d.
- For Suspension: Adults- 500 mg t.i.d.; Children- 7.5 mg/kg body weight t.i.d.
Postoperative anaerobic infection (specially in operation abdominal or gynecological surgery): Duration 7 Days;
- For Tablet: Adults- 500 mg t.i.d. before and after operation; Children- 7.5 mg/kg body weight t.i.d.
- For Suspension: Adults- 500 mg t.i.d. before and after operation; Children- 7.5 mg/kg body weight t.i.d.
Bacterial vaginitis: Duration 7 Days;
- For Tablet: Adults- 500 mg b.i.d.
- For Suspension: Adults- 500 mg b.i.d.
Leg ulcers: Duration 1 Day;
- For Tablet: Adults- 2 g as a single dose
- For Suspension: Adults- 2 g as a single dose
Pressure sores: Duration 7 Days;
- For Tablet: Adults- 500 mg t.i.d.
- For Suspension: Adults- 500 mg t.i.d.
H. pylori infection: Duration 7 Days;
- For Tablet: Adults- 500 mg b.i.d
- For Suspension: Adults-500 mg b.i.d
Antibiotic Associated Pseudomembranus colitis: Duration 7 Days;
- For Tablet: Adults- 500 mg b.i.d
- For Suspension: Adults- 500 mg b.i.d
Vaginal Gel:
The recommended dose is one applicator full of Metronidazole GEL (approximately 5 grams containing approximately 37.5 mg of Metronidazole) intravaginally once or twice a day for 5 days. For once a day dosing, Metronidazole GEL should be administered at bedtime.
Suppository:
Anaerobic infections:
- Adult: 1 g 8 hrly for 3 days, then 12 hrly thereafter until oral medication is possible.
- Child: 5-10 yr 500 mg. All doses to be given 8 hrly for 3 days, then 12 hrly thereafter until oral medication is possible.
Prophylaxis of postoperative anaerobic bacterial infections:
- Adult: 1 g 2 hr before surgery, repeated 8 hrly for 3 days, then 12 hrly thereafter until oral medication is possible.
- Child: 5-10 yr 500 mg 2 hr before surgery, repeated 8 hrly for 3 days, then 12 hrly thereafter until oral medication is possible.
IV Infusion:
Metronidazole injection should be infused intravenously at an approximate rate of 5 ml/min. Oral medication should be substituted as soon as feasible. Treatment for 7 days should be satisfactory for most patients, but the physician might decide to prolong treatment.
- For bacterial infections: Adults: 500 mg (100 ml) 8 hourly. Children: 7.5 mg/kg (1.5 ml/kg) 8 hourly.
- For treatment before and during surgery: Adults: 500 mg (100 ml) shortly before operation, repeated 8 hourly. Children: 7.5 mg/kg (1.5 ml/kg) 8 hourly
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