Metronidazole tablets 250mg №10×3

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Metronidazole tablets 250mg, 30 pcs.
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Tablets white with a yellowish-greenish tint, flat-cylindrical, with a risk on one side and a chamfer. The main active ingredient is Metronidazole. Release form Tablets. Dosage 250mg. Pharmacological action Synthetic antibacterial and antiprotozoal drug of the 5-nitroimidazole group. The drug has an antibacterial, antiprotozoal effect. Suppresses the development of protozoa (Trichomonas vaginalis, Entamoeba histolytica, Gardnerella vaginalis, Giardia intestinalis, Lamblia spp.), highly effective against obligate anaerobic bacteria Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus), Fusobacterium spp., Veillonella spp., Prevotella (Prevotella bivia, Prevotella buccae, Prevotella disiens) and some Gram-positive microorganisms (Eubacter spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp.). In combination with amoxicillin, it is active against Helicobacter pylori (amoxicillin inhibits the development of resistance to metronidazole). Does not have a direct effect on aerobes and facultative anaerobes. In mixed aerobic-anaerobic infections, metronidazole acts synergistically with antibiotics effective against pathogenic aerobes. Increases the sensitivity of tumors to radiation, causes disulfiram-like reactions, stimulates reparative processes. Indications for use In order to avoid the development of resistance of microorganisms, metronidazole should only be used to treat infections caused by metronidazole-sensitive strains (according to microbiological examination of the material or epidemiological data). Trichomoniasis with clinical symptoms. Metronidazole is indicated for the treatment of symptomatic trichomoniasis in women and men when the presence of Trichomonas has been confirmed by appropriate laboratory tests (smear and/or culture). Asymptomatic trichomoniasis. Metronidazole is indicated for the treatment of women with asymptomatic trichomoniasis (endocervicitis, cervicitis, or cervical erosions). Since there is evidence that the presence of Trichomonas may interfere with the accurate assessment of cytological smears, additional smears should be performed after eradication of the parasite. Treatment of a spouse without clinical manifestations. T. vaginalis infection is a sexually transmitted disease. Thus, asymptomatic sexual partners should be treated at the same time in order to prevent re-infection from the partner, even if the pathogen is not isolated. The decision on whether to treat an asymptomatic male partner who has not been diagnosed with Trichomonas, or if no analysis has been performed, is an individual decision. In making this decision, it should be noted that there is evidence that a woman can become reinfected if her husband is not treated. In addition, since there is considerable difficulty in isolating the pathogen in an asymptomatic patient, one should not rely on a negative smear and culture result. In any case, in case of re-infection, spouses should be treated with metronidazole at the same time. Amoebiasis. Metronidazole is indicated for the treatment of acute intestinal amoebiasis (amebic dysentery) and liver abscess caused by amoebas. In the treatment of liver abscess caused by amoebas with metronidazole, the need for aspiration or drainage of pus cannot be ruled out. Anaerobic bacterial infections. Metronidazole is indicated for the treatment of severe infections caused by susceptible anaerobic bacteria. Necessary surgical procedures should be performed in conjunction with metronidazole therapy. In case of mixed aerobic and anaerobic infection, appropriate antimicrobial agents should be used in addition to metronidazole. In the treatment of severe anaerobic infections, metronidazole is usually given first. Intra-abdominal infections, including peritonitis, intra-abdominal abscess, and liver abscess, are caused by Bacteroides, including the B. fragilis group (B. fragilis, B. distasonis, B. ovatus, B. thetaiotaomicron, B. vulgatus), Clostridium, Eubacterium, Peptococcus niger, and Peptostreptococcus . Infections of the skin and skin structures caused by Bacteroides (including the B. fragilis group), Clostridium, Peptococcus niger, Peptostreptococcus and Fusobacterium. Gynecological infections, including endometritis, endomyometritis, tubo-ovarian abscess, and post-gynecological infections caused by Bacteroides (including the B. fragilis group), Clostridium, Peptococcus niger and Peptostreptococcus. Bacterial septicemia caused by Bacteroides (including the B. fragilis group) and Clostridium. Bacteroides species (including the B. fragilis group) infections of bones and joints as adjunctive therapy. Infections of the central nervous system, including meningitis and brain abscess, caused by Bacteroides (including the B. fragilis group). Lower respiratory tract infections, including pneumonia, empyema and lung abscess, caused by Bacteroides (including the B. fragilis group). Endocarditis caused by Bacteroides (including the B. fragilis group). Dosage and administration Take orally, during or after a meal, without chewing. Trichomoniasis in women and men. The course of treatment is chosen individually. One-day course of treatment – 2 grams (8 tablets) as a single dose or divided into two doses of 1 gram (4 tablets) 2 times a day. One-day treatment is indicated in cases where there is an assumption that the patient cannot strictly adhere to the treatment regimen. A seven-day course of treatment – 250 mg (1 tablet) three times a day for 7 days. The cure rate may be higher after a seven-day course of treatment. Pregnant women should not take metronidazole during the first trimester of pregnancy. Carrying out a one-day course of therapy for pregnant women is contraindicated, since it leads to a high concentration of metronidazole in the blood plasma and the agent can penetrate into the fetus. With repeated courses of treatment with metronidazole, it is recommended to take a break of 4-6 weeks. Before and after these courses, it is necessary to perform a blood test for the total number of leukocytes and the leukocyte formula. Amoebiasis. Adults: for intestinal amoebiasis, 750 mg orally three times a day for 5 to 10 days; with a liver abscess, 500 mg or 750 mg three times a day for 5 to 10 days. Children: daily dose of 35–50 mg/kg divided into three oral doses for 10 days. For the treatment of severe anaerobic bacterial infections. Metronidazole is prescribed at the initial stage. The usual adult dose is 7.5 mg/kg every six hours by mouth (about 500 mg for a 70 kg patient). The maximum daily dose is 4 g. The duration of therapy is from 7 to 10 days (treatment of infections of the bones and joints, lower respiratory tract and endocardium may be longer). In elderly patients, the pharmacodynamics of metronidazole may be changed; monitoring of the content of metronidazole in the blood serum is necessary to select the dose. In patients with severe liver disease, metronidazole may accumulate and doses should be reduced. Close monitoring of plasma levels of metronidazole and signs of toxicity is recommended. Use during pregnancy and lactation During the first trimester of pregnancy, metronidazole is contraindicated. In the II and III trimesters of pregnancy, the drug should be used with caution, in case of emergency, with a proper assessment of the benefits of therapy for the mother and the potential risk to the fetus. Metronidazole passes into breast milk. When prescribing the drug to nursing mothers, breastfeeding should be stopped. Influence on the ability to drive vehicles and other potentially dangerous mechanisms Dizziness, confusion, hallucinations or convulsions associated with taking this drug may develop, which disrupts operator activity. Precautions During the treatment period, ethanol is contraindicated (possible development of disulfiram-like reactions: spastic abdominal pain, nausea, vomiting, headache, sudden flushing of blood to the face). Patients should refrain from drinking alcohol for at least 48 hours after stopping metronidazole therapy. In the treatment of trichomonas vaginitis in women and trichomonas urethritis in men, it is necessary to refrain from sexual activity. Mandatory simultaneous treatment of sexual partners. Treatment does not stop during menstruation. After therapy for trichomoniasis, control tests should be carried out for 3 regular cycles before and after menstruation. During treatment with metronidazole, symptoms of a candidal infection may appear. Due to insufficient data regarding the risk of mutagenicity in humans, the decision to prescribe long-term use of metronidazole should be carefully weighed. Use with caution in patients with porphyria. Regular clinical and laboratory monitoring is recommended if treatment is continued for more than 10 days. With prolonged therapy, it is necessary to control the picture of peripheral blood. With leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process. Caution should be exercised in patients with a history of epilepsy or seizures, as high doses of metronidazole may induce seizures in such individuals. With long-term treatment, the risk of developing peripheral neuropathy should be taken into account. The appearance of ataxia, dizziness and any other deterioration in the neurological status of patients requires discontinuation of treatment. In persons with impaired renal function, the half-life of metronidazole does not change and correction of the mode of its use is not required, despite the fact that metronidazole metabolites may linger in the body in such patients. With hemodialysis, metronidazole is completely removed in 8 hours, therefore, after the dialysis procedure, the next dose of metronidazole should be taken immediately. It is not required to change the dosing regimen of metronidazole in patients who are on periodic or continuous peritoneal dialysis. In patients with hepatic insufficiency and encephalopathy, the appointment of metronidazole can lead to an aggravation of the symptoms of encephalopathy due to metabolic disorders, so care should be taken when prescribing metronidazole in this category of patients. Metronidazole can immobilize treponemas and lead to a false positive Nelson test. Metronidazole may affect the determination of biochemical parameters such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), triglycerides, glucose. Metronidazole stains urine dark. Interaction with other drugs Enhances the effect of indirect anticoagulants, which leads to an increase in the time of formation of prothrombin (dose adjustment of anticoagulants is required). Simultaneous administration of drugs that stimulate microsomal oxidation enzymes in the liver (phenobarbital, phenytoin) can accelerate the excretion of metronidazole, resulting in a decrease in its plasma concentration. Cimetidine inhibits the metabolism of metronidazole, which can lead to an increase in its concentration in the blood serum and an increase in the risk of side effects. Simultaneous use with disulfiram can lead to the development of various neurological symptoms (the interval between administration is at least 2 weeks). When taken simultaneously with lithium preparations, the concentration of the latter in plasma and the development of symptoms of intoxication may increase (stop taking lithium preparations or reduce the dose). It is not recommended to combine with non-depolarizing muscle relaxants (vecuronium bromide). Sulfonamides enhance the antimicrobial effect of metronidazole. The simultaneous use of alcohol and metronidazole causes disulfiram-like reactions (cramping abdominal pain, nausea, vomiting, headache, skin flushing). Metronidazole reduces the clearance of 5-fluorouracil, their combined use may lead to an increase in the toxicity of 5-fluorouracil. Patients receiving ciclosporin concomitantly with metronidazole are at risk of elevated serum ciclosporin levels. If co-administration is necessary, serum cyclosporine and creatinine levels should be carefully monitored. Metronidazole may increase busulfan plasma levels and increase busulfan toxicity. Contraindications Hypersensitivity, leukopenia (including history), organic lesions of the central nervous system (including epilepsy), liver failure (in case of high doses), pregnancy (I trimester), lactation period, children under 6 years of age. Carefully. Pregnancy (II-III trimesters), renal/liver failure. Composition Each tablet contains: active ingredient: metronidazole – 250.0 mg; excipients: microcrystalline cellulose, calcium stearate, potato starch. Overdose Symptoms: nausea, vomiting, anorexia, convulsions. Treatment: gastric lavage, administration of activated charcoal, symptomatic therapy. There is no specific antidote, it is excreted from the body during hemodialysis. Peritoneal dialysis is ineffective. Side effects The frequency of side effects is given in the following gradation: very often (≥ 1/10); often (≥ 1/100, < 1/10); infrequently (≥ 1/1000, < 1/100); rarely (≥ 1/10,000, < 1/1000); very rarely (< 1/10,000); unknown (according to the available data, it is not possible to determine the frequency of occurrence). The frequency of cases, the type and intensity of manifestation of undesirable effects in children are the same as in adults. Severe adverse reactions are rare with recommended treatment regimens. If the clinician wants to continue therapy for the relief of chronic diseases for longer than recommended, he should weigh the potential therapeutic benefit against the risk of peripheral neuropathy. Blood and lymphatic system disorders: very rarely - agranulocytosis, neutropenia, thrombocytopenia, pancytopenia; unknown - leukopenia. Immune system disorders: rarely - anaphylaxis; unknown - angioedema, urticaria, fever. Metabolic and nutritional disorders: unknown - anorexia. Mental disorders: very rarely - mental disorders, including confusion and hallucinations; unknown - depression. Nervous system disorders Very rare: encephalopathy (eg, confusion, fever, headache, hallucinations, paralysis, photophobia, visual and movement disturbances, neck stiffness) and subacute cerebellar syndrome (eg, ataxia, dysarthria, gait disturbance, nystagmus and tremor), which are reversed after the abolition of metronidazole, drowsiness, dizziness, convulsions, headache; unknown - peripheral sensory neuropathy or transient epileptic seizures, which in most cases disappear after discontinuation of the drug or dose reduction, aseptic meningitis. On the part of the organ of vision: very rarely - transient visual impairment, including diplopia and myopia; unknown - neuropathy or optic neuritis. Gastrointestinal disorders: unknown - taste disturbances, stomatitis, coated tongue, nausea, vomiting, epigastric pain, diarrhea. On the part of the liver and biliary tract: very rarely - increased levels of liver enzymes (AST, ALT, alkaline phosphatase), cholestatic or mixed hepatitis and hepatocellular liver damage, jaundice and pancreatitis, which is reversible after discontinuation of the drug. In patients treated with metronidazole in combination with other antibiotics, there have been cases of liver failure requiring liver transplantation. Skin and subcutaneous tissue disorders: very rarely - rash, pustular skin rash, itching, skin flushing; unknown - erythema multiforme, Stevens-Johnson syndrome or toxic epidermal necrolysis. Musculoskeletal and connective tissue disorders: very rarely - myalgia, arthralgia. Renal and urinary disorders: Very rarely, dark urine due to the presence of metronidazole pigments. Genital and breast disorders: unknown - vaginal pain and candidiasis. In the event of the above adverse reactions or adverse reactions not listed in these instructions for medical use of the drug, you should consult a doctor. Storage conditions In a place protected from moisture and light at a temperature not exceeding 25 ° C. Keep out of the reach of children. Buy Metronidazole tablets 250mg No. 10x3 Price for Metronidazole tablets 250mg No. 10x3