Instructions for medical use

medicinal product

Metrogil ®

Trade title

Metrogil ®

international generic title

Metronidazole

Dosage form

Gel for external use 10 mg/g 30 g

Compound

1 g of gel contains

active substance - metronidazole 10.0 mg

Excipients: methyl parahydroxybenzoate, propyl parahydroxybenzoate, carbomer 940, disodium edetate, sodium hydroxide, propylene glycol, purified water.

Description

Homogeneous gel from colorless to yellow

Pharmacotherapeutic group

Antimicrobials for topical use. Other antimicrobials. Metronidazole.

ATX code D06BX01

Pharmacological properties

Pharmacokinetics

Absorption is minimal; after external application of the gel, only trace amounts of the drug are found in the blood serum. Absorbed metronidazole passes through the placenta and the blood-brain barrier.

The maximum plasma concentration is up to 66 ng / ml (when applying 1 g of the gel, equivalent to 7.5 mg of metronidazole).

Pharmacodynamics

Metronidazole is a synthetic antimicrobial and antiprotozoal broad-spectrum agent from the group of imidazoles. For external use Metrogyl ® the gel has an anti-acne effect, the mechanism of which is unknown. Active against anaerobes ( Bacteroides spp., Fusobacterium spp., Mobiluncus spp., Peptococcus spp., Peptostreptococcus spp., Clostridium, Eubacterium, Bacteroides fragilis, Prevotella) and the simplest ( Trichomonas vaginalis, Giardia intestinalis, Entamoeba histolytica, Lamblia intestinalis).

Metrogil ® gel for external use is ineffective against telangiectasias noted in acne rosacea.

Indications for use

• for external treatment of inflammatory manifestations of rosacea

Dosage and administration

Outwardly. Metrogil ® the gel is applied to previously cleansed affected areas of the skin with a thin layer 1 time per day.

Drug Metrogyl ® gel for external use 10 mg/g is not intended for oral use, in ophthalmology, for intravaginal use.

Side effects

® gel for external use, the absorption of metronidazole is minimal and the concentration in the blood plasma is negligible, and therefore, the risk of developing systemic side effects is low.

Often (≥ 1/ 100, < 1/10)

Dry skin, itching, peeling of the skin, discomfort (burning, pain)

Tearing (when applying the gel close to the eyes)

Upper respiratory infections, bronchitis, nasopharyngitis, sinusitis, nasal congestion

Urinary tract infections

hypertension

Headache

contact dermatitis

Infrequently(≥ 1/ 1000, < 1/100)

- backache

Vaginal mycosis

Basal cell carcinoma

Neoplasm

- swelling of the face

Frequency unknown

Skin irritation, transient facial flushing, tingling or numbness in extremities, nausea, metallic taste

Post-registration data

According to post-marketing studies, isolated cases of peripheral neuropathy have been reported in patients using metronidazole, a gel for external use. Since this reaction has been reported spontaneously and the total number of patients using the drug is unknown, it is not possible to reliably estimate the frequency or the presence of a causal relationship with the drug.

Contraindications

Hypersensitivity to the components of the drug.

Drug Interactions

When applied topically Metrogyl ® gel for external use interaction with other drugs is negligible.

Caution should be exercised when co-administered with warfarin and other indirect anticoagulants (increase prothrombin time).

special instructions

For external use only!

In patients with diseases of the central nervous system, metronidazole should be used with caution. In patients receiving systemic treatment with metronidazole, there have been cases of peripheral neuropathy, characterized by numbness or paresthesia of the extremities. Despite the lack of evidence from clinical trials of topical metronidazole, cases of peripheral neuropathy have been observed in post-registration use. If any symptoms of neuropathy appear, it is necessary to immediately review the prescribed therapy with Metrogyl. ® gel.

Metronidazole belongs to the group of nitroimidazole derivatives; in patients with signs of blood dyscrasia, including a history, the drug should be used with caution.

When using the drug, irritation and allergic contact dermatitis were noted. If signs of dermatitis appear after consulting a doctor, the frequency of application of the gel should be reduced, temporarily suspended or completely canceled the use of the drug.

Avoid contact with eyes! Topical formulations of metronidazole have been reported to cause lacrimation. If the gel gets into your eyes, rinse them thoroughly with plenty of water.

Pregnancy and lactation

There is no clinical experience with the external use of Metrogyl® gel in pregnant women.

Metronidazole crosses the placental barrier and rapidly enters the fetal circulation. After oral administration of metronidazole to rats or mice at doses 200 and 20 times, respectively, higher than clinical doses, no manifestations of fetotoxicity were observed. However, since reproductive toxicity studies in animals are not always predictive of human response, and metronidazole has been shown to be carcinogenic when administered orally to rodents, Metrogyl® Gel should only be used during pregnancy if clearly indicated, after consultation with a physician.

After oral administration, metronidazole passes into breast milk at concentrations similar to those found in plasma. Despite the fact that after the external use of the drug Metrogyl ® gel, its blood level is significantly lower than after taking metronidazole orally, the decision to stop breastfeeding or stop using the drug should be made taking into account the importance of using the drug for the mother and the risk to the newborn.

Use in children

There are no data on the safety and efficacy of Metrogyl® gel in children, and therefore, the drug is not recommended for use in patients of this age group.

Use in the elderly

Based on the results of clinical studies, no differences in safety or efficacy were observed when using metronidazole in a gel dosage form for external use in people over 65 years of age and in young patients. Patients in this age group do not require dose adjustment, however, it cannot be ruled out that some elderly patients have increased sensitivity to the drug.

The drug contains methyl parahydroxybenzoate, propyl parahydroxybenzoate, which can cause allergic reactions, including delayed action.

Features of the effect of the drug on the ability to drive vehicles or potentially dangerous mechanisms.

The drug does not affect the ability to drive vehicles or operate potentially dangerous machinery.

Overdose

Release form and packaging

30 g of the drug in an aluminum or plastic laminated tube with a screw cap.

1 tube, together with instructions for medical use in the state and Russian languages, is placed in a cardboard box.

Storage conditions

gel for external use

Owner/Registrar

UNIQUE PHARMACEUTICAL Laboratories

International Classification of Diseases (ICD-10)

I83.2 Varicose veins of the lower extremities with ulcer and inflammation I84 Hemorrhoids K60 Fissure and fistula of the anus and rectum L21 Seborrheic dermatitis L70 Acne L71.9 Rosacea, unspecified L89 Decubital ulcer

Pharmacological group

Antiprotozoal drug with antibacterial activity for external use

pharmachologic effect

Metronidazole is a synthetic antimicrobial and antiprotozoal broad-spectrum agent from the group of imidazoles. Active against anaerobes(Bacteroides spp., Fusobacterium spp., Mobiluncus spp., Peptococcus spp., Peptostreptococcus spp., Clostridium spp., Eubacterium spp., Bacteroides fragilis, Prevotella spp.) and protozoa(Trichomonas vaginalis, Giardia intestinalis, Entamoeba histolytica).

When applied topically, it has an anti-acne effect, the mechanism of which is not exactly known (it is not associated with an effect on the Demodex folliculorum mite found in the hair follicles and secretion of the sebaceous glands, and any effect on the production of this secret).

Metronidazole for topical use may have antioxidant activity. It has been established that it significantly reduces the production of active oxygen, hydroxyl radicals and hydrogen peroxide by neutrophils, which are potential oxidants that can cause tissue damage at the site of inflammation. Metronidazole for external use is not effective against telangiectasias noted in acne rosacea.

Pharmacokinetics

Absorption is minimal; after external application of the gel, only trace amounts of the drug are found in the blood serum. Absorbed metronidazole passes through the placenta and the blood-brain barrier. C max in the blood - up to 66 ng / ml (when applying 1 g of gel equivalent to 7.5 mg of metronidazole).

Rosacea (including post-steroid);

Vulgar acne;

Oily seborrhea, seborrheic dermatitis;

Trophic ulcers of the lower extremities (against the background of varicose veins, diabetes mellitus);

Poorly healing wounds;

bedsores;

Hemorrhoids, anal fissures.

Hypersensitivity to the components of the drug.

With topical application of the gel, the concentration of metronidazole in the blood is very low, so the risk of developing systemic side effects is low.

Rarely allergic reactions (urticaria, skin rash) may occur; hyperemia, peeling, slight dryness and burning of the skin, lacrimation (if the gel is applied close to the eyes).

Overdose

special instructions

Avoid contact with eyes. If the gel gets into your eyes, rinse them immediately with plenty of water.

Use during pregnancy and lactation

FROM caution - I trimester of pregnancy, lactation.

drug interaction

With topical application of the gel, interaction with other drugs is insignificant, however, care should be taken when administered simultaneously with warfarin and other indirect anticoagulants (increases prothrombin time).

For outdoor use. The gel is applied to previously cleansed affected areas of the skin with a thin layer 2 times / day, morning and evening, for 3-9 weeks.

The duration of treatment is 3-4 months, the therapeutic effect is usually noted after 3 weeks of treatment.

Storage conditions and shelf life

Store at a temperature not exceeding 30 ° C, out of the reach of children. Do not freeze. Shelf life - 3 years. Do not use after the expiry date stated on the package.

Vacation from pharmacies

The drug is approved for use as a means of OTC.

Release form

Compound

Metronidazole 10 mg. Excipients: methyl parahydroxybenzoate, propyl parahydroxybenzoate, carbomer 940, disodium edetate, sodium hydroxide, propylene glycol, purified water.

Pharmacological effect

Metronidazole is a synthetic antimicrobial and antiprotozoal broad-spectrum agent from the group of imidazoles. Active against anaerobes (Bacteroides spp., Fusobacterium spp., Mobiluncus spp., Peptococcus spp., Peptostreptococcus spp., Clostridium spp., Eubacterium spp., Bacteroides fragilis, Prevotella spp.) and protozoa (Trichomonas vaginalis, Giardia intestinalis, Entamoeba histolytica). When applied topically, it has an anti-acne effect, the mechanism of which is not exactly known (not associated with the action on the Demodex folliculorum mite found in the hair follicles and secretion of the sebaceous glands, and any effect on the production of this secret). Metronidazole for external use, possibly , has antioxidant activity. It has been established that it significantly reduces the production of active oxygen, hydroxyl radicals and hydrogen peroxide by neutrophils, which are potential oxidants that can cause tissue damage at the site of inflammation. Metronidazole for external use is not effective against telangiectasias noted in acne rosacea.

Pharmacokinetics

Absorption is minimal; after external application of the gel, only trace amounts of the drug are found in the blood serum. Absorbed metronidazole passes through the placenta and the blood-brain barrier. Cmax in the blood - up to 66 ng / ml (when applying 1 g of gel equivalent to 7.5 mg of metronidazole).

Indications

Acne rosacea (including post-steroid); - acne vulgaris; - oily seborrhea, seborrheic dermatitis; - trophic ulcers of the lower extremities (against the background of varicose veins, diabetes mellitus); - poorly healing wounds; - bedsores; - hemorrhoids, anal fissures.

Contraindications

Hypersensitivity to the components of the drug.

Use during pregnancy and lactation

With caution - I trimester of pregnancy, lactation.

Dosage and administration

For outdoor use. The gel is applied to previously cleansed affected areas of the skin with a thin layer 2 times / day, morning and evening, for 3-9 weeks. The duration of treatment is 3-4 months, the therapeutic effect is usually noted after 3 weeks of treatment.

Side effects

With topical application of the gel, the concentration of metronidazole in the blood is very low, so the risk of developing systemic side effects is small. Rarely, allergic reactions (urticaria, skin rash) can be observed; hyperemia, peeling, slight dryness and burning of the skin, lacrimation (if the gel is applied close to the eyes).

The drug Metrogil gel with an affordable price and positive reviews, according to the instructions for use, is designed to destroy the simplest pathogenic microorganisms of the anaerobic spike type, as well as bacteria by suppressing the production of nucleic acids.

The composition of 1 g of the drug includes:

• 10 mg of the active substance metronidazole;
• clotrimazole;
• disodium edetate;
• methyl parahydroxybenzoate;
• propylene glycol;
• carbomer 940;
• sodium hydroxide;
• propyl parahydroxybenzoate;
• purified water.

Release form

The drug is a gel for external use, dispensed in 30 and 50 g in plastic laminated or aluminum tubes with a screw cap. The drug is produced in the form of a homogeneous substance having a gel consistency. and color ranging from transparent, white to yellowish.

Reviews report a convenient packaging of Metrogyl gel, complete with 1 tube of the drug and instructions for therapeutic use. The price of a product weighing 50 g and equipped with applicators in an amount of 1 to 10 pieces ranges from 219 to 240 rubles.

pharmachologic effect

The drug is an antiprotozoal agent with antibacterial and bacteriostatic properties, used for external use.

Pharmacokinetics

• Studies have shown minimal absorption of the drug. After external use, background amounts of the drug are found in the blood serum. Entered into the body, metronidazole is able to penetrate the blood-brain barrier and the placenta, enter various cells and breast milk, while the maximum concentration of the substance in the blood when applying 1 g of the drug is up to 66 ng / ml.
• With the intravaginal use of the substance, absorption of metronidazole in the bloodstream is observed at a level of 56%. The time to reach the maximum concentration of the active substance (237 ng / ml) is in the range from 6 to 12 hours. Stable bonds with blood plasma proteins are less than 20%. Research and practical application have confirmed the more effective action of Metrogyl in the form of a gel compared to the medicine produced in the form of tablets. Metabolism of metronidazole occurs in the liver, followed by excretion from the body during urination.
• Absorption of clotrimazole for intravaginal use ranges from 3 to 10%., while high norms of the substance remain in the vaginal lubrication for 48 - 72 hours.

Pharmacodynamics

Metrogyl gel (instructions for use, price, reviews for external use confirm the effectiveness of the combined action) demonstrates activity against such anaerobic bacteria as:

1. Peptostreptococcus spp.
2. Prevotella spp.
3. Peptococcus spp.
4. Mobiluncus spp.
5. Fusobacterium spp.
6. Clostridium difficile;
7. Eubacterium spp.
8. Bacteroides fragilis;
9. Gardnerella vaginalis;
10. Bacteroides spp.

In addition, the active component of the drug affects such types of protozoa as:

• Trichomonas vaginalis;
• Entamoeba histolytica;
• Giardia intestinalis;
• Entamoeba histolytica;
• Giardia lamblia;
• Lamblia intestinalis.

Metrogyl gel: instructions for use (price, reviews correspond to the declared effect) reports that in addition to metronidazole, the product contains clotrimazole, which is characterized by a fungicidal and bactericidal effect. When interacting with microorganisms, clotrimazole slows down the production of ergosterol, which affects the permeability of microorganism cell membranes.

At the same time, low doses of the substance provide a fungistatic effect. The interaction of clotrimazole with peroxidases and mitochondrial enzymes leads to an increase in the percentage of hydrogen peroxide to critical values, causing the death of formations that have a mycotic nature.

Indications for use in gynecology

Metrogyl gel: instructions for use (price, reviews confirm effectiveness) of an antifungal and antimicrobial drug, indicates how to use it in the form of a vaginal gel.

The drug is dispensed according to the prescription of the attending specialist and is prescribed for the treatment of such urogenital diseases as:

1. candidal vulvitis;
2. urogenital trichomonas;
3. candidal vulvovaginitis;
4. confirmed vaginosis, having a bacterial nature.

Indications for the face

Metrogyl gel is used for topical external use, to relieve puffiness, improve the condition and heal thinned vessels.

Shows high efficiency in therapy:

• acne;
• infectious dermatological lesions caused by varicose veins or diabetes mellitus;
• eczema;
• difficult to heal areas of the skin;
• the fight against subcutaneous ticks with demodicosis;
• seborrhea;

Metrogyl gel is used in the treatment of seborrhea.

• rosacea that appears on the face due to the use of hormonal drugs;
• acne, which manifests itself in the face during puberty in adolescents.

Contraindications

Metrogil gel (instructions for use, price, reviews are contained in various forums and discussions) is recommended to be limited if there is an increased sensitivity of the patient's body to nitroimidazole derivatives and other components of the drug.

But there are some special cases, stipulating the conditions for taking the drug for certain groups of patients, among which it is necessary to highlight:

1. The patient has liver failure, epilepsy, leukopenia, a tendency to seizures.
2. The ban on the appointment and use of the drug for the treatment of children under the age of 12 years.
3. Careful use of the drug by patients with diseases of the central nervous system, since the occurrence of cases of peripheral neuropathy, in particular paresthesia and numbness of the extremities, has been noted during systematic therapy with the use of metronidazole. If any signs of neuropathy appear, you should immediately inform your doctor about the changes, who will review the therapy, which involves the use of Metrogyl gel.
4. Diseases of the hematopoietic system and liver dysfunctions.
5. Use in small doses for patients with signs of blood dyscrasia in symptomatic manifestations of the disease.
6. Avoid getting the drug into the area of ​​the mucous surfaces of the eyes during the antibacterial treatment of the face, which can result in profuse lacrimation. If the drug gets into the eye area, it is necessary to perform a thorough rinsing using plenty of water.
7. Cautious use in the first trimester of pregnancy and when breastfeeding.

Side effects

When used externally, in accordance with the recommended dosages, usually there are no adverse reactions to metronidazole, which is one of the main components.

In rare cases, as a result of an individual reaction of the body to the drug, consequences such as:

• skin itching;
• irritation;
• infections of the upper respiratory tract, manifested in pathologies such as nasopharyngitis, nasal congestion, bronchitis, sinusitis;
• burning;
• sensation of a metallic taste on the surface of the lips;
• hives;

• migraine;
• the appearance of a feeling of tingling or numbness of the limbs;
• swelling and hyperemia of the skin, manifested at the site of application of the drug;
• the appearance of infection in the organs of the urinary system;
• nausea;
• the appearance of signs of contact and allergic dermatitis;
• hypertension;
• feeling of tightness of the skin and dryness of the integument.

If signs of dermatitis appear, you should immediately seek advice from your doctor, after which, in accordance with the instructions, either reduce the frequency of application of the product, or permanently stop using it.

In more rare cases, side effects such as:

1. neoplasm;
2. the appearance of pain in the back;
3. swelling of the face;
4. basal cell carcinoma;
5. the appearance of fungal infections in the vaginal area.

Instructions for use, price and reviews indicate the high quality and effectiveness of Metrogyl gel. But when using it, the appearance of some side effects is not excluded. To avoid this, before carrying out therapy, it is necessary to undergo a thorough examination by an endocrinologist, dermatologist, dentist and gynecologist.

Contraindications

Medical practice does not note known cases of overdose of the drug, however, there are situations in which it is recommended to avoid during treatment with Metrogyl gel:

• When using any medicines based on metronidazole (regular and vaginal), the use of alcoholic beverages is contraindicated, due to a decrease in the effectiveness of the drug and a simultaneous increase in the risk of allergic reactions.
• Exclude visiting the sauna, taking hot baths, being under the influence of direct ultraviolet radiation, eating smoked meats and spicy dishes.
• Limit, and if possible, completely eliminate the wearing of underwear based on synthetics, since in this case the risk of recurrence of vaginitis increases significantly. During treatment and after recovery, it is recommended to prefer natural cotton-based underwear.

Special instructions for pregnancy and lactation

There are no data from studies on the use of Metrogyl gel for antibiotic therapy in pregnant women. Instructions for use of the drug recommends using it during pregnancy only if there are appropriate recommendations from the attending specialist.

After using the gel, there is a slight (at the level of the concentration of the substance in the blood plasma) increase in the concentration of metronidazole in breast milk. The decision to stop breastfeeding or taking the drug should be made by the treating specialist based on an assessment of the positive effect for the mother and the risk to the health of the child.

Application to children

Due to the lack of laboratory studies on the efficacy and safety of using the gel for the treatment of children, it is recommended to refrain from prescribing and using the drug in patients of the younger age group and children under the age of 12 years.

Metrogyl face gel, instructions for use

For external use to eliminate pathogenic microflora in the face area, it is recommended to apply the gel 1-2 times on a previously prepared area of ​​the skin. Double treatment of the affected areas is carried out in the presence of acne, affected areas and blackheads, while the treatment of the affected areas is carried out in the morning and in the evening.

The tool is characterized by a light consistency, easy to use. After application to the surface of the skin, it is located on it in an even layer, forming a thin film.

The course of treatment can reach 9 weeks. It is noted that with daily use of the product, noticeable results are observed already after a few weeks from the start of the procedures.

The use of the gel for therapy in the face area includes the sequential implementation of a number of procedures, including:

1. Thorough hand washing before and after handling.
2. Carrying out skin cleansing using mild soap, foam, milk or gel.
3. Wiping the treated surface with an alcohol-free lotion.
4. Performing a spot application of the drug with rubbing with the palms or fingertips until a homogeneous thin layer is formed on the skin surface. In special cases, the gel can be applied under the dressing as recommended by the attending physician.

Cosmetologists emphasize the high effectiveness of the drug for the treatment of oily skin.

Vaginal gel Metrogyl, instructions for use

Metrogyl gel is used twice a day (morning and evening), while the recommended dosage for intervaginal use is 1 full applicator (5 g). The duration of treatment depends on the recommendations of a specialist and can be from 5 to 10 days.

If necessary, to completely eliminate pathogens of pathogenic microflora, it is possible to repeat the course of therapy, carried out after 14 days. At the time of treatment, gynecologists recommend to refrain from sexual intercourse.

The algorithm for applying the Metrogyl gel includes the sequential execution of a number of operations:

• Removing the applicator from the package, removing the cap from the tube.
• Putting the applicator on the neck of the tube, positioning in space so that the applicator is pointing upwards.
• Pressure on the surface of the tube until the entire volume of the nozzle is filled.
• Dismantling the applicator from the surface of the tube, sealing it with a cap.
• Careful introduction of the nozzle into the vagina with a gradual pressure on the piston to ensure that the gel flows completely inside.
• Removal of the applicator and its treatment with medical alcohol for subsequent storage in a pure form until the next use.

drug interaction

Gynecologists take into account the interaction of the drug with other drugs, since some of them can have a negative impact on the course of therapy, cause side effects and complications.

1. amphotericin, nystatin, natamycin, since these substances reduce the effectiveness of clotrimazole;
2. medications based on lithium, the use of which increases the percentage of this element in the blood plasma;
3. neopolarizing muscle relaxants;
4. phenobarbital, which accelerates the metabolism of the active substance;
5. indirect anticoagulants, the interaction of the drug with which leads to an increase in their effect;
6. cimetidine, which reduces the metabolism of the active substance, resulting in its increase in blood serum, which in turn increases the risk of complications

To eliminate bacterial and infectious pathologies on the face and in the area of ​​the organs of the reproductive system in women, as well as to prevent their occurrence, it is recommended to take measures to treat and strengthen the immune system with Metrogyl gel.

Detailed instructions for use are attached to the tool. Affordable price and numerous reviews testify to the high effectiveness of the drug.

Video about Metrogyl gel, the rules for its use and effectiveness

Metrogyl gel for the treatment of bacterial vaginosis, expert advice:

The effectiveness of Metrogyl gel in the fight against acne:

Instructions for use
Metrogil

Dosage forms

Gel for external use 1% 30g

Synonyms
Bacimex
Klion
Metronidazole
Metronidazole Nycomed
Metronidazole-AKOS
Metronidazole-Ros
Metronidazole-Rusfar
Metronidazole-Teva
Metronidazole-UBF
Metronidazole tablets
Rozamet
Rosex
Trihopex
Trichopolum
Flagyl
Efloran

Group
Means for the treatment of trichomoniasis, amebiasis and other protozoal infections

International non-proprietary name
Metronidazole

Compound
The active substance is metronidazole.

Manufacturers
Unique Pharmaceutical Laboratories (India)

pharmachologic effect
Antibacterial, antiprotozoal (trichomonacid), antiulcer, anti-alcohol. The nitro group of the molecule, which is an electron acceptor, is integrated into the respiratory chain of protozoa and anaerobes, which disrupts the respiratory processes and causes cell death. In addition, in some species of anaerobes, it has the ability to inhibit DNA synthesis and cause its degradation. After oral administration, it is rapidly and completely absorbed from the gastrointestinal tract. The maximum concentration is reached in 1-2 hours. It penetrates well into tissues and body fluids, creating bactericidal concentrations in saliva, seminal fluid, and vaginal secretions; penetrates the BBB and placental barriers, is secreted into breast milk. At repeated receptions cumulates. Undergoes biotransformation in the liver. It is excreted by the kidneys and intestines, with about 20% unchanged. The spectrum of action includes protozoa: Trichomonas vaginalis, Entamoeba histolytica; anaerobic gram-negative microorganisms: bacteroides, including the Bacteroides fragilis group (B. fragilis, B. caccae, B. uniformis, B. distasonis, B. ovatus, B. thetaiotaomicron, B. vulgatus); fusobacteria Prevotella (P. bivia, P. buccae, P. disiens); anaerobic gram-positive rods: Clostridium, Eubacterium; anaerobic gram-positive cocci: Peptococcus, Peptostreptococcus; trichomonacid action is observed at a drug concentration of 2.5 μg / ml for 24 hours. It is active against Helicobacter pylori.

Side effect
Headache, dizziness, syncope, ataxia, impaired consciousness, epileptic seizures, neutropenia (leukopenia), nausea, vomiting, abdominal pain, diarrhea, unpleasant metallic taste, erythematous rashes, pruritus, dark urine staining, allergic reactions, thrombophlebitis (after intravenous administration).

Indications for use
Amebiasis, trichomoniasis, giardiasis, giardiasis, intra-abdominal infections (peritonitis, abscess), anaerobic infections of bones and joints, skin and soft tissues, female genital organs (endometritis, tubo-ovarian abscess), CNS (meningitis, brain abscess), lower respiratory tract (pneumonia) , empyema, lung abscess), endocarditis, pseudomembranous colitis, eradication of Helicobacter pylori, chronic alcoholism, prevention of postoperative anaerobic infection. For external and topical use: rosacea and acne vulgaris, bacterial vaginosis, long-term non-healing wounds, trophic ulcers.

Contraindications
Hypersensitivity (including to other nitroimidazole derivatives), pregnancy, lactation, childhood (excluding cases of amoebiasis).

Method of application and dosage
Outwardly: apply 2 times a day, the dose is set individually.

Overdose
Symptoms: nausea, vomiting, ataxia, in severe cases - peripheral neuropathy and epileptic seizures. Treatment: symptomatic; there are no specific antidotes.

Interaction
Enhances the effects of indirect anticoagulants and lithium salts. Phenytoin and phenobarbital reduce the effect (by activating the microsomal system of the liver and accelerating metabolism and excretion), and cimetidine increases (inhibits the enzymatic systems of the liver and, as a result, slows down biotransformation). Incompatible with alcohol (when taken together, an antabuse-like syndrome develops).

special instructions
In the treatment of metronidazole, sometimes there is an overdevelopment of the fungal flora of the vagina (candidiasis), which requires the appointment of antifungal drugs.

Storage conditions
In a cool, dry, dark place. List B.