Metronidazole + Clotrimazole Pharmacology

Metronidazole + Clotrimazole

About Metronidazole + Clotrimazole
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Mechanism of Action of Metronidazole + Clotrimazole
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Pharmacokinets of Metronidazole + Clotrimazole
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Onset of Action for Metronidazole + Clotrimazole
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Duration of Action for Metronidazole + Clotrimazole
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Half Life of Metronidazole + Clotrimazole
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Side Effects of Metronidazole + Clotrimazole
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Contra-indications of Metronidazole + Clotrimazole
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Special Precautions while taking Metronidazole + Clotrimazole
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Metronidazole + Clotrimazole
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Interactions for Metronidazole + Clotrimazole
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Typical Dosage for Metronidazole + Clotrimazole
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Schedule of Metronidazole + Clotrimazole
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Storage Requirements for Metronidazole + Clotrimazole
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Effects of Missed Dosage of Metronidazole + Clotrimazole
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Effects of Overdose of Metronidazole + Clotrimazole
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Metronidazole

About Metronidazole
A nitroimidazole antibiotic, Anti-infective, Antiprotozoal,amebicide.
Mechanism of Action of Metronidazole
Metronidazole is nitro imidazoles which have broad spectrum cidal activity against Protozoa and some anaerobic bacteria. Its selective toxicity to anaerobic microbes involves 1. Drug enters the cell by diffusion, 2. Nitro group of drug is reduced by redox proteins present only in anaerobic organisms to reactive nitro radical which exerts cytotoxic action by damaging DNA and other critical biomolecules. 3. DNA helix destabilization & strand breakage has been observed.
Pharmacokinets of Metronidazole
Absorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver by oxidation & glucuronide conjugation, Excretion: Excreted in urine.
Onset of Action for Metronidazole
1 to 2 days
Duration of Action for Metronidazole
8hours.
Half Life of Metronidazole
8 hours.
Side Effects of Metronidazole
1.Anorexia.
2.Metallic taste
3.Nausea
4.Vomiting
5.Diarrhoea
6.Headache
7.Looseness of stool.
8.Peripheral neuropathy &CNS effects.
9.Mutagenesis.
10.Radiosensitisation.
11.Transient leucopenia
12.Dry mouth
13.Abdominal distress
14.Dizziness
15.Vertigo
16.Thrombophlebitis at site of injection
17.Ototoxicity
Contra-indications of Metronidazole
1.Hypersensitivity to the drug
2.Blood dyscrasias
3.CNS disorders
Special Precautions while taking Metronidazole
1.Renal impairment
2.Hepatic impairment
3.Alcoholic cirrhosis
4.Use cautiously along with other hepatotoxic drugs & In visual field changes
Pregnancy Related Information
Use with caution
First trimester:contra indicated
Old Age Related Information
May be used.
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Neonates: Contraindicated
Indications for Metronidazole
1.Amoebiasis
2.Giardiasis
3.Trichomonas vaginitis
4.Pseudo membranous enterocolitis
5.Anaerobic bacterial infections after surgery, Brain abscess, & Endocarditis
6.Helicobacter pylori infections
7.Ulcerative gingivitis
Interactions for Metronidazole
Warfarin & other coumarin anticoagulants: Potentiates the anticoagulant effect resulting in increased prothrombin time.
Alcohol: A disulfiram-like reaction. Abdominal cramps, nausea, vomiting, headache & flushing.
Disulfiram: Acute psychotic reaction or confusional state.
Phenobarbital & Phenytoin: Increased metabolism of metronidazole resulting in decreased efficacy.
Lithium: Increased lithium levels and toxicity.
Flurouracil: Increased toxicity of flurouracil.
Lab tests: May interfere with chemical analysis for AST,SGOT, ALT, SGPT, LDH, triglycerides and hexokinase glucose. Zero values may occur.
Typical Dosage for Metronidazole
Adult
Amoebiasis:400 to 800 mg 8hourly for 5 to 10days depending up on the severity of infection
In severe infections and liver abscess: 1gm as slow I.V. infusion followed by 0.5 gm twice daily till oral therapy is started
Giardiasis:200mg 8hourly for 1week or 2gm/day for 3days or I.V.500mg thrice daily
Trichomonas vaginitis: 400mg 8 hourly for a week or 2gm once daily for a week.
Male partner should be concurrently treated with the drug
Pseudo membranous enterocolitis:800 mg 8hourly
Anaerobic bacterial infections after surgery, Brain abscess, & Endocarditis:400 to 800 mg 8hourly
In severe cases: 15mg/kg I.V. infusion for 1hour followed by 7.5mg/kg 4 times daily till oral therapy is substituted
Helicobacter pylori infections:400mg 8hourly along with amoxicillin/clarithromycin and a proton pump inhibitor
Ulcerative gingivitis:200 to 800mg 8hourly
Children
Amoebiasis: 30 to 50mg/kg/day for 5to10 days.
Giardiasis:10 to 15mg/kg/day thrice daily
Children (below 12years): 7.5mg/kg I.V.
Schedule of Metronidazole
H
Storage Requirements for Metronidazole
Store in a well closed container in a cool dark place. Keep out of the reach of children.
Effects of Missed Dosage of Metronidazole
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Metronidazole
Treatment is supportive & symptomatic. Drug is removed by induced emesis, gastric lavage, and administration of activated charcoal & use of cathartics. For controlling seizures diazepam & phenytoin may be used.

Clotrimazole

About Clotrimazole
A broad-spectrum antifungal antibiotic, imidazole derivative, Oral Nonabsorbed Antifungal Agent.
Mechanism of Action of Clotrimazole
Clotrimazole is fungicidal or fungistatic depending on the drug concentrations. It inhibits the conversion of Lanosterol to 14 demethyl Lanosterol by inhibiting the cytochromeP450 enzyme 14 alpha demethylase and impair ergosterol synthesis which is an essential constituent of cell membrane. Inhibition of ergosterol synthesis will alter the membrane permeability of the susceptible fungus and kill or inhibit them.
Pharmacokinets of Clotrimazole
Absorption: Absorption is minimal after topical administration.
Onset of Action for Clotrimazole
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Duration of Action for Clotrimazole
3 hours
Half Life of Clotrimazole
N/A
Side Effects of Clotrimazole
1.Stinging
2.Erythema
3.Burning
4.Pruritis
5.Vesication
6.Desquamation
7.Urticaria
8.Burning
9.Peeling
10.Irritation
Contra-indications of Clotrimazole
Hypersensitivity to Clotrimazole
Special Precautions while taking Clotrimazole
1.Avoid contact with eyes, nose and mouth.
2.Do not wear occlusive dress over the medicament.
Pregnancy Related Information
Use with caution.
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Use with caution.
Children Related Information
Use with caution.
NEONATES: contraindicated
Indications for Clotrimazole
1.Tinea pedis
2.Tinea cruris
3.Tinea versicolor
4.Tinea corporis
5.Cutaneous candidiasis
6.Vulvovaginal candidiasis
Interactions for Clotrimazole
Polyene Antibiotics : Antagonises effects of polyene antibiotics.
Typical Dosage for Clotrimazole
Topical: Clotrimazole cream, lotion and solution 1 % is used.
Clean and dry the affected area and apply the medicament with gentle massage 2 -3 times daily for 2 - 4 weeks.
Vaginal candidiasis: Insert 1 applicator full (vaginal cream 1%) intravaginally at night for 1 -2 weeks.
Vaginal tablets 100. 200 and 500mg tablet is available.
Vulvovaginal candidiasis: Insert 100mg tablet intravaginally at bed time for 7 consecutive days or 200 mg tablet for 3 consecutive days or 500 mg tablet for 1 day at night.
Oral lozenge 10 mg is available
Oropharyngeal candidiasis: 1 lozenge orally 5 times daily for 2 weeks
Prophylaxis of Oropharyngeal candidiasis: 1 lozenge is used 3 times daily
Gel: Insert with an applicator intravaginally at night for 1 - 2 weeks.
Powder (1% w/ w): dusted over the body parts as required
Schedule of Clotrimazole
H
Storage Requirements for Clotrimazole
Store at room temperature (15 - 25 degree C). Protect from heat and moisture. Keep out of the reach of children
Effects of Missed Dosage of Clotrimazole
Apply the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Clotrimazole
Give supportive measures and symptomatic treatment.

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Metronidazole + Clotrimazole is a generic medicine name and there are several brands available for it. Some of the brands for metronidazole + clotrimazole might be better known than metronidazole + clotrimazole itself. If the pharmacy that's willing to deliver medicines to your home doesn't have metronidazole + clotrimazole in stock, you can ask for one of the branded alternatives for metronidazole + clotrimazole.