Metronidazole + Loperamide Pharmacology
Metronidazole + Loperamide
Metabolism: Metabolized in liver by oxidation & glucuronide conjugation, Excretion: Excreted in urine.
7.Looseness of stool.
8.Peripheral neuropathy &CNS effects.
16.Thrombophlebitis at site of injection
4.Use cautiously along with other hepatotoxic drugs & In visual field changes
First trimester:contra indicated
4.Pseudo membranous enterocolitis
5.Anaerobic bacterial infections after surgery, Brain abscess, & Endocarditis
6.Helicobacter pylori infections
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.
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
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.
Distribution: It is widely distributed mainly in protein bound form
Metabolism: Absorbed drug undergoes metabolism in the liver
Excretion: It is excreted mainly in the faeces and small amount in the urine.
2.Severe diarrhoea where inhibition of peristalsis is not desirable
4.Bloody stool diarrhoea
2.Acute ulcerative colitis
6.Urinary bladder neck obstruction
8.Use caution while driving vehicle or operating machine or performing activities requiring mental alertness
Maximum dose: 16 mg / day
2 - 5 years: 3 mg / day in 3 divided doses
6 - 8 years: 4 mg / day in 2 divided doses
8 - 12 years: 6 mg / day in 3 divided doses
If it is taken as a regular schedule then 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.
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