Generic Flagyl is a broad-spectrum drug against microbes. It effectively copes with bacteria and protozoa, such as vaginal trichomonas, intestinal lamblia, dysentery amoeba. The drug is not effective against actinomycetes, propionibacterium, acne and mobilkus.
What is this medicine?
Flagyl (metronidazole) is nitro-5-imidazole. The mechanism of action of metronidazole is the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitro group of metronidazole interacts with the DNA of the cell of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of microorganisms. The main metabolite (2-hydroxymetronidazole) also has an antiprotozoal and antimicrobial effect.
It is used for the treatment of infectious diseases caused by the microorganisms Bifidobacterium, Bacteroides fragilis, Bilophilia, Clostridium perfringens, Clostridium difficile, Eubacterium, Peptostreptococcus, Fusobacterium, Prophyromonas, Prevotella and Veilonella.
It is effective in the treatment of amoebiasis, nonspecific vaginitis, urogenital trichomoniasis, surgical infections, giardiasis.
Tablets may be prescribed as a continuation of non-oral metronidazole therapy.
Who should not take Flagyl?
- Patients with allergic reactions to metronidazole, its derivatives and to any component of the drug should not take Flagyl;
- It is contraindicated to use the drug if you have a sensitivity to gluten, as well as if you have complex diseases of the central nervous system;
- The drug is not used in patients weighing less than 16 kg (usually children under 6 years old);
- The drug is contraindicated to patients who are currently taking disulfiram and/or ethyl alcohol;
- The drug is prescribed with caution to people with blood diseases (including cured ones). During the course of treatment, the patient’s blood condition should be constantly monitored;
- Since the drug affects consciousness and vision, control of mechanisms and vehicles should be postponed until the therapy is over.
How to take Flagyl?
Tablets are taken orally.
Doses and duration of treatment are determined by the doctor, based on the general picture of the course of the disease, patient tolerance to the drug, and additional drugs that the patient takes.
- Amoebiasis: 1.5 g / day for 3 doses (adults) for 7 days;
- Giardiasis is treated for 5 days: adults take 750-1000 mg / day, children 6-10 years old – 375 mg / day (1.5 tablets) and children 10-15 years old – 500 mg / day (2 tablets). For children under 6 years of age, it is preferable to use metronidazole in the form of a suspension;
- Trichomoniasis in women (urethritis and vaginitis): a single dose of 2 g or as a course of treatment for 10 days: 1 tab. (250 mg) 2 times/day;
- Trichomoniasis in men (urethritis): a single dose of 2 g or as a course of treatment for 10 days, 1 tab. (250 mg) 2 times/day;
- Non-specific vaginitis: 500 mg 2 times / day for 7 days;
- Anaerobic infections (adults): 1-1.5 g / day.
With severe renal impairment (CC less than 10 ml/min), it is recommended to reduce the daily dose of the drug by 2 times.
What may interact with this drug?
- Not recommended combinations: alcohol, disulfiram, busulfan;
- Combinations to be used with caution: Oral anticoagulant therapy.
What should I watch for while taking this drug?
Data on the effect of Flagyl on the course of pregnancy has not been clarified to the end. Therefore, it is recommended to use the drug carefully with regular and careful monitoring of the woman and fetus. If there is a safer and more studied alternative to this drug, it is recommended to use it.
Metronidazole has the ability to penetrate into the amniotic fluid and breast milk, therefore it is recommended either to refrain from feeding during the treatment period or to stop breastfeeding.
An overdose of the drug may cause vomiting, ataxia, and disorientation.
There is no specific antidote. Typically, standard techniques for intoxication are performed.
Since the simultaneous administration of the drug with alcohol can cause a feeling of heat, vomiting, tachycardia, patients should be warned that alcoholic beverages or medicines containing alcohol should not be used during treatment with Flagyl.
Long-term administration of the drug should be carried out under the control of a blood formula. With leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process.
In the treatment of trichomonas vaginitis in women and trichomonas urethritis in men, it is necessary to refrain from sexual activity. Be sure to simultaneously treat sexual partners. Treatment does not stop during menstruation. After treatment of trichomoniasis, control tests should be carried out for 3 consecutive cycles before and after menstruation.
After treatment of giardiasis, if symptoms persist after 3 to 4 weeks, perform 3 fecal analyzes at intervals of several days (in some successfully treated patients, lactose intolerance caused by invasion can persist for several weeks or months, resembling symptoms of giardiasis).
Treatment should be discontinued if you have ataxia, dizziness, hallucinations, a deterioration in the neurological status.
Keep in mind that metronidazole can immobilize treponema, which leads to a false-positive Nelson test.
Due to the possibility of dizziness and other side effects associated with taking the drug, it is recommended to refrain from driving and other mechanisms.
What are the side effects of taking Flagyl?
This drug is generally well tolerated without causing adverse reactions.
But in rare cases, patients reported the following side effects:
- sensory peripheral neuropathy;
- headache, dizziness;
- nausea, vomiting;
- impaired stools;
- dry mouth and stomatitis;
- a decrease in vision;
- allergic reactions;
- discoloration of urine.
All cases were reversible and passed on their own.
If you notice atoxia, clouding of consciousness and dizziness after taking Flagyl, you’d better stop taking it. If any of the side effects occur, you should inform your doctor.
How to store this medicine?
Store below 25°C (77°F) and protect from light.