Metrogyl injection 5mg ml 100ml
Condition: New product
1000 Items
Rating:
Be the first to write a review!
More info
Active ingredients
Metronidazole
Release form
Solution
Composition
1 ml contains: Active substances: metronidazole 5 mg. Auxiliary substances: sodium chloride, citric acid (monohydrate), anhydrous sodium hydrogen phosphate, water d / and.
Pharmacological effect
Anti-protozoan and antimicrobial drug, a derivative of 5-nitroimidazole. The mechanism of action consists in the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The restored 5-nitro group of metronidazole interacts with the cell DNA of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria. It is active against Trichomonas vaginalis, Entamoeba histolytica, Gardnerella vaginalis, Giardiai ntestinalis, Lamblia sap., Gardnerella vaginalis, Giardiai ntestinalis, Lamblia sap., Gardnerella vaginalis, Giardiai ntestinalis, Lamblia sap., Gardnerella vaginalis, Giardiai ntestinalis, Lamblia sap., Gardnerella vaginalis, Giardiai ntestinalis, Lamblia sap., Gardnerella vaginalis, Giardiai ntestinalis, Lamblia sap. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus), Fusobacterium spp., Veillonella spp., Prevolella spp. (Prevotella bivia, Prevotella buccae, Prevotella disiens) and some gram-positive microorganisms (Eubacterium spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp). In combination with amoxicillin, it is active against Helicobacter pylori (amoxicillin inhibits the development of resistances to metronidazole). To metronidazole, aerobic microorganisms and facultative anaerobes are insensitive, but in the presence of a mixed flora (aerobes and anaerobes), metronidazole acts synergically and synergistically for synergy with anaerobes, but in the presence of mixed flora (aerobes and anaerobes), metronidazole acts synergistically and synergically without the anaerobes, but in the presence of mixed flora (aerobes and anaerobes) It increases the sensitivity of tumors to radiation, causes disulfiram-like reactions, stimulates reparative processes.
Pharmacokinetics
With intravenous injection of 500 mg of Metrogyl for 20 minutes, the concentration of the drug in the serum was 35.2 mcg / ml after an hour, 33.9 mcg / ml after 4 hours, 25.7 mcg / ml after 8 hours. In normal bile formation, the concentration of metronidazole in bile after intravenous administration can significantly exceed the concentration in plasma. In the body, about 30-60% of metronidazole is metabolized by hydroxylation, oxidation and glucuronidation. The main metabolite (2-hydroxymetronidazole) also has an antiprotozoal and antimicrobial effect. T1 / 2 with normal liver function - 8 hours (from 6 to 12 hours), with alcoholic liver damage - 18 hours (from 10 to 29 hours), in newborns: born during the gestation period - 28-30 weeks - approximately 75 hours, 32-35 weeks - 35 hours, 36-40 weeks - 25 hours. 60-80% are excreted by the kidneys (20% unchanged), through the intestines - 6-15 % Renal clearance - 10.2 ml / min.In patients with impaired renal function, after repeated administration, cumulation of metronidazole in serum may be observed (therefore, in patients with severe renal insufficiency, the frequency of administration should be reduced). Metronidazole and the major metabolites are rapidly removed from the blood during hemodialysis (T1 / 2 is reduced to 2.6 hours). With peritoneal dialysis is displayed in small quantities.
Indications
- protozoal infections: extraintestinal amebiasis, including amebic liver abscess, intestinal amebiasis (amoebic dysentery), trichomoniasis, giardiasis, balantidiasis, giardiasis, cutaneous leishmaniasis, trichomonas vaginitis, trichomoniasis urethritis; (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus): infections of bones and joints, infections of the central nervous system, including meningitis, brain abscess, bacterial endocarditis, pneumonia, empyema and lung abscess - infections caused by Bacteroides spp. species, including group B. fragilis, Clostridium spp.,, Peptococcus spp., and Peptostreptococcus spp. liver abscess), pelvic infections (endometritis, endomyometritis, abscess of the fallopian tubes and ovaries, vaginal fornix infections after surgery), skin and soft tissue infections; infections caused by Bacteroides spp., including B. fragilis group, Clostridium spp. : sepsis; - pseudomembranous colitis (associated with the use of m of antibiotics); - gastritis or duodenal ulcer associated with Helicobacter pylori; - alcoholism; - prevention of postoperative complications (especially interventions on the colon, near-rectal region, apendectomy, gynecological surgery).
Contraindications
- organic lesions of the central nervous system (including epilepsy); - liver failure (in the case of large doses); - blood diseases; - pregnancy (I term); - lactation period; - hypersensitivity to metronidazole or other nitroimidazole derivatives. - renal failure.
Use during pregnancy and lactation
I trimester of pregnancy is contraindicated; II and III trimesters of pregnancy - only for life reasons; Nursing mothers - for indications with simultaneous cessation of breastfeeding.
Dosage and administration
In / in the introduction of the drug is shown in severe infections, as well as in the absence of the possibility of taking the drug inside. Adults and children over 12 years old - in the initial dose of 0.5-1 g / drip in (the duration of infusions - 30-40 minutes), and then - Every 8 hours at 500 mg at a rate of 5 ml / min.With good portability after the first 2-3 infusions, they are transferred to the jet injection. The course of treatment is 7 days. If necessary, on / in the introduction continue for a longer time. The maximum daily dose is 4 g. According to the indications, a transition is made to supporting ingestion in a dose of 400 mg 3 times / day. Children under the age of 12 are prescribed by the same scheme in a single dose of 7.5 mg / kg. For purulent-septic diseases usually 1 course of treatment is given. For prophylactic purposes, adults and children over 12 years old are prescribed intravenously 0.5–1 g before the operation, on the day of surgery and the next day 1.5 g / day (500 mg every 8 hours). After 1-2 days, they switch to maintenance therapy by mouth. Patients with chronic renal failure and QC less than 30 ml / min and / or liver failure have a maximum daily dose of not more than 1 g, the dose rate is 2 times / day.
Side effects
On the part of the digestive system: diarrhea, loss of appetite, nausea, vomiting, intestinal colic, constipation, metallic taste in the mouth, dry mouth, glossitis, stomatitis, pancreatitis. For the nervous system: dizziness, impaired coordination of movements, ataxia, confusion, irritability, depression, irritability, weakness, insomnia, headache, convulsions, hallucinations, peripheral neuropathy. Allergic reactions: urticaria, skin rash, skin hyperemia, nasal congestion, fever, arthralgia. ochevydelitelnoy system: dysuria, cystitis, polyuria, incontinence, candidiasis, urinary staining in the red-brown reaction tsvet.Mestnye: thrombophlebitis (pain, redness or swelling at the injection site) Other: neutropenia, leukopenia, flattening of the T wave on an electrocardiogram.
Interaction with other drugs
Metrogyl for IV administration is not recommended to be mixed with other drugs. It enhances the effect of indirect anticoagulants, which leads to an increase in the time of prothrombin formation. Similarly, disulfiram causes intolerance to ethanol. Simultaneous use with disulfiram can lead to the development of various neurological symptoms (the interval between administration is at least 2 weeks). Cimetidine inhibits the metabolism of metronidazole, which can lead to an increase in its concentration in blood serum and an increase in the risk of side effects. Simultaneous administration of drugs that stimulate enzymes of microsomal oxidation in the liver (phenobarbital, phenytoin), can accelerate the elimination of metronidazole,as a result of which its concentration in plasma decreases. When used simultaneously with lithium preparations, the concentration of the latter in plasma and the development of symptoms of intoxication may increase. It is not recommended to combine with non-depolarizing muscle relaxants (vecuronium bromide). Sulfanilamides enhance the antimicrobial action of metronidazole.
special instructions
Alcohol is contraindicated during treatment (disulfiram-like reactions may develop: abdominal pain of a spastic nature, nausea, vomiting, headache, sudden blood rush to the face). In combination with amoxicillin, it is not recommended to be used in patients younger than 18 years of age. of blood. In case of leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process. The appearance of ataxia, dizziness and any other deterioration of the neurological status of patients rebuet termination lecheniya.Mozhet immobilize Treponema and lead to a false positive urine test Nelsona.Okrashivaet in a dark color.