Metrogil - instructions for use, reviews, analogs and forms of release (tablets 200 mg and 400 mg, gel vaginal 1% plus and Denta for dentistry and external 1% solution) for the treatment of infections in adults, children and pregnancy
In this article, you can read the instructions for using the drug Metrogil. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of physicians specialists on the use of Metrogil in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Metrogil in the presence of existing structural analogues. Use for the treatment of gingivitis, stomatitis, vaginosis and other infectious diseases in adults, children, as well as during pregnancy and lactation.
Metrogil antiprotozoal and antibacterial means of a wide spectrum of action. The mechanism of action of the drug consists in the restoration of the 5-nitro group of Metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitro group of metronidazole reacts with the DNA of a cell of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria. The active substance of the drug is Metronidazole.
Pharmacokinetics
After ingestion of a single dose of the drug 200 mg or 400 mg Metrogil quickly and completely absorbed. Has high penetrating ability in tissues (lungs, kidneys, liver, skin), spinal fluid, brain, bile, saliva, amniotic fluid, vaginal secretion, seminal fluid, breast milk. It is excreted by the kidneys (60-80% of the dose), 20% of the drug is excreted unchanged.
Indications
- protozoal infections (amebiasis, trichomoniasis, giardiasis, balantidiasis, trichomonas vaginitis and urethritis, amoebic dysentery);
- anaerobic infections (caused by Bac.fragilis and other bacteroids, fusobacteria, eubacteria, clostridia, anaerobic cocci);
- after surgical interventions on the organs of the abdominal cavity and urinary tract (intraperitoneal infections, appendicitis, cholecystitis, peritonitis, liver abscess, postoperative wound infections, postpartum sepsis, pelvic abscesses, peritonitis, including the prevention of postoperative anaerobic infections);
- infections of the respiratory tract (necrotic pneumonia, lung abscess);
- septicemia;
- gas gangrene;
- osteomyelitis;
- tetanus;
- meningitis, brain abscess
- pink acne (pimples) (including post-steroids);
- vulgar acne;
- oily seborrhea, seborrheic dermatitis;
- trophic ulcers of the lower extremities (against the background of varicose veins, diabetes mellitus);
- poorly healing wounds;
- pressure sores;
- hemorrhoids, anal fissures
- bacterial vaginosis of different etiology, confirmed by clinical and microbiological data;
- candidiasis vulvitis and vulvovaginitis;
- acute and chronic gingivitis;
- acute ulcerous-necrotic gingivitis of Vincent;
- acute and chronic periodontitis;
- juvenile periodontitis;
- periodontal disease complicated by gingivitis;
- aphthous stomatitis;
- cheilitis;
- inflammation of the oral mucosa during the wearing of prostheses;
- postextraction alveolitis;
- periodontitis, periodontal abscess (as part of combination therapy).
Forms of release
Tablets, film-coated 200 mg and 400 mg.
Gel for vaginal application Metrogil Plus 1%.
Gel for external use 1%.
Solution for intravenous administration (injections in ampoules for injection) 5 mg / ml.
Suspension for oral administration.
Gel stomatologic Metrogil Denta.
Instructions for use and how to use them
Pills
Inside with food or after eating, without chewing or squeezing milk.
Adults and children over 15 years of age - 200-400 mg 2-3 times a day.
The dose of the drug and the course of treatment is determined by the nature of the infection.
Trichomoniasis: 200 mg 3 times a day for 7 days; women need to additionally prescribe metronidazole in the form of vaginal suppositories or vaginal ointments. If necessary, you can repeat the course of treatment or increase the dose to 750-1000 mg per day. Between the courses should be a break in 3-4 weeks with the holding of repeated control laboratory tests. An alternative scheme of therapy is the appointment of 2 g once to the patient and his sexual partner.
Amoebiasis: adults - 400 mg three times a day; children - 30-40 mg / kg per day in 3 divided doses. The course of treatment is 7-10 days.
Amoebic liver abscess: adults - 400 mg or 800 mg 3 times a day in combination with antibiotics (tetracycline or other methods); children - 30-35 mg / kg per day (in 3 divided doses). The course of treatment is 5-10 days.
Anaerobic bacterial infections: adults - 200-400 mg 2-3 times a day; children - 7 mg / kg every 8 hours. The course of treatment - 7-10 days;
For the prevention of anaerobic infection before surgery on the pelvic organs and the large intestine appoint a single oral intake of 1000 mg, then - 200 mg 3 times a day.
In combination with Amoxicillin (2.25 g / day), the daily dose of metronidazole is 1.5 g, the frequency of administration is 3 times a day.
Patients with severe violations of the liver and kidneys daily dose of metronidazole - 1 g, amoxicillin - 1.5 g. The frequency of admission - 2 times a day.
Gel
For external use. The gel is applied to the previously cleaned lesions of the skin with a thin layer 2 times a day, in the morning and in the evening, for 3-9 weeks.
The duration of treatment is 3-4 months, the therapeutic effect is usually noted after 3 weeks of treatment.
Candles
The drug is administered intravaginally.The recommended dose is 5 g (one complete applicator) 2 times a day (morning and evening). The course of treatment is 5 days. If necessary, the course of treatment can be repeated after 2 weeks.
Gel Metrogil Denta
The drug is intended only for use in dental practice.
Adults and children over 6 years old with gingivitis Metrogil Dent applied to the gum area 2 times a day with a thin layer (finger or with the help of a cotton swab), it is not recommended to rinse the gel. The duration of therapy is an average of 7-10 days. After applying the gel, you should refrain from drinking and eating for 30 minutes.
When periodontitis after removal of dental deposits, periodontal pockets are treated with the drug and gel application is applied to the gum area. Exposure time - 30 min. The number of procedures depends on the severity of the disease. In the future, the patient can apply the gel on his own: the drug should be applied to the gum area 2 times a day for 7-10 days.
With aphthous stomatitis, the gel is applied to the affected area of the mucous membrane of the oral cavity 2 times a day for 7-10 days.
To prevent exacerbations of chronic gingivitis and periodontitis, the gel is applied to the gum area 2 times a day for 7-10 days. Preventative courses are held 2-3 times a year.
For the prevention of postextraction alveolitis, the drug is treated with a hole after tooth extraction, then the gel is applied on an outpatient basis 2-3 times a day for 7-10 days.
Side effect
- dry mouth;
- nausea, vomiting;
- constipation, diarrhea;
- pseudomembranous colitis;
- intestinal colic;
- glossitis, stomatitis;
- lack of appetite;
- unpleasant metallic taste in the mouth;
- headache;
- dizziness;
- impaired consciousness;
- increased excitability;
- depression;
- sleep disturbance;
- weakness;
- seizures of epilepsy;
- peripheral neuropathy;
- violation of coordination of movements;
- hallucinations;
- burning sensation in the urethra;
- fungal flora of the vagina (candidiasis);
- red-brown staining of urine;
- urinary incontinence;
- nasal congestion;
- hyperemia of the skin;
- skin rash;
- itching;
- hives;
- fever;
- anaphylactic shock;
- leukopenia, thrombocytopenia.
Contraindications
- organic lesions of the central nervous system (including epilepsy);
- blood diseases (including in the anamnesis);
- hepatic failure (in the case of the appointment of large doses);
- 1 trimester of pregnancy;
- children's age (up to 12 years);
- increased sensitivity to metronidazole or components included in the preparation, as well as to other derivatives of nitroimidazole.
Application in pregnancy and lactation
2 and 3 trimesters of pregnancy - only for life indications; breastfeeding mothers - according to indications, with simultaneous cessation of breastfeeding
special instructions
During the drug intake, alcohol can not be consumed (it is possible to develop a disulfiram-like reaction: abdominal pain of a spastic nature, nausea, vomiting, headache, sudden rush of blood to the face). Metronidazole is used to treat alcoholism and pathological cravings for alcohol.
In combination with amoxicillin it is not recommended to use in patients younger than 18 years.
With leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process.
Long-term use of the drug is desirable to be carried out under the control of peripheral blood.
The appearance of ataxia, dizziness and any other deterioration in the neurological status of patients requires discontinuation of treatment.
Can immobilize treponema and lead to Nelson's false positive test.
When treating trichomonadic vaginitis in women and trichomoniasis, men should abstain from sexual activity. It is necessary to simultaneously treat sexual partners. Treatment does not stop during menstruation.After therapy with trichomoniasis, control tests should be performed for 3 consecutive cycles before and after menstruation.
After the treatment of giardiasis, if symptoms persist, after 3 to 4 weeks, 3 feces should be analyzed at intervals of several days (in some patients the lactose intolerance caused by the invasion can persist for several weeks or months, recalling the symptoms of giardiasis).
Drug Interactions
Metronidazole increases the effect of indirect anticoagulants, which leads to an increase in the time of prothrombin formation.
Similarly, Disulfiram can cause intolerance to ethanol.
Cimetidine inhibits metronidazole metabolism, which can lead to an increase in its serum concentration and an increased risk of side effects.
Sulfonamides increase the antimicrobial effect of metronidazole.
Simultaneous administration of drugs stimulating enzymes of microsomal oxidation in the liver (phenobarbital, phenytoin) can accelerate the elimination of metronidazole, resulting in a decrease in its concentration in the plasma.
It is not recommended to combine metronidazole with depolarizing muscle relaxants (vecuronium bromide).
In patients who receive long-term treatment with lithium preparations in high doses, with the use of metronidazole, an increase in the concentration of lithium in the blood plasma and the development of symptoms of intoxication are possible.
Analogues of the drug Metrogil
Structural analogs for the active substance:
- Bacimex;
- Dentamet;
- Deflamon;
- Clion;
- Metrovagin;
- Metroxan;
- Metrolacker;
- Metron;
- Metronidazole;
- Metronidazole Nycomed;
- Metronidal;
- Metroseptol;
- Orvagil;
- Rosamet;
- Rosex;
- Siptrogyl;
- Tricho-PIN;
- Trichobrol;
- Trichopol;
- Trichosept;
- Flagel;
- Efloran.
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