ADAP drugs: metronidazole

metronidazole
(Flagyl, Metryl, Protostat, Satric, Neo-Tric)

Drug description

Metronidazole is an antibacterial and antiprotozoal drug. It is commonly used to treat a condition called amebiasis. Amebiasis can cause diarrhea in people with HIV/AIDS. If the amebiasis is severe or does not respond to treatment with metronidazole alone, iodoquinol or diloxanide furoate may be added. Another intestinal condition called giardiasis is also treated with metronidazole. Other conditions that this drug may be prescribed to treat are trichomoniasis, anaerobic bacterial infections, bacterial vaginosis, Helicobacter pylori and antibiotic-associated diarrhea and colitis. Both pill and ointment preparations of metronidazole have been used with some success in treating the skin inflammations and eruptions caused by rosacea.

Side effects
The most frequent side effect is nausea. This is sometimes accompanied by headache, anorexia, dry mouth, and a sharp, unpleasant metallic taste. Rarer side effects can include vomiting, diarrhea, abdominal pain and constipation. The drug can affect the nervous system and cause headache, dizziness and peripheral neuropathy. Less frequently it may cause depression, irritability, restlessness, insomnia and convulsions. Urinating may become painful and urine may become dark or reddish-brown due to the way the body absorbs the drug. Rare effects on the blood are leukopenia and thrombocytopenia. In cases of hypersensitivity, allergic-type skin reactions and nasal congestion may occur.

Dosage
For acute intestinal amebiasis the standard dose is 750 mg three times a day. In children this is reduced to 35-50 mg per kg of body weight in three divided doses daily. For giardiasis the usual dosage is 250 mg three times daily.

How long it may take to work
Your doctor will monitor your stools for the presence of the parasites that cause amebiasis and giardiasis. Treatment is usually for 5-10 days in cases of amebiasis, 5-7 days for giardiasis.

Managing side effects
Take with meals to avoid stomach upset. Avoid alcohol as vomiting will result due to the drug. Other medications can be affected by metronidazole. Levels of anticoagulants, lithium and phenytoin may be dangerously increased. Disulfiram and metronidazole should not be used together due to the possibility of acute psychoses and confusion - manufacturers recommend a two week break between these treatments. Barbituates may increase levels of metronidazole in the body, increasing the risk of side effects. Cimetidine (Tagamet) may decrease the amount of metronidazole in the body and lessen its effects.

This information is specific to the use of this medication for HIV-related conditions. For additional information about this drug for other conditions, refer to: www.nursespdr.com/ and www.healthanswers.com/Library/library_fset.asp

The drug descriptions on these pages are intended for informational purposes only. The Network does not promote or endorse the use of any specific treatment for any health-related condition. The medications described here can only be dispensed by a licensed health care professional. The information may have changed since these pages were updated, though every effort is made to keep these pages current. Please contact The Network at (800) 734-7104 to make sure you have the most up-to-date information

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