D Metro - Metronidazole | VetSafeCare.Com

Tab.

D Metro

Metronidazole — Desh Pharmaceuticals Ltd.
400mg / tablet · 200mg / 5 ml

Alternatives

101

Routes

PO

Presentations

2

Generic profile Browse alternatives View combinations

Presentations

Tablet · 400mg / tablet

1 tablet

৳0.8

Oral Suspension · 200mg / 5 ml

60 ml

৳16.8

Dose rules

No structured dose rules are linked to this brand yet.

Dose reference

Cat

For treatment of Giardia:
a) 15–25 mg/kg PO q12–24h daily for 5–7 days (Lappin 2006)
b) 25 mg/kg PO q12h for 7 days (Zoran 2007)
c) 22 mg/kg PO twice daily for 5 days. May be combined with fenbendazole (50 mg/kg PO once daily for 3 or 5 days) to relieve clinical signs and eliminate parasites. (Payne, 2009)
For other protozoal infections:
a) Entamoeba histolytica or Pentatrichomas hominis: 25 mg/kg PO q12h for 8 days (Lappin, 2000)
For treating H. pylori:
a) Metronidazole 10–15 mg/kg PO two times a day; clarithromycin 7.5 mg/kg PO two times a day; amoxicillin 20 mg/kg PO twice daily for 14 days (Simpson 2003)
For anaerobic infections:
a) For sepsis: 15 mg/kg IV q12h (Hall 2000)
For adjunctive therapy of GI conditions:
a) 10–20 mg/kg PO two to three times a day has been used in thetreatment of mild to moderate cases of large bowel IBD. (Washabau 2009)
b) For inflammatory bowel disease: With a change of diet to “hypoallergenic”, may give metronidazole at 62.5 mg (total dose) PO per cat once daily for 10–20 days. Resistant cats or those with severe disease are given immunosuppressive doses of prednisolone (1–2 mg/kg initially twice daily). (Gaschen 2006)
c) 10–15 mg/kg PO q8–12h; combine with prednisone to manage moderate to severe cases. (Marks 2007)
d) For hepatic encephalopathy: 7.5 mg/kg PO q8–12h (Cornelius et al. 2000)

Horse

For susceptible anaerobic infections:
a) 20–25 mg/kg PO q8–12h; for treatment of colitis due to Clostridium spp., may dose at 15 mg/kg PO q8h. Can also dose at same dosages rectally if unable to dose PO. Metronidazole is uncommonly associated with diarrhea and neurologic side effects. (Bentz 2007)
b) For metritis secondary to B. fragilis: 15–25 mg/kg PO q12h. (LeBlanc
2009)
c) Foals: Oral metronidazole therapy should be strongly considered for all foals with severe diarrhea as about 35% of foals tested are positive for toxins associated with clostridia. Oral metronidazole is typically administered at 15–25 mg/kg PO q8h, but doses of 25 mg/kg q12h have recently also been recommended. May also give IV; authors use a loading dose of 15 mg/kg, and then give 7.5 mg/kg q6h based on the human dose recommendation. (Corley & Hollis 2009)
d) Foals with C. perfringens: 10–15 mg/kg PO 3–4 times a day (dose depends on severity); if animal has an ileus and is intolerant of oral feeding give IV at 10 mg/kg IV 4 times a day (Slovis 2003)
e) For L. intracellularis infections: metronidazole 10–15 mg/kg PO q8– 12h with either oxytetracycline (10–18 mg/kg via slow IV q24h) or chloramphenicol (44 mg/kg PO q6–8h). (Frazer 2007)

Cattle

40-50 mg/kg 

Treatment of trichomoniasis (bulls): 75 mg/kg q12h IV for three doses.

Dog

For treatment of Giardia:
a) 15–25 mg/kg PO q12–24h daily for 5–7 days (Lappin 2006)
b) 22 mg/kg PO twice daily for 5 days. May be combined with fenbendazole (50 mg/kg PO once daily for 3 or 5 days) to relieve clinical signs and eliminate parasites. (Payne & Artzer 2009) 

For other protozoal infections:
a) Entamoeba histolytica or Pentatrichomas hominis: 25 mg/kg PO q12h for 8 days (Lappin 2000)
For anaerobic infections:
a) For sepsis: 15 mg/kg IV q12h (Hardie 2000) 

For eliminating Helicobacter gastritis infections:
a) Using triple therapy: Metronidazole 15.4 mg/kg q8h, amoxicillin 11 mg/kg q8h and bismuth subsalicylate (original Pepto-Bismol®) 0.22 mL/kg PO q4–6h. Give each for 3 weeks. (Hall 2000)
For adjunctive therapy of plasmacytic/lymphocytic enteritis:
a) 10–30 mg/kg PO q8–24h for 2–4 weeks in refractory cases (Leib, M.S. et al. 1989)
For Clostridium perfringens enterotoxicosis:
a) 10–20 mg/kg PO twice daily for 7–28 days. (Tams 2007)
For inflammatory bowel disease:
a) 10–20 mg/kg PO two to three times a day has been used in the treatment of mild to moderate cases of large bowel IBD. (Washabau 2009)
b) For ulcerative colitis in dogs refractory to other therapies (e.g., sulfasalazine, immunosuppressants, diet, etc.): 10–20 mg/kg PO twice daily–three times a day; may be beneficial in treating for 2–4 weeks those dogs with chronic colitis having unexplained diarrhea (Leib, M. 2000).
c) 10–15 mg/kg PO q8–12h; combine with prednisone to manage moderate to severe cases. (Marks 2007)
d) In cases of predominantly large bowel diarrhea (colitis with typical clinical presentation) if parasiticide treatment and elimination diet fail, a therapeutic trial can be made: metronidazole 20–25 mg/kg PO twice daily for 5-10 days with the addition of fiber to the diet (e.g., psyllium at 0.5 tablespoon for toy breeds, 1 tablespoon for small dogs, 2 tablespoons for medium dogs, and 3 tablespoons for large dogs. However, sampling of mucosal biopsies prior to further treatment may be the best course of action. (Gaschen 2008)
For treatment of medial canthus syndrome (tear staining):
a) 100–200 mg (total dose) PO once per day for 10 days each month.(Krohne 2008)

Sheep

40-50 mg/kg 

Goat

40-50 mg/kg 

Human

Tablet and Suspension: Trichomoniasis (Adults & Children over 10 yrs)- 200 mg tid or 400 mg bid for 7 days 800 mg in the morning and 1-2 gm at night for 2 days 2 gm as a single dose for 1 days Trichomoniasis (Children)- Children 7-10 yrs: 100 mg tid Children 3-7 yrs: 100 mg bid Children 1-3 yrs: 50 mg tid Intestinal amoebiasis (Adults & Children over 10 yrs)-  800 mg tid for 5 days Intestinal amoebiasis (Children)- Children 7-10 yrs: 400 mg tid Children 3-7 yrs: 200 mg qid Children 1-3 yrs: 200 mg tid Extra-intestinal & Asymptomatic amoebiasis (Adults & Children over 10 yrs)- 400-800 mg tid for 5-10 days Extra-intestinal & Asymptomatic amoebiasis (Children)- Children 7-10 yrs: 200-400 mg tid Children 3-7 yrs: 100-200 mg qid Children 1-3 yrs: 100-200 mg tid Giardiasis (Adults & Children over 10 yrs)- 2 gm once daily for 3 days Giardiasis (Children)- Children 7-10 yrs: 1 gm once daily Children 3-7 yrs: 600-800 mg once daily Children 1-3 yrs: 500 mg once daily Acute ulcerative  gingivitis (Adults & Children over 10 yrs)- 200 mg tid for 3 days Acute ulcerative  gingivitis (Children)- Children 7-10 yrs: 100 mg tid Children 3-7 yrs: 100 mg bid Children 1-3 yrs: 50 mg tid Acute dental infections (Adults & Children over 10 yrs)- 200 mg tid for 3-7 days Bacterial Vaginosis (Adults & Children over 10 yrs)- 400 mg bid for 7 days 2 gm as a single dose for 1 days Leg ulcers and pressure sores (Adults & Children over 10 yrs)- 400 mg tid for 7 days Anaerobic infections (Adults & Children over 10 yrs)- 800 mg initially and then 400 mg tid for 7 days Anaerobic infections (Children)- Children 1-10 yrs: 7.5 mg/kg tid Surgical prophylaxis (Adults & Children over 10 yrs)- 400 mg tid started 24  hours before  surgery for 1 days Surgical prophylaxis (Children)- Children 1-10 yrs: 7.5 mg/kg tid Vaginal Gel: The recommended dose is one applicator full of Metronidazole gel (approximately 5 grams containing approximately 37.5 mg of Metronidazole) intravaginally once or twice a day for 5 days. For once a day dosing, Metronidazole gel should be administered at bedtime. Suppository: Anaerobic Infections- Adults: 1 g every 8 hours for 3 days, then 1 g every 12 hours. Children: 5-10 years: 500 mg every 8 hours for 3 days, then every 12 hours, Over 10 years adult dose. Surgical Prophylaxis- Adults: 1 g 2 hours before surgery; up to 3 further doses of 1 g may be given every 8 hours for high risk procedures. Children: 5-10 years: 500 mg 2 hours before surgery; up to 3 further doses of 500 mg may be given every 8 hours for high risk procedures. IV Infusion: Metronidazole intravenous infusion requires no dilution and should not be mixed with any other drugs prior to administration. Adults and children over 12 years: Infuse 500 mg 8 hourly at a rate of 5 ml/minute and a maximum of 4 g should not be exceeded during a 24-hour period. Treatment for 7 days is sufficient for most patients, but treatment can be extended, especially for cases where reinfection is likely. For surgical prophylaxis, administration shortly before surgery should be followed by 8-hourly doses for the next 24 hours. Children under 12 years: 7.5 mg/kg body weight/day every 8 hours at a rate of 5 ml/minute.

Rabbit

For anaerobic infections: 20 mg/kg PO q12h for 3–5 days or 40 mg/kg PO once daily; 5 mg/kg slow IV q12h (Ivey & Morrisey 2000)

Birds (Other)

For susceptible infections (anaerobes; giardia):
a) 10–50 mg/kg PO q12h. (Oglesbee 2009)
b) Ratites (not to be used for food): 20–25 mg/kg PO twice daily (Jenson
1998)

Clinical notes

Applications:

N/A

Indication Notes:
Metronidazole is indicated in the treatment of following diseases: The prevention of post-operative infections due to anaerobic bacteria (particularly species of bacteroides and anaerobic streptococci). The treatment of septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis and post-operative wound infections caused by anaerobes. ... Read moreMetronidazole is indicated in the treatment of following diseases: The prevention of post-operative infections due to anaerobic bacteria (particularly species of bacteroides and anaerobic streptococci). The treatment of septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis and post-operative wound infections caused by anaerobes. In the treatment of urogenital trichomoniasis. Bacterial vaginosis (also known as non-specific vaginitis). All forms of amoebiasis (intestinal, extra-intestinal disease and that of symptomless cyst passers). Giardiasis. Acute ulcerative gingivitis. Anaerobically infected leg ulcers and pressure sores. Acute dental infections due to anaerobic organisms. Antibiotic associated pseudomembranus colitis.
Avoid In:
  • Hypersensitivity
Contraindication Notes:
Metronidazole is contraindicated in patients with a history of hypersensitivity to Metronidazole or other Nitroimidazole derivatives.
Metronidazole is a member of the imidazole class of antibacterial drug and is classified therapeutically as an antiprotozoal agent. The 5-nitro group of Metronidazole is reduced by anaerobes metabolically. Studies have demonstrated that the reduced form of this drug interacts with DNA and gives bactericidal action of Metronidazole.
Disulfiram: Psychotic reactions have been reported in patients who were using metronidazole and disulfiram concurrently. Alcohol: Alcoholic beverages and drugs containing alcohol should not be consumed during therapy and for at least one day afterwards because of the possibility of a disulfiram-like (antabuse effect) reaction (flushing, vomiting, tachycardia). Oral anticoagulant therapy (warfarin type): Potentiation of the anticoagulant effect and increased hemorrhagic risk caused by decreased hepatic catabolism. In case of co-administration, prothrombin time should be more frequently monitored and anticoagulant therapy adjusted during treatment with metronidazole. Lithium: Plasma levels of lithium may be increased by metronidazole. Cyclosporin: Serum cyclosporin and serum creatinine should be closely monitored when co-administration is necessary. Phenytoin or phenobarbital: increased elimination of metronidazole resulting in reduced plasma levels. 5-Fluorouracil: Reduced clearance of 5-fluorouracil resulting in increased toxicity of 5-fluorouracil. Busulfan: Plasma levels of busulfan may be increased by metronidazole, which may lead to severe busulfan toxicity.
Metallic taste, nausea, vomiting, diarrhoea, drowsiness, rashes may be observed during treatment.
Single oral doses of metronidazole, up to 12 g have been reported in suicide attempts and accidental overdoses. Symptoms were limited to vomiting, ataxia and slight disorientation. There is no specific antidote for metronidazole overdosages. In case of suspected massive overdosages, a symptomatic and supportive treatment should be instituted.
US FDA Pregnancy Category of Metronidazole is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Metronidazole have been shown to be excreted in human milk. So, caution should be exercised when Metronidazole is administered to a nursing woman.
If for compelling reasons, metronidazole must be administered longer than the usually recommended duration, it is recommended that hematological tests, especially leucocyte count should be carried out regularly and that patients should be monitored for adverse reactions such as peripheral or central neuropathy (such as paresthesia, ataxia, dizziness, convulsive seizures). Metronidazole should be administered with caution to patients with hepatic encephalopathy. Patients should be warned that metronidazole may darken urine.
Hepatic impairment: Metronidazole is mainly metabolised by hepatic oxidation. Substantial impairment of metronidazole clearance may occur in the presence of advanced hepatic insufficiency. Significant cumulation may occur in patients with hepatic encephalopathy and the resulting high plasma concentrations of metronidazole may contribute to the symptoms of the encephalopathy. Metronidazole should therefore, be administered with caution to patients with hepatic encephalopathy. The daily dosage should be reduced to one third and may be administered once daily. Patients should be warned that metronidazole may darken urine.Renal impairment: The elimination half-life of metronidazole remains unchanged in the presence of renal failure. The dosage of metronidazole therefore needs no reduction. Such patients however retain the metabolites of metronidazole. The clinical significance of this is not known at present. In patients undergoing haemodialysis metronidazole and metabolites are efficiently removed during an eight hour period of dialysis. Metronidazole should therefore be re-administered immediately after haemodialysis. No routine adjustment in the dosage of Metronidazole need be made in patients with renal failure undergoing intermittent peritoneal dialysis (IDP) or continuous ambulatory peritoneal dialysis (CAPD).