Metronidazole is a Medicine belongs to Antiprotozoals group whose information about Brand can be referenced from   Book : Martindale    Page : 936   Edition : 38,    Page :   Edition : ,

  ►   Brandname : Flagyl,Monizole,Acea,Metrogel,Metrogyl

  ►  Strength : Tablet with 250  mg, Tablet with 500  mg, Capsule with 375  mg, Extended- release tablets with 750  mg, Gel with 0.75  %, Injection with 5  mg/ml, Injection with 500  mg, infusion with   , Oral Suspension with   , Suppository with   ,

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 898   Edition : 12, Martindale    Page : 941   Edition : 38,
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : Oral, Topical, IV infusion, rectal,
Reference :-   Book : Martindale    Page : 936   Edition : 38, Martindale    Page : 937   Edition : 38,

Dosing of Medicine differ in Adult & Pediatrics ↓


Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 Amoebiasis Oral 400 800 mg t.i.d. For 5 to 10 days.
2 Balantidiasis Oral 750 mg t.i.d. For 5 and 10 days,
3 Blastocystis hominis infections Oral 750 mg t.i.d. For 5 and 10 days.
4 Giardiasis Oral 2 gm o.d. For 3 successive days.
5 Giardiasis Oral 400 mg t.i.d. For 5 days.
6 Giardiasis Oral 500 mg b.d. For 7 to 10 days.
7 Trichomoniasis Oral t.i.d. A single 2-g dose, as a 7-days course of 200 mg every 8 hours, or at a dose of 400 to 500mg every 12 hours for 5 to 7 days.
8 Bacterial vaginosis Oral b.d. A single 2-g dose or as a 5 to 7-day course of 400 or 500 mg twice daily. Alternatively it may be applied locally as 5 g of a 0.75% gel once or twice daily for 5 days.
9 Acute necrotising ulcerative gingivitis Oral 200 250 mg t.i.d. For 3 days.
10 Anaerobic bacterial infections Oral An initial dose of 800 mg followed by 400 mg every 8 hours, usually for about 7 days
11 Anaerobic bacterial infections IV infusion Injection A regimen of 500 mg every 8 hours is alternatively used. When oral therapy is precluded metronidazole may be given intravenously, 500 mg being infused as 100 mL of a 5 mg/mL solution at a rate of 5 mL/minute every 8 hours.
12 Anaerobic bacterial infections rectal 1 gm Suppository t.i.d. For 3 days.
13 Postoperative anaerobic bacterial infections Oral 400 mg t.i.d. Before surgery.
14 Postoperative anaerobic bacterial infections IV infusion 500 mg Injection t.i.d.
15 Postoperative anaerobic bacterial infections Oral 200 mg or 400 mg t.i.d.
16 Postoperative anaerobic bacterial infections rectal 1 gm Suppository t.i.d. Starting 2 hours before surgery.
17 Peptic ulcer Oral 400 mg b.d. when given with omeprazole and amoxicillin, when metronidazole 400 mg three times daily is used. Treatment is continued for 1 week.
18 Leg ulcers Oral 400 mg t.i.d. For 7 days.
19 Pressure sores Oral 400 mg t.i.d. For 7 days.
20 Fungating tumours Topical 0.75 % Gel Or 0.8% gel to reduce the odour associated with anaerobic infection in fungating tumours.

Ref :-  Book : Martindale    Page : 936   Edition : 38, Martindale    Page : 937   Edition : 38,




Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 Invasive intestinal amoebiasis and Extra-intestinal amoebiasis 1 Year 3 Year Oral 200 mg t.i.d.
2 Invasive intestinal amoebiasis and Extra-intestinal amoebiasis 3 Year 7 Year Oral 200 mg q.i.d.
3 Invasive intestinal amoebiasis and Extra-intestinal amoebiasis 7 Year 10 Year Oral 400 mg t.i.d.
4 Invasive intestinal amoebiasis and Extra-intestinal amoebiasis More than 10 Year Oral 800 mg t.i.d.
5 Giardiasis 1 Year 3 Year Oral 500 mg o.d.
6 Giardiasis 3 Year 7 Year Oral 600 800 mg o.d.
7 Giardiasis 7 Year 10 Year Oral 1 gm o.d.
8 Giardiasis More than 10 Year Oral 2 gm o.d.
9 Giardiasis More than 10 Year Oral 400 mg t.i.d.
10 Giardiasis More than 10 Year Oral 500 mg b.d.
11 Trichomoniasis 1 Year 3 Year Oral 50 mg t.i.d.
12 Trichomoniasis 3 Year 7 Year Oral 100 mg b.d.
13 Trichomoniasis 7 Year 10 Year Oral 100 mg t.i.d.
14 Trichomoniasis More than 10 Year Oral 200 mg t.i.d.
15 Trichomoniasis More than 10 Year Oral 400 500 mg b.d.
16 Anaerobic bacterial infections IV infusion 7.5 mg/kg Injection b.d.
17 Anaerobic bacterial infections 1 Month 2 Month Oral 7.5 mg/kg b.d.
18 Anaerobic bacterial infections 1 Month 2 Month IV infusion 7.5 mg/kg b.d.
19 Anaerobic bacterial infections 2 Month More than 2 Month Oral 7.5 mg/kg t.i.d.
20 Anaerobic bacterial infections 2 Month more than 2 Month IV infusion 7.5 mg/kg Injection t.i.d.

Ref :- Book : Martindale    Page : 937   Edition : 38,
Precaution :- If a Patient is using 'Metronidazole' drug in  PID  disease, then Please Contraindication: 1st Trimester of pregnancy .

Precaution :- If a Patient is using 'Metronidazole' drug in  Amebiasis  disease, then Please Contraindications: Hypersensitivity to metronidazole or other nitroimidazoles (although cautious desensitization has been applied) .

Precaution :- If a Patient is using 'Metronidazole' drug in  Amebiasis  disease, then Please Pregnancy, Do not use in1st trimester (controversial) .

Precaution :- If a Patient is using 'Metronidazole' drug in  Amebiasis  disease, then Please Contraindication: Use of disulfiram within past 2 weeks; use of alcohol during therapy or within 3 days of discontinuing therapy .

Precaution :- If a Patient is using 'Metronidazole' drug in  Trichomoniasis  disease, then Please Contraindication: Use of disulfiram within past 2 weeks; use of alcohol during therapy or within 3 days of discontinuing therapy .

Precaution :- If a Patient is using 'Metronidazole' drug in  Trichomoniasis  disease, then Please Avoid in Pregnancy, 1st trimester (controversial) .

Precaution :- If a Patient is using 'Metronidazole' drug in  Trichomoniasis  disease, then Please Contraindication: Hypersensitivity to metronidazole or other nitroimidazoles (although cautious desensitization has been applied) .

►  Side Effect : headache, nausea, dry mouth, metallic taste, vomiting, diarrhoea, Furry tongue, abdominal distress , glossitis, stomatitis, Dizziness, vertigo, , dysuria, cystitis, flushing, A sense of pelvic pressure ,
Ref :-   Book : Goodman    Page : 1430   Edition : 12, Goodman    Page : 1430   Edition : 38,

►  Drug Interaction : Drug interaction of Metronidazole is with Alcohol, ,  Disulfiram, Warfarin , Phenytoin , Cyclosporine , Fluorouracil , Phenobarbital , Cimetidine ,
Ref :-   Book : Martindale    Page : 939   Edition : 38,


  ►    Mechanism of Drug Drug Interaction :  When given with alcohol, metronidazole may provoke a disulfiram-like reaction in some patients. Acute psychoses or confusion have been associated with the use of metronidazole and disulfiram together. Metronidazole is reported to impair the metabolism or excretion of several drugs including warfarin, phenytoin , lithium, ciclosporin, and fluorouracil with the consequent potential for an increased incidence of adverse effects. There is some evidence that phenytoin might accelerate the metabolism of metronidazole. Plasma concentrations of metronidazole are decreased by phenobarbital, with a consequent reduction in the effectiveness of metronidazole. Cimetidine has increased plasma concentrations of metronidazole and might increase the risk of neurological adverse effects. For references to some of these interactions. For incompatibilities between metronidazole and other drugs in solutions for injection.,
Ref :-   Book : Martindale    Page : 939   Edition : 38,


►  Contraindication : First trimester of Pregnancy,
Ref :-   Book : Martindale    Page : 939   Edition : 38,
  ►  Mechanism of Action :   Metronidazole is selectively absorbed by anaerobic bacteria and sensitive protozoa. Once taken up by anaerobes, it is nonenzymatically reduced by reacting with reduced ferredoxin. This reduction results in products that are toxic to anaerobic cells, and allows for their selective accumulation in anaerobes. The metabolites are taken up into bacterial DNA, forming unstable molecules. This action only occurs when metronidazole is partially reduced, and because this reduction usually happens only in anaerobic cells. ,
Ref :-   Book : Basic & Clinical pharmacology    Page : 891   Edition : 12,

Pathway of Dietry Product


​   ► Act.Comp / Nutrient / Food / Herb as follows :- Beal with Another pathway,

  ►  Pathway with its reference as follows :-
  • anti diarrhea --- (http://downloadspharmacy.blogspot.com/2011/07/pharmacognosy-ckkokate_21.html )

  •   ►  URL -- Kokate, C. (2013). Pharmacognosy (4th ed.). Pune: Nirali Prakashan.,


    Dietry Substance Interactions


    ​   ► This Medicine interact with :- ZINC with Dietary Substance is Drug Enhancer,

      ►  Reference :-
  • Gaby, A. (2006). A–Z Guide to Drug-Herb-Vitamin Interactions. 2nd ed. New York: Three Rivers Press

  •   ►  URL -- http://www.wjgnet.com/1948-9358/,


    ContraIndication Dietry Substance


    ​   ► This Medicine contraindicate with :- ALCOHOL with alcohol consumpsion causes headache,palpitation,nausea & vomiting.,

      ►  Reference :-
  • YAHEYA, MOHAMMAD. "DRUG-FOOD INTERACTIONS AND ROLE OF PHARMACIST". Asian Journal of Pharmaceutical and Clinical Research 2.4 (2009): n. pag. Print.

  •   ►  URL -- http://ajpcr.com/Vol2Issue4/226.pdf,

    ►   Route of Elimination :   Fecal, Renal,
    Ref :-   Book : Martindale    Page : 940   Edition : 38,


    ►    Plasma Half-life :   Min value :-   8 hours,    Max value :-   NA
    Ref :-   Book : Martindale    Page : 940   Edition : 38,


    ►    Peak Plasma Concentration :   Min value :-   within 1 to 2 hours after oral doses and 8 hours after intravaginal dose,    Max value :-   NA
    Ref :-   Book : Martindale    Page : 940   Edition : 38,