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Release form: Liquid dosage forms. Injection.

General characteristics. Compound:

Pharmacological properties:

Indications for use:

Important! Get to know the treatment

Directions for use and dosage:

Features of application:

Side effects:

Interaction with other drugs:

Contraindications:

Overdose:

Storage conditions:

Store at room temperature out of the reach of children. Do not freeze. Protect from light.

Vacation conditions:

On prescription

Package:

Disposable plastic bottles of 100 ml (5 mg/ml); glass ampoules of 20 ml (5 mg/ml)

Metrogyl is a drug based on the synthetic substance metronidazole. It is available in various forms: gel for external use, oral tablets, solution for intravenous administration. Intravenous administration of the solution can be carried out either as a stream (with a syringe) or as a drip (using a dropper). Let's consider in what cases the use of Metrogyl through a dropper is indicated, how such procedures are carried out, what their effect and contraindications are.

Indications for use of Metrogyl using a dropper

Metrogyl is an antiprotozoal drug with antibacterial activity, active against the following microorganisms:

• Trichomonas;
• gardnerella;
• Giardia;
• clostridia;
• dysenteric amoeba;
• bacteroides;
• fusobacteria;
• veillonella;
• prevotella;
• eubacteria, etc.

In addition to suppressing infectious processes, this drug can increase the sensitivity of tumors to radiation and stimulate reparative processes in the body.

Intravenous infusion of the drug through a dropper is recommended for severe infectious processes of various localizations, as well as when it is impossible to take Metrogyl orally. The medicine can be prescribed for the following diagnoses:

• intestinal and extraintestinal amebiasis (for example, amoebic process in the liver);
• trichomoniasis;
• trichomonas urethritis;
• trichomonas vaginitis;
• cutaneous leishmaniasis;
• giardiasis;
• balantidiasis;
• infections affecting bones and joints;
• meningitis;
• brain abscess;
• endocarditis of bacterial etiology;
• inflammation and abscess of the lungs;
• infections of the abdominal cavity and pelvic organs;
• chronic alcoholism;
• peptic ulcer and gastritis associated with Helicobacter pylori infection (in combination with amoxicillin);
• surgical interventions on the colon and perirectal area, appendectomy, gynecological and other operations (to prevent infectious complications).

Dropper with Metrogyl for peritonsillar abscess

Peritonsillar abscess is an acute inflammatory process localized in the peritonsillar tissue, most often developing as a complication of tonsillitis or exacerbation of chronic tonsillitis, less often as a result of pericoronitis. This disease is accompanied by severe swelling and inflammation, accompanied by intense pain, which makes swallowing difficult. Therefore, oral administration of drugs in this case may not be possible, and drugs to stop the infectious process are often prescribed in infusion form. In particular, Metrogyl is sometimes prescribed as an IV for peritonsillar abscess.

How to place IVs with the drug Metrogyl?

The initial dosage of the drug is, as a rule, 0.5-1 g, with the infusion duration being about half an hour. Further Metrogyl is administered every 8 hours, 0.5 g at a rate of 5 ml/min. The course of treatment can be a week or more.

When placing an IV, the patient should be in a comfortable position lying on his back. The drug is injected into a vein through a needle, and the rate of infusion is adjusted using the dropper slider. When the medicine runs out, the dropper is closed and the needle is removed.

If the doctor recommended Metrogyl droppers to the patient, then questions arise. It is important to understand how it affects the human body. Metrogyl is prescribed for inflammatory processes, giardiasis or gynecological pathologies. Let's look at how the Metrogyl dropper is used and how to place it correctly, indications and side effects.

Description of the drug

The main effect of Metrogil is antibacterial. Once in the patient’s body, metrogil kills pathogenic bacteria.

Metrogyl is available in three pharmacological forms:

• Solution for intravenous injection. Available in a plastic container with a volume of 100 ml or in the form of ampoules of 20 ml. One package contains 10 ampoules or 1 bottle.
• Pills in blister packs. Dosage 200 and 400 mg. Sold in packs of 10, 50, 100 pcs.
• Suspension for oral administration. Glass bottle in a box of 60 and 100 ml.

The effectiveness and choice of form for administration depends on the type of disease. A drip for intravenous administration, tablets and suspension are prescribed only by a doctor. You can independently use the injection solution when rinsing the nasopharynx as a disinfectant.

The solution for droppers is light yellow in color. The solution must be clear, without sediment and sterile.

The solution for injection is dispensed from pharmacies only according to prescription.

Purpose of the drug

Metrogyl solution for injection has the following indications:

• Treatment and as a prophylactic against airborne infections in the preoperative period. Frequent indications before operations on the urinary system and gastrointestinal tract.
• Indications for mixed infections of various etiologies.
• Purulent-serous infections (intestinal amebiasis, sepsis, abscess of the brain or pelvic organs, peritonitis, suppuration of the skin or soft tissues, bone and joint lesions).
• Indications for intravenous use in acute diseases: giardiasis, trichomonas vaginitis, urethritis, amebiasis. At the initial stage, a suspension is used.

After the dropper, the concentration of metrogil in the blood is 35.2 mcg/ml. It falls gradually and is eliminated unchanged by 80%. Complete blood purification occurs on the third day after the last dropper.

Dosage for infusion

The drug is prescribed intravenously only for acute forms of the disease. At the initial stages, oral forms are prescribed - tablets, suspension. Their regimen for use will depend on the form and type of disease.

Adult dosage

Metrogyl droppers according to the adult regimen can also be used by children over 12 years of age. Instructions for use:

• The first dose is 0.5–1 g with a dropper duration of 30–40 minutes.
• Further, the course is prescribed once every 8 hours with a dosage of 500 mg. The solution injection rate is 5 ml/min.

If a child or adult has good infusion tolerance, then after 3–4 droppers they switch to jet administration. The duration of the IV course is 7–8 days. If the infection progresses further, the course is extended. In 24 hours, the maximum amount of metrogyl for an adult is 4 g.

After the drip, Metrogyl is prescribed in the form of tablets or suspension, 200 mg/2 times a day, as maintenance therapy.

Pediatric dosage

For children, the solution for administration is prescribed in the most extreme cases. The application regimen is similar to that for adults. The dosage is selected for each child individually, but should not exceed 7–8 mg/kg of weight per administration.

In many ways, the regimen for use and purpose depends on the type of disease. If Metrogyl droppers were prescribed for purulent infections, then one course of administration is sufficient for recovery. In the preoperative period, adults and children over 12 years of age are prescribed 1 infusion of 0.5–1 g 24 hours before surgery. On the day of surgery, 1.5 g of metrogil is instilled according to the regimen of 500 mg/administration every 8 hours.

After surgery, on the second day, maintenance treatment with tablets or suspension is prescribed. If the patient has renal failure, the dosage of the dropper is reduced to 1 mg/2 doses per day.

In the treatment of cancer, metrogil is used as a radiosensitizing agent. The dropper is placed 2–3 hours before the start of the irradiation procedure at a dosage of 160 mg per 1 kg of patient weight. Next, the procedure is repeated for 2 weeks, before each irradiation procedure. The maximum dosage per administration should not be more than 10 g, and the dose should not exceed 60 g of the drug per course. At the remaining stage of radiation therapy, the drug is not used.

For uterine oncology, Metrogyl is not given by dropper. Before irradiation, it is enough to make an application of 3 g of metrogil and dimethyl sulfoxide 10%.

What side effects should you expect and when should you not use the drug?

When treating Metrogyl with droppers, you should expect side effects. Conventionally, side effects can be divided into common and rare.

Some of the most common ones include:

• The nasopharyngeal mucosa dries out.
• Single nausea.
• Loss of appetite.
• Dull pain in the gastrointestinal tract.
• Metallic taste in mouth.

Less commonly observed side effects:

• From the gastrointestinal tract: stool retention, nausea, occasional vomiting.
• From the side of the central nervous system: loss of coordination, dizziness, hyperexcitability, loss of sleep, migraines, general weakening of the body.
• Allergic manifestations from the body: skin rashes, swelling of the nasopharyngeal mucosa, hyperemia of the skin.
• From the urinary system: incontinence, urine becomes red or dark brown, cystitis, candidiasis, increased protein in the urine.
• On the vascular side, increased thrombophlebitis.

In rare cases, a Metrogyl drip may cause hallucinations, loss of consciousness, or confusion. In one out of 100 patients, the drug causes pancreatitis, so people with gastrointestinal disorders should be treated with caution.

Contraindications for the medication

The drug is contraindicated for people with the following diseases:

• The patient had a history of intolerance to metronedazole and its derivatives.
• Pathologies and disorders of the central nervous system.
• High dosage is contraindicated in people with liver failure.
• Any blood diseases.
• The first three months of pregnancy and the period of breastfeeding.

Metrogyl should not be taken simultaneously with other medications. It is not recommended to take dietary supplements and dietary supplements at the same time. It is especially dangerous to use droppers together with medications that contain ethyl alcohol. The patient is strictly prohibited from drinking alcohol throughout the course of treatment and for 2 weeks after its completion.

Active substance

Metronidazole

Release form, composition and packaging

Solution for intravenous administration

Excipients: citric acid (monohydrate), sodium hydrogen phosphate (anhydrous), water for injection.

20 ml - glass ampoules (5) - thermal containers (1) - cardboard packs.
20 ml - glass ampoules (5) - cardboard packs.

Solution for intravenous administration transparent, colorless to pale yellow.

Excipients: sodium chloride, citric acid (monohydrate), anhydrous sodium hydrogen phosphate, water for injection.

100 ml - polyethylene bottles (1) - cellophane wrappers (1) - cardboard packs.
100 ml - polyethylene bottles (1) - film wrappers (1) - cardboard packs.

pharmachologic effect

Antiprotozoal and drug, a derivative of 5-nitroimidazole. The mechanism of action is the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitro group of metronidazole interacts with the DNA of microbial cells, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria.

Active against Trichomonas vaginalis, Entamoeba histolytica, Gardnerella vaginalis, Giardiai ntestinalis, Lamblia spp., as well as obligate anaerobes Bacteroides spp. (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, it is active against Helicobacter pylori (amoxicillin suppresses the development of resistance to metronidazole).

Aerobic microorganisms and facultative anaerobes are insensitive to metronidazole, but in the presence of mixed flora (aerobes and anaerobes), metronidazole acts synergistically with antibiotics effective against common aerobes. Increases the sensitivity of tumors to radiation, causes disulfiram-like reactions, and stimulates reparative processes.

Pharmacokinetics

With intravenous administration of 500 mg of Metrogyl over 20 minutes, the concentration of the drug in the blood serum was 35.2 μg/ml after an hour, 33.9 μg/ml after 4 hours, and 25.7 μg/ml after 8 hours. With normal bile formation, the concentration of metronidazole in bile after intravenous administration may significantly exceed the concentration in. About 30-60% of metronidazole is metabolized in the body by hydroxylation, oxidation and glucuronidation. The main metabolite (2-oxymetronidazole) also has antiprotozoal and antimicrobial effects.

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: those born during pregnancy - 28-30 weeks - approximately 75 hours , 32-35 weeks - 35 hours, 36-40 weeks - 25 hours. 60-80% is excreted by the kidneys (20% unchanged), through the intestines - 6-15%. Renal clearance – 10.2 ml/min. In patients with impaired renal function, accumulation of metronidazole in the blood serum may occur after repeated administration (therefore, the frequency of dosing should be reduced in patients with severe renal impairment). Metronidazole and its main metabolites are quickly removed from the blood during hemodialysis (T1/2 is reduced to 2.6 hours). During peritoneal dialysis, it is excreted in small quantities.

Indications

- protozoal infections: extraintestinal amebiasis, including amoebic liver abscess, intestinal amebiasis (amebic dysentery), trichomoniasis, giardiasis, balantidiasis, giardiasis, cutaneous leishmaniasis, trichomonas vaginitis, trichomonas urethritis;

— infections caused by Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus): infections of bones and joints, infections of the central nervous system, incl. meningitis, brain abscess, bacterial endocarditis, pneumonia, empyema and lung abscess;

- infections caused by Bacteroides spp., including the group B. fragilis, Clostridium spp., Peptococcus spp., and Peptostreptococcus spp.: infections of the abdominal cavity (peritonitis, liver abscess), infections of the pelvic organs (endometritis, endomyometritis, fallopian tube abscess and ovaries, infections of the vaginal vault after surgery), infections of the skin and soft tissues;

— infections caused by Bacteroides spp., including the B. fragilis group, Clostridium spp.;

- sepsis;

- pseudomembranous colitis (associated with the use of antibiotics);

- gastritis or duodenal ulcer associated with Helicobacter pylori;

- alcoholism;

- prevention of postoperative complications (especially interventions on the colon, perirectal area, appendectomy, gynecological operations).

Contraindications

— organic lesions of the central nervous system (including epilepsy);

- liver failure (in case of prescribing large doses);

- blood diseases;

— pregnancy (first trimester);

- lactation period;

- hypersensitivity to metronidazole or other nitroimidazole derivatives.

Carefully: renal failure.

Dosage

IV administration of the drug is indicated for severe infections, as well as in the absence of the possibility of taking the drug orally.

For adults and children over 12 years old -

Children under 12 years of age

At

IN for preventive purposes adults and children over 12 years old

Patients with chronic renal failure and CC less than 30 ml/min and/or liver failure The maximum daily dose is no more than 1 g, the frequency of administration is 2 times a day.

Side effects

From the digestive system: diarrhea, loss of appetite, nausea, vomiting, intestinal colic, constipation, metallic taste in the mouth, dry mouth, glossitis, stomatitis, pancreatitis.

From the nervous system: dizziness, impaired coordination of movements, ataxia, confusion, irritability, depression, increased excitability, weakness, insomnia, headache, convulsions, hallucinations, peripheral neuropathy.

Allergic reactions: urticaria, skin rash, skin hyperemia, nasal congestion, fever, arthralgia.

From the urinary system: dysuria, cystitis, polyuria, urinary incontinence, candidiasis, red-brown coloring of urine.

Local reactions: thrombophlebitis (pain, hyperemia or swelling at the injection site).

Others: neutropenia, leukopenia, flattening of the T wave on the ECG.

Drug interactions

Strengthens the effect of indirect ones, which leads to an increase in the time of prothrombin formation.

Similar to disulfiram, it causes ethanol intolerance. Concomitant use with disulfiram can lead to the development of various neurological symptoms (the interval between prescriptions is at least 2 weeks).

Cimetidine inhibits the metabolism of metronidazole, which may lead to an increase in its concentration in the blood serum and an increased risk of side effects.

The simultaneous administration of drugs that stimulate microsomal oxidation enzymes in the liver (phenobarbital, phenytoin) can accelerate the elimination of metronidazole, resulting in a decrease in its plasma concentration.

When taken simultaneously with lithium preparations, the concentration of the latter in the plasma may increase and the development of symptoms of intoxication.

Sulfonamides enhance the antimicrobial effect of metronidazole.

special instructions

During the treatment period, alcohol intake is contraindicated (disulfiram-like reactions may develop: abdominal pain of a spastic nature, nausea, vomiting, headache, sudden rush of blood to the face).

With long-term therapy, it is necessary to monitor the blood picture.

With leukopenia, the possibility of continuing treatment depends on the risk of developing an infectious process.

The appearance of ataxia, dizziness and any other deterioration in the neurological status of patients requires cessation of treatment.

May immobilize treponemes and lead to a false-positive Nelson test.

Colors urine dark.

Pregnancy and lactation

I trimester of pregnancy is contraindicated; II and III trimesters of pregnancy - only for health reasons;

For nursing mothers - according to indications with simultaneous cessation of breastfeeding.

Use in childhood

Children over 12 years old - in an initial dose of 0.5-1 g intravenously (duration of infusions - 30-40 minutes), and then every 8 hours, 500 mg at a rate of 5 ml/min. If well tolerated, after the first 2-3 infusions they switch to jet administration. The course of treatment is 7 days. If necessary, intravenous administration is continued for a longer time. The maximum daily dose is 4 g. According to indications, switch to maintenance oral administration at a dose of 400 mg 3 times a day.

Children under 12 years of age prescribed according to the same regimen in a single dose - 7.5 mg/kg.

At purulent-septic diseases usually carry out 1 course of treatment.

IN for preventive purposes children over 12 years old Prescribe 0.5-1 g intravenously on the eve of surgery, 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 orally.

For serious infections, the doctor may prescribe the drug Metrogyl in droppers. Metrogyl solution has a number of contraindications and is prescribed for very limited indications.

Metrogyl - medicine and its action

Metrogyl solution is used for intravenous administration and belongs to the group of antiprotozoal and antibacterial agents. Available in 100 ml bottles, the cost per package is about 150 rubles. The solution is transparent, colorless or light yellow. Manufacturers: Sintez, Unique and others.

The active substance is metronidazole (5 mg/ml), an antiprotozoal agent, a derivative of 5-nitroimidazole.

The drug contains a number of excipients - citric acid, water, sodium hydrogen phosphate, saline solution.

The mechanism of action of the drug has not been reliably studied; it is assumed that the substance disrupts the DNA structure of microorganisms that are sensitive to it. Metronidazole is most effective in diseases caused by:

The drug can be used in second-line regimens for the treatment of Helicobacter pylori in combination with penicillins. Many anaerobes are not sensitive to the drug. Additionally, it has a regenerating effect, accelerates tissue repair, and increases the effectiveness of radiation therapy against tumors.

Indications and contraindications

Most often, as an indication for use, Metrogyl in droppers is prescribed against genital infections.

In women, this is vaginitis caused by Trichomonas and other microbes, as well as endometritis, damage to the vaginal vault and other organs during surgical interventions, endomyometritis, giardiasis of the genital organs.

The administration of the solution is practiced for ulcers, purulent cavities in the area of ​​the ovaries, and fallopian tubes.

Dermatological diseases can also be treated with this drug, as well as infectious diseases of soft tissues. Thus, treatment is prescribed for tetanus and other diseases caused by anaerobes, and for cutaneous leishmaniasis. Infections of internal organs are treated using drips for:

Protozoal intestinal infections are treated with a course of droppers with the drug, we are talking about balantidiasis, amoebic dysentery. Treatment is carried out for damage to the organs of the urinary system, bones, joints, brain, heart. For pneumonia, abscess and empyema of the lungs, which are caused by microbes sensitive to Metrogyl, treatment will also bring positive results.

Contraindications include leukopenia, epilepsy, other organic diseases of the nervous system, severe pathologies of the blood, bone marrow, and the last stages of renal failure. In the first trimester of gestation, during lactation, treatment is prohibited; women in the 2-3 trimesters of gestation are treated carefully and according to strict indications.

How to use Metrogyl correctly?

In childhood, therapy is carried out only in a hospital. In adults, due to the seriousness of the indications for using the solution, therapy is also performed mainly in a medical facility. Dosages and recommendations are as follows:

Usually, droppers are prescribed for only 2-3 days, then they switch to injecting the medicine into a vein. The general course of therapy is a week, the course can be extended individually

Instead of jet administration, metronidazole tablets may be prescribed.

In case of renal or liver failure, the dosage of the drug is selected by the doctor. They will depend on the severity of the disease and the parameters of the biochemical blood test.

Analogues and important information about Metrogil

Metrogyl should not be mixed with other medications in the same dropper. It is strictly forbidden to use while intoxicated - this leads to the appearance of neurological symptoms.

A number of drugs serve as analogues of Metrogyl (different dosage forms):

The drug often causes diarrhea, dyspepsia, loss of appetite, abdominal cramps, and stomach pain. With a long course there is a risk of developing pancreatitis, stomatitis, glossitis, and depression. Allergic reactions, candidiasis, and cystitis often occur. When Metrogyl is administered, urine turns brown.