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GENERIC NAME: metronidazole
DRUG CLASS AND MECHANISM: Metronidazole is an antibiotic effective against anaerobic bacteria and certain parasites. Anaerobic bacteria are single-cell living organisms that thrive in low oxygen environments and can cause disease in the abdomen (bacterial peritonitis) liver (liver abscess), and pelvis ( abscess of the ovaries and the fallopian tubes). Giardia lamblia and ameba are parasites that can cause abdominal pain and chronic diarrhea in infected individuals. Metronidazole selectively blocks some of the cell functions in these microorganisms, resulting in their demise.
PREPARATIONS: Tablets: 250mg, 500mg.
STORAGE: Metronidazole should be stored at room temperature and protected from light.
PRESCRIBED FOR: Metronidazole is used to treat giardia infections of the small intestines, amebic liver abscess and dysentery (amebic colon infection causing bloody diarrhea), trichomonas vaginal infections, and carriers of trichomonas (both sexual partners) who do not have symptoms of infection. Metronidazole is also used alone or in combination with other antibiotics in treating abscesses in the liver, pelvis, abdomen and brain caused by susceptible anaerobic bacteria. Metronidazole is also used in treating colon infection caused by a bacteria called C. difficile. Many commonly used antibiotics can alter the normal type of bacteria that inhabit the colon. C. difficile is an anaerobic bacteria that can infect the colon when the normal bacteria types of the colon are altered by common antibiotics. This leads to inflammation of the colon (pseudomembranous colitis) with severe diarrhea and abdominal pain.
DOSING: Metronidazole may be taken with or without food. In the hospital, metronidazole can be administered intravenously to treat serious infections. Metronidazole is metabolized mainly by the liver and dosages may need to be reduced in patients with abnormal liver function.
DRUG INTERACTIONS: Alcohol should be avoided because metronidazole and alcohol together can cause severe nausea, vomiting, cramps, flushing, and headache. Metronidazole can increase the blood thinning effects of warfarin (Coumadin) and increase the risk of bleeding. Cimetidine (Tagamet) increases the blood level of metronidazole.
PREGNANCY: Metronidazole is not used in early pregnancy because of potential adverse effects on the babies.
NURSING MOTHERS: Metronidazole is not used by nursing mothers because of potential adverse effects on the babies.
SIDE EFFECTS: Metronidazole is a valuable antibiotic, and is generally well tolerated with appropriate use. Serious side effects of metronidazole are rare; and include seizures and damage of nerves resulting in numbness and tingling of extremities (peripheral neuropathy). Metronidazole should be stopped if these symptoms appear. Minor side effects include nausea, headaches, loss of appetite, a metallic taste, and rarely a rash. | 
