Metronidazole

Metronidazole is a antiprotozoal & antibacterial (nitroimidazole) medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

• Amoebic dysentery and amoebic liver abscess
• Giardiasis (Giardia infection of the gut)
• Trichomoniasis and bacterial vaginosis
• Anaerobic bacterial infections (dental, abdominal, pelvic)
• Helicobacter pylori eradication (as part of combination therapy)
• Prevention of infection after certain surgeries

Common side effects of metronidazole include nausea, a metallic or bitter taste in the mouth, loss of appetite, stomach discomfort, and headache. The urine may turn slightly dark, which is harmless. Less commonly, dizziness, furred tongue, or oral thrush may occur. Prolonged or high-dose use can rarely cause numbness or tingling in the hands and feet (peripheral neuropathy) — stop the medicine and inform your doctor if this happens. Seek urgent care for rash, swelling of the face, or seizures.

Strictly avoid alcohol while taking metronidazole and for at least 48 hours after the last dose. Combining alcohol with this medicine causes a severe reaction with flushing, vomiting, palpitations, and headache. Use with caution in liver disease, blood disorders, or a history of seizures or nerve problems. If treatment lasts more than 10 days, your doctor may monitor blood counts. Tell your doctor about all medicines you take, and do not share this antibiotic with others.

Metronidazole interacts with alcohol (severe disulfiram-like reaction — strictly avoid), warfarin and other blood thinners (increased bleeding risk), lithium (raised lithium levels), phenytoin and phenobarbital (altered levels of either drug), and disulfiram (risk of confusion or psychosis). It may also increase the effect of ciclosporin and busulfan. Always tell your doctor and pharmacist about every medicine, herbal product, or supplement you are taking before starting metronidazole.

Metronidazole should not be used in people with known hypersensitivity to metronidazole or other nitroimidazoles. It is generally avoided in the first trimester of pregnancy, especially for trichomoniasis. Use is contraindicated with recent alcohol intake or disulfiram therapy within the last two weeks. Caution or avoidance is needed in severe liver disease and in active neurological disorders unless the doctor judges the benefit to outweigh the risk.

Pregnancy: Avoid in the first trimester. In later pregnancy, metronidazole may be used only if a doctor decides it is clearly needed. Lactation: The drug passes into breast milk and can give it a bitter taste. For single high-dose regimens, doctors often advise withholding breastfeeding for 12–24 hours. Always consult your doctor before using this medicine during pregnancy or while breastfeeding.

Store below 30°C in a cool, dry place away from direct sunlight. Keep the medicine in its original pack and out of the reach of children. Do not use after the expiry date printed on the pack. Shake suspensions well before each use and discard as directed on the label.