Metronidazole 750 miconazole 200 candles. Metromico-neo - instructions for use. Application with violations of liver function

02.10.2020 Diet

Metromeconomic neo: Instructions for use and reviews

Latin name: Metromicon-neo.

ATX code: G01AF20

Active substance: Metronidazole + Mikonazole (Metronidazole + Miconazole)

Manufacturer: Aveksim Siberia LLC (Russia), OOO Farmaprim (Republic of Moldova)

Actualization of the description and photo: 26.10.2018

Metromecon neo - combined drug with antibacterial, antifungal and antiprotozoic effect.

Release form and composition

Dosage form - suppositories Vaginal: torpedo-shaped, white with a yellowish tinge or white, with a permissible air porous rod or a funnel-shaped recess on a slice (in a cell contour package or a blister 7 pcs, in a cardboard box for 2 packs or blister).

Composition 1 Suppository:

active substances: metronidazole - 500 mg; miconazole nitrate - 100 mg;
auxiliary components: semi-synthetic glycerides (SupPocyr AM).

Pharmacological properties

Pharmacodynamics

The active component of the drug Metromico-neo, metronidazole, is a substance producing antimicrobial and anti-prototocyne effect. The bactericidal action is due to the biochemical reduction of the 5-nitro group of metronidazole with intracellular transport proteins of the anaerobic bacteria and the simplest and further interaction of the reduced 5-nitro-group with deoxyribonucleic acid (DNA) of bacteria cells, during which inhibit the synthesis of nucleic acids of microorganisms and, as a result, the death of bacteria occurs.

Metronidazole is active in relation to Gardnerella Vaginalis, Trichomonas Vaginalis, Entamoeba Histolytica, Giardia Intestinalis, bonded anaerobic bacteria - Veillonella SPP., Fusobacterium SPP., Prevotella SPP. Prevotella Bivia, Prevotella Buccae, Prevotella Disiens), Bacteroides SPP. (Including Bacteroides ovatus, Bacteroides distasonis, Bacteroides fragilis, Bacteroides vulgatus, Bacteroides thetaiotaomicron), Gram-positive bacteria - Peptostreptococcus spp, Peptococcus spp, Mobiluncus spp, Clostridium spp, Eubacterium spp, as well as Gram-negative Helicobacter pylori......

Sustainability of aerobic microorganisms are shown to metronidazole, but in mixed flora (anaerobes and aerobes), the drug acts in synergies with antibiotics, which are effective against ordinary aerobones.

Another acting component of the drug Metromecon neo, miconazole nitrate belongs to antifungal drugs, Azole derivative. The fungicidal and fungistatic effect of miconazole is associated with the suppression of the synthesis of ergosternerine, which is a component of the shell and membrane of the mushroom cells, and damage to the integrity of the cell membrane, which causes the death of pathogenic cells. The most sensitive to the drug dermatomycetes and yeast. It is active in pathogens of dermatomycosis (including Candida Albicans, Microsporum, Epidermophyton Floccosum, Trichophyton), the pathogen of multicolored by Malassezia Furfur and other pathogenic microorganisms.

Pharmacokinetics

In case of intravaginal administration, the metronidazole bioavailability is 20%. The substance in the liver is metabolized to form active hydroxyl metabolites. T 1/2 (half-life) metronidazole - from 6 to 11 hours. Approximately 20% of the administered dose is derived from the urine in its original form.

Miconazole nitrate with intravaginal use is absorbed in minor quantities and is not determined in the plasma.

Indications for use

According to the instructions, metromecoma-neo is shown to use with the following vaginal infectious affects:

vaginal candidiasis;
bacterial vaginosis;
trichomonade vaginitis, trichomonademic vulvovaginitis;
mixed vaginal infection.

Contraindications

Absolute:

virginity;
first trimester of pregnancy, lactation period;
age up to 18 years;
increased individual sensitivity to metronidazole, another nitroimidazole derivative, miconazole or any auxiliary substance of the drug.

To prescribe metromecoma-neo with violations of the kidney function and / or liver, porphyria, diseases of the central and peripheral nervous system, bleeding disorders and microcirculation, diabetes, as well as in the second and third trimesters of pregnancy, it is necessary with caution.

Instructions for use of metromek neo: method and dosage

Suppositories metromek-neo use intravaginal. Freeing with the help of scissors suppository from contour packaging, it is introduced deep into the vagina.

with bacterial vaginosis, sharp vaginites: one suppository 2 times a day, in the morning and immediately before bedtime, within 7 days;
with chronic vaginites: one suppository 1 time per day for the night for 14 days;
with often recurrent vaginites or the absence of a positive clinical effect on the use of other treatment methods: one suppository 2 times a day, in the morning and before bedtime, within 14 days.

Side effects

local reactions: irritation of the mucous membrane of the vagina, strengthening of the swelling, itching, burning. With vaginity, the irritation can increase after using the first suppository or on the third day of treatment due to inflammation of the mucous membrane of the vagina. As a rule, after the termination of therapy, these symptoms quickly pass;
from the nervous system: Ataxia ( motor disorders), headache, dizziness, convulsions, psycho-emotional disorders;
from side digestive system: pain / spasms in the abdomen, diarrhea, constipation, nausea / vomiting, dry mouth, metal taste, loss of appetite;
from the system of blood formation: leukopenia;
allergic reactions: Skin rash (including urticule).

Overdose

Low absorption of the active components of the drug Metromico-Neo excludes an overdose subject to the recommended dosing regime.

Perhaps manifestation the following symptoms: under the overdose of metronidazole - nausea, vomiting, diarrhea, abdominal pain, ataxia, metal taste in mouth, paresthesia, cramps, dark urine dye, leukopenia, peripheral neuropathy (with long use High doses); Under overdose of micronazole nitrate - nausea, vomiting, diarrhea, anorexia.

Treatment is symptomatic and supportive therapy. In case of random drug intake, stomach washing is recommended.

special instructions

During the use of membrane-neo suppositories, it is recommended to refrain from sex contacts. To prevent re-infection, simultaneous therapy of the sexual partner is necessary, and in the case of trichomonaceous vaginitis, the partner is recommended dosage forms Metronidazole for oral application.

During the period of treatment and after the end of the course of therapy within 24-48 hours, admission should be avoided ethyl alcohol Due to the probability of developing disulfiram-like reactions.

In case of strong irritation of the mucous membrane of the vagina, the drug must be canceled.

The simultaneous use of the drug metromecoma-neo with vaginal diaphragm and latex or rubber condoms is not recommended due to their possible interaction with the basis of suppositories and a decrease in the reliability of mechanical contraception.

Suppositories need to be administered only intravaginal, swallow and apply them in other ways is prohibited.

When using the drug Metromico-Neo, together with the metronidazole for oral administration, in particular with a re-course, the picture of peripheral blood should be controlled due to the danger of leukopenia.

Impact on the ability to control vehicles and complex mechanisms

Patients receiving therapy by the drug Metromico-Neo, when managing vehicles and performing actions requiring increased attention and quick motor / mental reaction, care must be taken. In case of development adverse Reactions When using the drug from the central nervous system, you should refrain from potentially dangerous species Activities.

Application during pregnancy and lactation

In the first trimester of pregnancy, the prescription of the drug Metromicon-neo is contraindicated. Application in II and III trimesters is possible only in cases where the expected benefit for a woman exceeds potential risks for the fetus.

Since the metronidazole has a property to penetrate into breast milk, if necessary, apply suppositories in period lactation Breastfeeding should be stopped. You can resume breastfeeding 24-48 hours after the end of therapy.

Childcare

Metromicon-neo is contraindicated for children and adolescents under 18.

With violations of the kidney function

For renal failure The use of the drug Metromico neo requires caution.

When violations of the liver function

Assign metroCon-neo patients with impaired liver function should be careful.

Medicinal interaction

The use of metronidazole and miconazole nitrate simultaneously with some drugs May lead to the development of the following effects:

oral anticoagulants: enhancing action indirect anticoagulantov;
phenytoin: an increase in the concentration of phenytoin in the blood, a decrease in the concentration of metronidazole in the blood;
cimetidine: an increase in the concentration of metronidazole in the blood;
disulfiram: Development of disorders by the central nervous system in the form of mental reactions. It is not recommended to prescribe metronidazole patients hosting disulfiram last two weeks;
lithium preparations: an increase in their toxicity;
phenobarbital: decrease in the concentration of metronidazole in the blood;
terfenadine, Asthemisol: an increase in their plasma concentration as a result of suppressing their metronidazole metabolism and miconazole;
ethanol: Development of disulfiram-like reactions.

Analogs

Analogues of Metromico-Neo are: Ginokaps, Neo-Penotran, Neo-Penotran Forte and others.

Terms and conditions of storage

Store in a dry, dry place, at a temperature of from 15 to 25 ° C.

Take care of children.

Shelf life - 3 years.

Anzhero-Sudzhensky HFZ, OOO Farmaprim LLC

Country of origin

Moldova, Republic of Russia

Group of goods

Antifungal drugs

Antimicrobial remedy Combined (antimicrobial and antiprotozoic agent + antifungal agent)

Forms of release

suppositories Vaginal 14 pieces in UP

Description of the dosage form

White or white with a yellowish tinge of a torpedo-shaped suppositorine. On the cut, the presence of a air rod or funnel-shaped recess is allowed.

pharmachologic effect

Metromicon-neo - combined drug with anti-polotozoic, antifungal and antibacterial effect. Contains metronidazole and miconazole. Pharmacodynamics. Metronidazole refers to 5 nitrimidazoles and is a drug with a bactericidal type of action that manifests the tropiness (ability of interaction) to deoxyribonucleic acid. The mechanism of action lies in the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and the simplest. The reduced 5-nitro group of metronidazole interacts with the deoxyribonucleic acid of the cell of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria. Active in relation to the simplest: Trichomonas Vaginalis, Entamoeba Histolytica, as well as bonded anaerobic bacteria: gram-negative - Bacteroides SPP. (including Bacteroides Fragilis, Bacteroides DistasOnis, Bacteroides Ovatus, Bacteroides Thetaiotaomicron, Bacteroides Vulgatus), Fusobacterium SPP., Veillonella SPP., Prevotella SPP. (Prevotella Bivia, Prevotella Buccae, Prevotella Disiens), gram-positive - Clostridium SPP., EUBACTERIUM SPP., PEPTOCOCCUS SPP., PepTostReptococcus SPP., Mobiluncus SPP. and optional anaeroba - Gardnerella vaginalis. An aerobic microorganisms are insensitive to metronidazole, but in the presence of mixed flora (aerobes and anaerobes) metronidazole acts synergistically with antibiotics, effective against ordinary aerobones. Mikonazole is antifungal tool, Azole derivative. When intravaginal use is active in terms of Candida Albicans. The fungicidal and fungistatic effect of the micronazole is due to inhibiting the biosynthesis of ergosterol shell and plasma membranes of mushrooms, a change in the lipid composition and the permeability of the cell wall, causing the death of the mushroom cell.

Pharmacokinetics

Compared to intake, metronidazole bioavailability in intravaginal administration is 20%. Metronidazole is metabolized in the liver. Hydroxyl metabolites are active. The semi-anniversary period of metronidazole is 6 to 11 hours. About 20% of the dose is excreted unchanged with urine. With intravaginal administration, the miconazole is absorbed slightly and is not defined in the plasma.

Special conditions

When using the drug, refrain from sexual contacts. In order to avoid re-infection, simultaneous treatment of the sexual partner is necessary. In the case of trichomonaceous vaginitis, it is advisable to simultaneously treat the sexual partner in the metronidazole to receive inside. During treatment and at least within 24-48 hours after the course of treatment, it should be avoided by ethanol (intolerance of ethanol). The simultaneous use of the drug with contraceptive diaphragms and condoms from rubber or latex is not recommended (interaction with the base of suppositories is possible). With strong irritation of the vagina, the treatment should be discontinued. Suppositories should be used only intravaginal, they cannot be swallowed or applied in another way. In the case of the use of the drug in conjunction with the metronidazole to receive inside, especially with a re-course, control of the peripheral blood pattern (the danger of leukopenia) is necessary. Effect on the ability to drive vehicles and management potentially hazardous mechanisms: caution is recommended, since a possible negative impact on the ability to driving cars and manage complex mechanisms Cannot be excluded. When appearance side Effects From the central nervous system, it should be refracted from managing vehicles and work with potentially hazardous mechanisms.

Structure

One suppository contains: active substances: metronidazole 500 mg, miconazole nitrate 100 mg; Auxiliary substances: semi-synthetic glycerides (SupPocyr AM) - a sufficient amount to obtain a suppository weighing 2000 mg.

Metromeconomic neo testimony for use

Vaginal infections: Vaginal Candidiasis; trichomonophone vaginitis and vulvovaginitis, bacterial vaginosis; Mixed vaginal infection.

Metromicon-neo Contraindication

Hypersensitivity to the components of the drug or other nitroimidazole derivatives, pregnancy, lactation period.

Metromecoma-Neo Dosage

500 mg + 100 mg

METROKON-NEO Side effects

Local reactions: burning, itching, irritation of the mucous membrane of the vagina and the strengthening of the swelling. Due to the inflammation of the mucous membrane of the vagina with vaginity, the irritation may increase after the introduction of the first suppository or to the third day of treatment. These complications quickly disappear after the cessation of treatment. From side gastrointestinal tract: pain or spasms in the stomach, "metal" taste, dry mouth, constipation, diarrhea, loss of appetite, nausea, vomiting. From the nervous system: headache, motor disorders (ataxia), dizziness, psycho-emotional violations, convulsions. From the system of blood formation: leukopenia. Allergic reactions: skin rashes, including urticaria.

Medicinal interaction

In connection with the ingress of metronidazole in the systemic blood flows, the following reactions of interaction with simultaneous use with some substances can be noted: oral anticoagulants: the effect of indirect anticoagulants is enhanced. Disoulphyram: There may be violations by the CNS (mental reactions); should not be prescribed by metronidazole patients who took disulfiram over the last 2 weeks; Phenytoin: The concentration of phenytoin in the blood increases, and the concentration of metronidazole in the blood decreases. Lithium preparations: There may be an increase in their toxicity. Phenobarbital: The concentration of metronidazole in the blood is reduced. Cimetidine: the concentration of metronidazole in the blood can increase. Asthemisol and Terfenadine: Metronidazole and Mikonazole inhibit the metabolism of these drugs and increase the blood plasma concentration. Ethanol: the interaction of metronidazole with ethanol causes disulfiram-like reactions.

Overdose

Under the recommended doses, due to the low absorption of the drug, the overdose cases are not detected. Possible symptoms: Nausea, vomiting, abdominal pain, diarrhea, itching, metal taste in the mouth, ataxia, dizziness, paresthesia, peripheral neuropathy (with long-term use in high doses), convulsions, leukopenia, dark urine dye (due to metronidazole overdose). The symptoms of the micronazole overdose are not detected. Treatment: symptomatic and maintenance therapy, with random reception inside - washing the stomach.

Storage conditions

dry
bear from children
storing

Information provided

Metromicon-Neo is a combined drug based on two active ingredients with antifungal and antibacterial effect: metronidazole and miconazole.

The means is actively used in gynecological practice to combat sexual diseases, including vaginitis and vaginal bacteriosis.

When is it assigned?

Testimony for prescribing the drug are fungal and bacterial infections genital organs and vagina, as well as mixed sex infections. Most often, Metromico-Neo is used to treat the following states:

candidiasis of the vagina;
vaginal trichomoniasis;
vaginitis (in acute and chronic form);
vulvovaginitis;
vaginal bacteriosis;
sex infections of mixed type.

Important! The drug is ineffective for the treatment of infections caused by aerobic organisms, but with simultaneous reception with Metromicon-Neo antibiotics, it enhances their action (with a mixed type of pathogenic flora) and suppresses the growth of pathogenic bacteria.

How to apply?

Suppositories "Metromicon Neo" are inserted deep into the vagina. On all stage of treatment, it is necessary to monitor the intimate zone hygiene. Immediately before the introduction of the candle, it is recommended to carry out hygienic tool and handling of hands (antiseptic or disinfectant solution).

For achievement therapeutic effect 1 suppository is used per day. The recommended time for the procedure is immediately before bedtime. After the introduction of the candle should remain in horizontal position Not less than half an hour.

The duration of treatment depends on the diagnosis and degree of severity of symptoms. Standard treatment time looks like this:

acute vaginitis - 7 days;
chronic vaginitis - 14 days;
vaginal bacteriosis - 7 days;
thrush (vaginal candidiasis) - 7 days.

When relapses, as well as the absence of the results of the treatment, it is recommended to use the drug at least 14 days.

Contraindications

Absolute contraindications for the use of Metromico-Neo suppositories are:

the first 12-14 weeks of pregnancy;
lactation;
the integrity of the virgin splava;
age up to 18 years;
increased sensitivity to ingredients;
allergy to drug components.

The attending physician after a thorough assessment may limit the use of the drug if there is a history of the following diagnoses (due to increased risk):

kidney and liver diseases / partial dysfunction of these organs;
pathology of the nervous system;
disturbed microcirculation;
blood breeding;
diabetes;
porphyry (violation of pigment exchange).

Pregnancy and lactation

In exceptional cases, Metromicon-Neo can be used to treat pregnant women in the second and third trimester in cases where there is no safe alternative, or there is no positive dynamics from the use of other methods. Pregnant women throughout the entire period of treatment should be under the supervision of a gynecologist or obstetrician.

Lactation is a contraindication for the use of the drug, since the metronidazole is highlighted in breast milk. If necessary, breastfeeding should be discontinued. The resumption of lactation should occur no earlier than 24-48 hours after the end of therapy is the period of complete removal of metronidazole from the body.

Overdose

With random use of large dosages of the drug, as well as during long-term therapy, the appearance of system effects, for example, a metal taste in the mouth, headache, dyspepsia, digestive disorders are possible.

Treatment is symptomatic and does not require cancellation.

Side effects

Side effects arising against the background of Candle Candles "Metromico-Neo" can be divided into two groups: Local (appear only at the site of use) and systemic (associated with work internal organson which absorption affects active ingredients).

Local side effects:

irritation (peeling, dryness);
rash;
burning and tingling;
allergic reactions (urticaria).

Systemic sideflines:

constipation or diarrhea;
nausea;
loss of appetite;
violation of taste;
leukopenia;
convulsions;
headache, dizziness (very rarely - loss of consciousness);
psychosis and neurosis (moderately pronounced);
coordination violation.

Important! In the event of negative high-intensity reactions, the use of the drug must be discontinued and contact your doctor.

Composition and pharmacokinetics

Metromicon-Neo consists of three ingredients:

The drug is produced in the form of white vaginal candles with a recess at the end (14 pieces per pack). The average cost is 314 rubles per pack.

The biological accessibility of metronidazole in intravaginal administration is 20%. The substance is metabolized in the liver, excreted from the body mainly with urine (half-life ranging from 6 to 11 hours).

The miconazole is practically not absorbed by the mucous membranes and is not detected in the systemic bloodstream.

Reviews

(Leave your feedback in the comments)

Stubbornly treated the thrush for six months, and she returned everything (as in famous advertising). When, finally, decided to go to another doctor and go through a full survey, it turned out that the disease had already passed into chronic staging. The doctor appointed me scriptures and candles "Metromico-Neo". The candle has a convenient form, a pleasant touch, although it is not very important, because the main thing is the result. I used all the packaging (14 pieces) 1 candle per day. Additionally performed all the prescriptions of the gynecologist about hygiene (boiling and stroked bed linen together with the bottom, for the arms used a special gel to normalize the vaginal flora). Two weeks later, I learned that my sore passed without a trace.

And I did not go around such dubious happiness. Like thrush. For treatment, some French candles were appointed, but they were not in the pharmacy, and the Pharmacist advised Metromicon Neo. They turned out to be a generic (a substitute with a completely identical composition) a medicine discharged to me, although it was worth almost 5 (!!!) times cheaper. Despite the fact that in the instructions to apply 1 suppository per day, for some reason I was prescribed them 2 times a day. Well, okay, if only it helped. Candles are small in size, comfortable. They can flow after administration, so do not get out of bed at least half an hour - during this time the composition will have time to absorb the walls of the vagina. From the side effects, I had a slight plug, but it took place 15-20 minutes after the use of medication. I needed 8 days for a complete getting rid of thrush. I hope that this dirtiness will no longer touched me. And if it touches, now I know what I will be treated.

* - The average value among several sellers at the time of monitoring is not a public offer.

24 comments

When taking METROKONK-neo began to appear with blood. There are no pain and unpleasant sensations. And this is definitely not monthly. What could it be? Prescribed candles for the treatment of bacterial vaginitis

Hello. Please tell me if it is possible to lay a momecon-neo candles if I'm still simply accepted by honey. Plebodia 600. Is it possible to combine them together?

Hello, I was prescribed metromek neo and lacker. The diagnosis did not say the doctor. But I read the instructions and realized that one from the thrush. And in the other this is a contraindication. How to be?

Drug with antibacterial, antiprotozoic and antifungal action for local application in gynecology

Active substances

Release form, composition and packaging

Vaginal suppositories White or white with a yellowish tint, torpedo-shaped; On the cut, the presence of a air rod or funnel-shaped recess is allowed.

Auxiliary substances: semi-synthetic glycerides (AM) - sufficient amount to obtain a suppository weighing 2000 mg.

7 pcs. - Packaging cell contour (2) - packs cardboard.

pharmachologic effect

Metronidazole refers to 5-nitroimidazoles and is a drug with a bactericidal type of action that manifests the tropiness (the ability of interaction) to deoxyribonucleic acid.

The mechanism of action lies in the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and the simplest. The reduced 5-nitro group of metronidazole interacts with the deoxyribonucleic acid of the cell of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria.

Active in relation to the simplest: Trichomonas Vaginalis, Entamoeba Histolytica, as well as bonded anaerobic bacteria: gram-negative - Bacteroides SPP. (including Bacteroides Fragilis, Bacteroides DistaSonis, Bacteroides Ovatus, Bacteroides Thetaiotaomicron, Bacteroides Vulgatus), Fusobacterium SPP., Veillonella SPP., Prevotella SPP; Prevotella Bivia, Prevotella Buccae, Prevotella Disiens), gram-positive - Clostridium SPP., EUBACTERIUM SPP., Peptococcus SPP., PepTostReptococcus SPP: Mobiluncus SPP. and optional anaeroba - Gardnerella vaginalis.

To metronidazole, the aerobic microorganisms are insensitive, but in the presence of mixed flora (aerobes, and anaerobes) metronidazole acts synergistically with antibiotics, effective against ordinary aerobones.

Mikonazole is an antifungal agent, azole derivative. When intravaginal use is active in terms of Candida Albicans. Fungation and the fungistatic effect of miconazole is due to the inhibiting biosynthesis of ergosterol shell and plasma membranes of mushrooms, a change in the lipid composition and permeability of the cell wall, causing the death of the mushroom cell.

Pharmacokinetics

Compared to intake, metronidazole bioavailability in intravaginal administration is 20%. Metronidazole is metabolized in the liver. Hydroxyl metabolites are active.

The semi-anniversary period of metronidazole is 6 to 11 hours. About 20% of the dose is excreted unchanged with urine.

With intravaginal administration, the miconazole is absorbed slightly and is not determined.

Indications

Vaginal infections:

- vaginal candidiasis;

- trichomonophone vaginitis and vulvovaginitis, bacterial vaginosis;

- Mixed vaginal infection.

Contraindications

- hypersensitivity to the components of the drug or another nitroimidazole derivative;

- I trimester of pregnancy, lactation period,

— childhood up to 18 years;

- In virgins.

Carefully: With liver and, porphyria, impaired blood formation and diseases of the peripheral and central nervous system, diabetes, microcirculation disorders, during pregnancy (II and III trimesters).

Dosage

Intravaginal.

Acute Vaginites,: 1 Suppository in the morning and at night for 7 days in a row.

Chronic vaginites: 1 Suppository 1 time per day, immediately before bedtime, for 14 days in a row.

Often recurrent vaginites or in the absence of positive clinical dynamics in the treatment of other methods: 1 Suppository in the morning and at night for 14 days.

Pre-release-suppository from contour packaging with scissors (cut the film over the loop of the suppository), enter it deep into the vagina.

Side effects

Local reactions: burning, itching, irritation of the mucous membrane of the vagina and the strengthening of the swelling. Due to the inflammation of the mucous membrane of the vagina with vaginity, the irritation may increase after the introduction of the first suppository or to the third day of treatment. These complications quickly disappear after the cessation of treatment.

From the gastrointestinal tract: Pain or spasms in the stomach, "metal" taste, dry mouth, constipation, diarrhea, loss of appetite, nausea, vomiting.

From the nervous system: Headache, motor disorders (ataxia), dizziness, psycho-emotional violations, convulsions.

From the hematopopitation system: leukopenia.

Allergic reactions: Skin rashes, including urticaria.

Overdose

Possible symptoms: nausea, vomiting, diarrhea, itching, metal taste in the mouth, ataxia, dizziness, paresthesia, peripheral neuropathy (with long-term use in high doses), convulsions, leukopenia, dark urine dye (due to metronidazole overdose).

The symptoms of the micronazole overdose are not detected.

Treatment: Symptomatic and maintenance therapy, with a random reception inside - washing the stomach.

Medicinal interaction

In connection with the ingress of metronidazole in the systemic bloodstream, the following reactions of interaction with simultaneous use with certain substances can be noted:

Oral: The effect of indirect anticoagulants increases.

Disulfiram: There may be violations by the CNS (mental reactions); No, the metronidazole patients should be prescribed, which took disulfiram over the last 2 weeks.

Phenitoin: The concentration of phenytoin in the blood increases, and the concentration of metronidazole in the blood decreases.

Lithium preparations: There may be an increase in their toxicity.

: The concentration of metronidazole in the blood is reduced.

Cimetidine: The concentration of metronidazole in the blood may increase.

Asthemisol and Terfenadine: Metronidazole and miconazole inhibit the metabolism of these drugs and increase the blood plasma concentration.

Ethanol: The interaction of metronidazole with ethanol causes disulfiram-like reactions.

special instructions

During treatment and at least within 24-48 hours after the course of treatment, it should be avoided by ethanol (intolerance of ethanol).

With strong irritation of the vagina, the treatment should be discontinued.

Suppositories should be used only intravaginal, they cannot be swallowed or applied in another way.

In the case of the use of the drug in conjunction with the metronidazole to receive inside, especially with a re-course, control of the peripheral blood pattern (the danger of leukopenia) is necessary.

Effect on the ability to driving vehicles and management potentially hazardous mechanisms: Care is recommended, since the possible, negative impact on the ability to drive cars and management complex mechanisms cannot be excluded. When side effects appear on the part of the central nervous system, you should refrain from managing vehicles and work with potentially hazardous mechanisms.

Pregnancy and lactation

The appointment of the drug is contraindicated in the first trimester of pregnancy. Application in the II and III of trimesters of pregnancy is possible only if the potential benefit for the mother exceeds possible risk For fetal.

If it is necessary to appoint the drug during lactation, breastfeeding should be discontinued, since the metronidazole penetrates breast milk. Breast-feeding It can be resumed 24-48 hours after the end of treatment.

Childcare

Contraindicated to children under 18.

With violations of the kidney function

With caution in renal failure.

When violations of the liver function

With caution with liver failure.

Conditions of vacation from pharmacies

On prescription.

Terms and Storage Terms

In a dry-protected place at a temperature of 15 to ° 25 C. Store out of the reach of children. Shelf life - 3 years.

Vaginal infections: - vaginal candidiasis; - trichomonophone vaginitis and vulvovaginitis, bacterial vaginosis; - Mixed vaginal infection.

Pharmacotherapeutic group

Antimicrobial remedy Combined (antimicrobial and antiprotozoic + antifungal agent).

Pharmacological property

Metronidazole refers to 5-nitroimidazoles and is a drug with a bactericidal type of action that manifests the tropiness (the ability of interaction) to deoxyribonucleic acid. The mechanism of action lies in the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and the simplest. The reduced 5-nitro group of metronidazole interacts with the deoxyribonucleic acid of the cell of microorganisms, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria. Active in relation to the simplest: Trichomonas Vaginalis, Entamoeba Histolytica, as well as bonded anaerobic bacteria: gram-negative - Bacteroides SPP. (including Bacteroides Fragilis, Bacteroides DistaSonis, Bacteroides Ovatus, Bacteroides Thetaiotaomicron, Bacteroides Vulgatus), Fusobacterium SPP., Veillonella SPP., Prevotella SPP; Prevotella Bivia, Prevotella Buccae, Prevotella Disiens), gram-positive - Clostridium SPP., EUBACTERIUM SPP., Peptococcus SPP., PepTostReptococcus SPP: Mobiluncus SPP. and optional anaeroba - Gardnerella vaginalis. To metronidazole, the aerobic microorganisms are insensitive, but in the presence of mixed flora (aerobes, and anaerobes) metronidazole acts synergistically with antibiotics, effective against ordinary aerobones. Mikonazole is an antifungal agent, azole derivative. When intravaginal use is active in terms of Candida Albicans. Fungation and the fungistatic effect of miconazole is due to the inhibiting biosynthesis of ergosterol shell and plasma membranes of mushrooms, a change in the lipid composition and permeability of the cell wall, causing the death of the mushroom cell.

Contraindications

Hypersensitivity to the components of the drug or other nitroimidazole derivatives; I trimester of pregnancy, lactation period, children's age up to 18 years; In virgins. With caution: with liver and renal failure, porphyria, impaired blood formation and diseases of the peripheral and central nervous system, diabetes mellitus, microcirculation disorders, during pregnancy (II and III trimesters).

Application

Intravaginal. Acute vaginites, bacterial vaginosis: 1 Suppository in the morning and at night for 7 days in a row; Chronic Vaginites: 1 Suppository 1 time per day, immediately before bedtime, for 14 days in a row; Often recurrent vaginites or in the absence of positive clinical dynamics in the treatment of other methods: 1 Suppository in the morning and at night for 14 days.

Side effects

Local reactions: burning, itching, irritation of the mucous membrane of the vagina and the strengthening of the swelling. Due to the inflammation of the mucous membrane of the vagina with vaginity, the irritation may increase after the introduction of the first suppository or to the third day of treatment. These complications quickly disappear after the cessation of treatment. From the gastrointestinal tract: pain or spasms in the abdomen, "metal" taste, dry mouth, constipation, diarrhea, loss of appetite, nausea, vomiting. From the nervous system: headache, motor disorders (ataxia), dizziness, psycho-emotional violations, convulsions. From the system of blood formation: leukopenia. Allergic reactions: skin rashes, including urticaria.

Overdose

Under the recommended doses, due to the low absorption of the drug, the overdose cases are not detected. Possible symptoms: nausea, vomiting, abdominal pain, diarrhea, itching, metal taste in the mouth, ataxia, dizziness, paresthesia, peripheral neuropathy (with long-term use in high doses), convulsions, leukopenia, dark urine dyeing (due to metronidazole overdose). The symptoms of the micronazole overdose are not detected. Treatment: symptomatic and maintenance therapy, with random reception inside - washing the stomach.

Interaction with other drugs

In connection with the ingress of metronidazole in the systemic blood flows, the following reactions of interaction with simultaneous use with some substances can be noted: oral anticoagulants: the effect of indirect anticoagulants is enhanced. Disoulphyram: There may be violations by the CNS (mental reactions); No, the metronidazole patients should be prescribed, which took disulfiram over the last 2 weeks. Phenytoin: The concentration of phenytoin in the blood increases, and the concentration of metronidazole in the blood decreases. Lithium preparations: There may be an increase in their toxicity. Phenobarbital: The concentration of metronidazole in the blood is reduced. Cimetidine: the concentration of metronidazole in the blood can increase. Asthemisol and Terfenadine: Metronidazole and Mikonazole inhibit the metabolism of these drugs and increase the blood plasma concentration. Ethanol: the interaction of metronidazole with ethanol causes disulfiram-like reactions.