Metrogyl dropper: indications, instructions for use, composition, dosage and side effects

• November 14, 2018
• Other drugs
• Savelyeva Victoria

In the article we will look at the instructions for Metrogil intravenously.

If the doctor recommended such droppers to the patient, then questions arise. It is important to understand how the drug affects the human body. Metrogyl is prescribed for inflammatory processes, giardiasis or gynecological pathologies.

The drug is a drug with trichomonacid, antiprotozoal and antibacterial properties.

This drug is produced in several dosage forms, but for administration through a dropper, Metrogyl is used in the form of solutions. The solution for intravenous use is presented as a clear, pale yellow or colorless liquid, in polyethylene bottles of 100 ml, in a cardboard pack of 1 bottle, or in ampoules of 20 ml, in a cardboard pack of 5 ampoules or in thermal containers, 1 pc. in a cardboard box.

The main active element in the medicine is metronidazole. Additional components are sodium chloride, citric acid (monohydrate), anhydrous sodium hydrogen phosphate, and water for injection.

Pharmacological action of this drug

Solution for intravenous administration "Metrogyl" is an antiprotozoal and antibacterial medicine with a wide spectrum of effects based on the active element - metronidazole. The mechanism of action of this medication is due to the reduction of the 5-nitro group of metronidazole by transport intracellular proteins of protozoa and anaerobic pathogens. The reduced 5-nitro group of this active substance interacts with the DNA of the bacterial cell, inhibiting the production of its nucleic acids, which leads to the destruction of the pathogenic bacterium.

Pharmacokinetic properties of the drug

After administration via a Metrogyl dropper in a single dose, metronidazole is completely and quickly absorbed, reaching the maximum level in the blood plasma after 2 hours. The substance has a pronounced penetrating ability into organs and tissues: lungs, liver, kidneys, skin, cerebrospinal fluid, bile, brain, saliva, vaginal secretions, amniotic fluid, seminal fluid, mother's milk. The drug binds to plasma proteins by 10-20%. Excreted through the kidneys (60-80% of the dosage), 20% of the drug is excreted from the body unchanged. The half-life is 8 hours.

In patients with impaired renal function, after repeated use of the drug, accumulation of metronidazole in the blood may occur (for people with severe renal failure, the daily dosage of metronidazole should be reduced).

Pharmacokinetics and pharmacodynamics

After a patient has been administered Metrogyl intravenously, approximately 30-60% of the substance is metabolized through hydroxylation, oxidation and glucuronidation. As a result, a metabolite, 2-oxymetronidazole, is formed, which also produces an antiprotozoal and antimicrobial effect. The half-life is 8 hours (subject to normal liver function), up to 18 hours (if the liver is damaged by alcohol).

Approximately 60-80% of the administered dose is excreted through the kidneys, another 6-15% is excreted through the intestines. Both metronidazole and its metabolites are eliminated from the blood by hemodialysis .

If the antibiotic is taken orally, it is quickly absorbed, and its maximum concentration in the blood is observed after 2 hours. The product has a high ability to penetrate tissues and body fluids. 10-20% bound to plasma proteins. About 60-80% is excreted through the kidneys, while approximately 20% is excreted unchanged. Half-life is 8 hours.

When the product is used externally, a minimal amount is absorbed, so only traces of the active component are detected in the blood. It should be taken into account that the absorbed active substance passes the blood-brain and placental barriers.

Indications for use

Metrogyl solutions for IV drips are prescribed to patients with the following pathologies:

1. Protozoal infections: giardiasis, trichomonas vaginitis, intestinal and extraintestinal amebiasis (amebic dysentery, amoebic liver abscess), balantidiasis, trichomoniasis, cutaneous leishmaniasis, trichomonas urethritis.
2. Infectious lesions caused by Bacteroides spp.: diseases of the joints, bones, central nervous system (including meningitis), bacterial endocarditis, pneumonia, brain abscess, lungs, empyema.
3. Infections caused by varieties of Bacteroides spp., including the B. fragilis group, Peptococcus spp., Clostridium spp., Peptostreptococcus spp.: infection of the abdominal cavity (including peritonitis, liver abscess), infection of soft tissues, skin, pelvic organs (including endomyometritis, endometritis, abscess of the ovaries and fallopian tubes, vaginal infections after surgical procedures). What are other indications for using the Metrogil drip?
4. Infections caused by Bacteroides spp., including the class Clostridium spp., B. fragilis: sepsis.
5. Alcoholism.
6. Pseudomembranous colitis, which develops as a result of the use of antibiotic medications.
7. Duodenal ulcer or inflammation of the gastric mucosa caused by the proliferation of Helicobacter pylori.
8. Some complications after surgical interventions, especially on the colon, in the anorectal area, gynecological operations, appendectomy (for preventive purposes).

Contraindications

Solutions for intravenous administration "Metrogil" are contraindicated for use in the following cases:

• organic damage to the central nervous system, including epilepsy;
• blood diseases, including indications of such in the anamnesis;
• liver failure (when prescribing large dosages);
• lactation period and first trimester of pregnancy;
• high sensitivity to components of the medicinal product, as well as to other nitroimidazole derivatives.

In the second and third trimesters of gestation, the prescription of a drug is possible only if there are vital indications. The medication should be used with caution in case of insufficient renal function.

How are droppers carried out with Metrogyl?

Compound

The Metrogyl solution contains the active ingredient metronidazole , as well as: sodium chloride, sodium hydrogen phosphate (anhydrous), citric acid, water.
Metrogyl tablets contain the active ingredient metronidazole , as well as: corn starch, magnesium stearate, colloidal silicon dioxide, hydrogenated castor oil, Opadry II dye, water.

Metrogyl gel includes metronidazole and additional components: propyl parahydroxybenzoate, methyl parahydroxybenzoate, disodium edetate, carbomer 940, sodium hydroxide, propylene glycol, water.

Dosages and method of administration

A solution for intravenous drip is indicated in cases of severe infection and the inability to use this drug orally.

According to the instructions for use of Metrogyl intravenously, for adults and children over 12 years of age, the medicine is prescribed in an initial dosage of 500-1000 mg (infusion duration is 40 minutes), then 500 mg is administered every 8 hours at a rate of 5 ml per minute. After the first 3 infusions, with normal tolerability of the medication, they switch to bolus administration. The duration of treatment is usually 7 days. If necessary, drip intravenous administration of the drug can be carried out for a longer period. The maximum dosage of Metrogyl solution for intravenous administration per day should be no more than 4000 mg. Subsequently, the patient is transferred to maintenance treatment, prescribed oral medication at a daily dosage of 1200 mg (3 times 400 mg per day). In children under 12 years of age, the drug is prescribed according to the same regimen, using a single dosage of 7.5 mg/kg. When treating purulent-septic pathologies, 1 course of therapy is usually carried out.

Release form and composition

Metrogyl is available in the following dosage forms:

• Solution for intravenous administration: transparent, pale yellow or colorless (100 ml in polyethylene bottles, 1 bottle in a cardboard box; 20 ml in ampoules, 5 ampoules in a cardboard box or in thermal containers, 1 thermal container in a cardboard box) ;
• Film-coated tablets: biconvex, round, pink (200 mg each) or orange (400 mg each) (10 pieces in strip packs, 2 or 10 packs in a cardboard box);
• Vaginal gel: from colorless to light yellow, homogeneous (30 g in tubes, 1 tube in a cardboard box complete with an applicator);
• Gel for external use: from colorless to yellow, homogeneous (30 g in aluminum tubes, 1 tube in a cardboard box);
• Suspension for oral use (60 or 100 ml in bottles, 1 bottle in a cardboard box).

The composition of 1 ml of injection solution includes:

• Active ingredient: metronidazole – 5 mg;
• Auxiliary components: citric acid monohydrate, anhydrous sodium hydrogen phosphate, sodium chloride, water for injection.

1 tablet contains:

• Active ingredient: metronidazole – 200 or 400 mg;
• Auxiliary components: magnesium stearate, colloidal silicon dioxide, corn starch, purified water; additionally: 200 mg tablets – hydrogenated castor oil and Opadry II pink dye 85G54815; 400 mg tablets – povidone and Opadry II orange dye 85G53070.

The composition of 100 mg vaginal gel includes:

• Active ingredient: metronidazole – 1 mg;
• Auxiliary components: propylene glycol, propyl hydroxybenzoate, sodium hydroxide, disodium edetate, carbomer-940, purified water.

The composition of 100 mg gel for external use includes:

• Active ingredient: metronidazole – 1 mg;
• Auxiliary components: carbomer 940, disodium edetate, propylene glycol, propyl parahydroxybenzoate, methyl parahydroxybenzoate, sodium hydroxide, purified water.

1 ml of oral suspension contains the active ingredient: metronidazole – 40 mg.

For prevention

For prophylactic purposes, children over 12 years of age and adults are prescribed the antibiotic "Metrogyl" intravenously through a dropper at a dose of 500-1000 mg before surgery. On the day of surgery, as well as the next day, the drug is administered at a dose of 500 mg every 8 hours. After 2 days, it is recommended to switch to maintenance treatment through oral administration of the medication.

The maximum dosage of Metrogyl in ampoules per day for chronic kidney failure and creatinine clearance less than 30 ml per minute or liver failure should not exceed 1000 mg (with a frequency of use 2 times a day).

Metrogil price, where to buy

The price of Metrogil in tablets is about 80 rubles per pack; suppositories with metronidazole can be bought at a price of 100 rubles.

You can buy Metrogyl facial gel for 160 – 180 rubles.

The price of ampoules depends on the volume; an IV solution in 5 ml ampoules costs 30 rubles. for 1 ampoule. The cost of 100 ml ampoules (for a dropper) is about 80 rubles.

Vaginal gel Metrogyl, price

You can buy vaginal gel for an average of 170 rubles (30 g ointment). The price of the gel in Ukraine (Kharkov, Kyiv, etc.) is 80 – 90 hryvnia. You can find out how much the gel costs at a specific pharmacy.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Metrogyl plus gel vag.
  10 mg/g 50 g (+10 applicators) Unique Pharmaceutical Laboratories RUR 311 order
• Metrogyl gel for external use. approx. 1% 30gUnique Pharmaceutical Lab.

  RUB 187 order

• Metrogyl gel vaginal. 10mg/g 30gUnique Pharmaceutical Lab.

  166 RUR order

• Metrogyl Denta dental gel for gums 20g 1pcUnique Pharmaceutical Lab.

  RUB 239 order

• Metrogyl plus vaginal gel 50g tube No. 1 Unique Pharmaceutical Laboratories

  RUB 227 order

Pharmacy Dialogue

• Metrogyl (vial 5mg/ml 100ml)Unique Farm Lab

  29 RUR order

• Metrogyl Denta gel for gums 20gUnique Farm Lab

  RUB 274 order

• Metrogyl gel (tube 30g)Unique Farm Lab

  RUB 209 order

• Metrogil vag. gel (tube 30g with applique)Unique Farm Lab

  RUB 171 order

• Metrogyl plus vag.gel (tube 50g + application No. 1)Unique Farm Lab

  RUB 241 order

show more

Pharmacy24

• Metrogyl Denta 20 g gel Unik Pharmaceutical Laboratories, India
  55 UAH order
• Metrogyl 30 g gel Unik Pharmaceutical Laboratories, India

  78 UAH order

• Metrogyl 30 g gel Unik Pharmaceutical Laboratories, India

  85 UAH order

• Metrogyl 5 mg/ml 100 ml solution for infusion

  20 UAH order

PaniPharmacy

• Metrogyl denta gel Metrogyl denta gel 20g India, Unique

  61 UAH order

• Metrogyl gel Metrogyl gel 30g India, Unique

  92 UAH order

• Metrogyl gel Metrogyl vag. gel 30g with appl. India, Unique

  103 UAH order

• Metrogyl infusion Metrogyl solution inf. 100ml India, Unique

  24 UAH order

show more

Side effects

A solution for intravenous drip use can provoke the following negative side reactions:

1. Digestive system: pseudomembranous colitis, vomiting, dry mouth, nausea, constipation, intestinal colic, diarrhea, lack of appetite, metallic taste on the tongue, increased concentration of liver enzymes, hepatitis, cholestatic jaundice, stomatitis, pancreatitis, glossitis.
2. Hematopoietic system: leukopenia, thrombocytopenia.
3. Genitourinary system: burning sensation and pain in the urethra, candidiasis (fungal microflora of the vagina), dysuria, red-brown urine color, urinary incontinence, polyuria.
4. Nervous system: ataxia, changes in coordination of movements, hallucinations, headache, dizziness, changes in consciousness, epilepsy attacks, increased excitability, depression, sleep disturbance, peripheral neuropathy, weakness.
5. Allergic reactions: lacrimation, nasal congestion, anaphylactic shock, arthralgia, skin rash, skin flushing, itching, urticaria, fever.
6. Local reactions: thrombophlebitis (pain, swelling or redness of the skin at the injection site).
7. Other reactions: on the electrocardiogram - flattening of the T wave, neutropenia.

Special Recommendations

While using the drug Metrogyl, you should not drink alcohol, as this can provoke the development of a disulfiram-like reaction, which manifests itself in the form of spastic abdominal pain, nausea, vomiting, headache, and flushing of the face. The concomitant use of Metrogyl with amoxicillin is not recommended for patients under the age of 18 years.

With leukopenia, the possibility of continuing therapeutic measures is determined by the risk of an infectious process. During long-term treatment, it is advisable to monitor peripheral blood counts. If ataxia, dizziness and other deterioration of neurological functions develop, therapy with this medication should be discontinued.

The use of Metrogyl can immobilize treponemes and provoke a false-positive Nelson test.

When treating trichomonas urethritis in men and vaginitis in women, one should abstain from sexual intercourse and carry out simultaneous treatment of partners. At the end of the course of treatment, control tests are required.

After completing therapy for giardiasis with this drug, if the symptoms persist, it is necessary to conduct laboratory tests of stool after several weeks (in some patients, lactose intolerance provoked by the invasion sometimes persists for a long time, resembling the symptoms of giardiasis).

What else can you learn from the instructions for use of the Metrogil drip?

Metrogil

Metrogyl (INN metronidazole) is an antibacterial and protoprotozoal (used for infections caused by protozoa) drug from UNIQUE PHARMACEUTICAL Laboratories (India). Available in the form of tablets, solutions for intravenous administration, gels for external and intravaginal use. According to its chemical structure, it is a derivative of 5-nitroimidazole. Activity against anaerobic bacteria and protozoa is due to the ability to restore its 5-nitro group (which is part of the structure of metronidazole) due to the intracellular transport proteins of the above pathogens. The 5-nitro group that has undergone these changes interacts with bacterial DNA, suppressing the formation of proteins in them, resulting in the bactericidal effect of the drug. The spectrum of therapeutic action of Metrogil extends to Bacteroides spp., Clostridium spp., Entamoeba histolytica, Eubacterium spp., Fusobacterium spp., Gardnerella vaginalis, Giardiai ntestinalis, Lamblia spp., Peptococcus spp., Prevolella spp., Peptostreptococcus spp., Trichomonas vaginalis, Veillonella spp. In combination with amoxicillin, Metrogyl will be effective in eradicating Helicobacter pylori (amoxicillin in this case prevents the development of resistance to metronidazole). Aerobic microorganisms and anaerobes that can exist with access to oxygen are insensitive to metronidazole. Nevertheless, in conditions of mixed microflora, Metrogyl exhibits synergism with antibacterial drugs active against “pure” aerobes.

The drug increases the reactivity of neoplasms to radiation therapy, causes disulfiram-like phenomena, and activates the course of recovery processes. When taken orally, Metrogyl is quickly and completely absorbed from the digestive tract into the systemic circulation, showing a maximum concentration in plasma 2 hours after administration. It binds weakly to blood proteins. Elimination from the body is carried out by the kidneys. A fifth of the drug is eliminated in its original form. The half-life is 8 hours. In patients suffering from renal dysfunction, after repeated administration of the drug, accumulation of the active substance in the blood may occur. In this regard, in such patients the daily dose should be reduced. Metrogyl is incompatible with alcohol due to the disulfiram-like reaction mentioned above, manifested by cramping abdominal pain, vomiting, headache, and hyperemia. The combination of the drug with amoxicillin is permissible only for persons over 18 years of age. Long-term use of Metrogyl should be accompanied by monitoring of peripheral blood parameters. Symptoms such as dizziness and ataxia are a signal to stop the medication course. When treating sexually transmitted diseases with Metrogyl, you should abstain from sexual activity.

Drug interactions

When the drug is used concomitantly with certain medications, the following reactions may develop:

1. Indirect anticoagulants: their actions are enhanced (increased time for prothrombin formation).
2. Drugs that stimulate microsomal oxidation substances in the liver (phenytoin, phenobarbital): increased elimination of metronidazole (sometimes leading to a decrease in its plasma level).
3. Ethanol: the occurrence of intolerance.
4. Cimetidine: suppresses the metabolism of metronidazole (sometimes leading to increased levels in the blood and risk of side effects).
5. Sulfonamides: the antimicrobial effect of the drug "Metrogil" is enhanced.
6. Lithium preparations (in high dosages): an increase in the level of lithium in the blood with the development of symptoms of intoxication.
7. Concomitant use of the drug with depolarizing muscle relaxants is not recommended.

According to the instructions for use, Metrogyl in a dropper should not be mixed with other medications.

Analogs

Drugs similar in structure and effect to the drug are the following:

• "Deflamon";
• "Klion";
• "Bacimex";
• "Metrovagin";
• "Metron";
• "Metrolacare";
• "Metronidazole";
• "Metroseptol";
• "Metronidazole Nycomed";
• "Orvagil";
• "Trichopolus";
• "Trichobrol";
• "Siptrogil";
• "Efloran";
• "Rosex."

A doctor should select a replacement.

Reviews

Medicines based on the active element metronidazole have been produced by Russian pharmaceutical companies for several decades. This determines the wide popularity of the drug Metrogyl, which is used intravenously in the form of droppers not only in inpatient settings for severe infectious diseases, but also on an outpatient basis, in the form of tablets and other dosage forms.

Patients who have used this medical product note that it is highly effective and helps well with purulent diseases affecting the skin, various gynecological inflammatory pathologies, diseases of the respiratory system and digestive organs.

Reviews about Metrogil

In most reviews about the drug, users write that all forms of the drug are quite effective. Women who have used Metrogyl vaginal gel leave reviews that the medicine is convenient to use and at the same time it helps to quickly and quite effectively cope with the treatment of infectious diseases. Many women write that vaginal gel helped cure thrush .

There are also often opinions that Metrogyl ointment is an excellent remedy for treating acne . Reading reviews about Metrogyl for acne, we can conclude that this medicine significantly improves the situation after a course of use. Patients consider severe dryness of the skin when using the cream to be a negative point. However, it is often used to combat acne; women also use external remedy Metrogyl under the supervision of a doctor during pregnancy.