Buy Flagyl online
Brand names: Flagyl, Flagyl IV, Metro, Flagyl ER
Active ingredient: Metronidazole
Flagyl is a 5-nitroimidazole derivative. The mechanism of action of Flagyl is the biochemical reduction of 5-nitro group of Flagyl intracellular transport proteins anaerobic bacteria and protozoa. Reconstituted 5-nitro Flagyl is reacted with the cellular DNA of microorganisms by inhibiting synthesis of nucleic acids, which leads to the death of microorganisms. Active against Trichomonas vaginalis, Entamoeba histolytica, as well as Gram-negative anaerobes, Bacteroides spp. (including B. fragilis, B. ovatus, B. distasonis, B. thetaiotaomicron, B. vulgatus), Fusobacterium spp., and some Gram-positive anaerobes (sensitive strains of Eubacterium spp., Clostridium spp., Peptococcus niger, Peptostreptococcus spp.). MIC for these strains is 0.125-6.25 mg / ml. In combination with amoxicillin is active against Helicobacter pylori (amoxicillin suppresses the development of resistance to Flagyl). Metronidazole insensitive aerobic microorganisms and facultative anaerobes, but in the presence of mixed flora (aerobic and anaerobic) Flagyl acts synergistically with antibiotics effective against conventional aerobic.
When administered metronidazole is rapidly and almost completely absorbed (about 80% for 1 hour). Ingestion not affect the absorption of Flagyl. The bioavailability of not less than 80%. After oral administration of 500 mg of Flagyl plasma concentration is after 1 hour - 10 ug / ml, and 3 hours - 13.5 ug / ml. The half-life of 8-10 hours, the connection with blood proteins insignificant and does not exceed 10-20%). Flagyl rapidly penetrates into tissues (lungs, kidneys, liver, skin, bile, cerebrospinal fluid, saliva, semen, vaginal secretions), in breast milk and crosses the placental barrier. Metabolized by about 30-60% of Flagyl by hydroxylation, oxidation and glyukuronirovaniya. The major metabolite (2-oximetronidazole) also provides protivoprotosanoe and antimicrobial action.
Excretion of Flagyl is carried by 40-70% through the kidneys (unchanged - about 35% of the dose). In patients with impaired renal function at course taking Flagyl may increase its concentration in the blood serum.
Indications for use
Protozoal infections: extraintestinal amebiasis, including amebic liver abscess, intestinal amebiasis (amebic dysentery), trichomoniasis (including). Infections caused by Bacteroides spp. (including B. fragilis, B. distasonis, B. ovatus, B. thetaiotaomicron, B. Vulgatus), bone and joint infections, infections of the central nervous system (CNS), including meningitis, brain abscess, bacterial endocarditis pneumonia, empyema and lung abscess, sepsis.
Infections caused by species of Clostridium spp., Peptococcu niger and Peptostreptococcus spp .: infection of the abdominal cavity (peritonitis, liver abscess), pelvic infections (endometritis, abscess of the fallopian tubes and ovaries, infection vaginal vault).
Pseudomembranous colitis (involving the use of antibiotics). Gastritis or ulcer 12 duodenal ulcer associated with Helicobacter pylori (combined therapy). Prevention of postoperative complications (especially interventions on colon, adrectal area apendektomiya, gynecological surgery).
Hypersensitivity to imidazoles and nitroimidazole derivatives. Organic CNS (including epilepsy). Leukopenia (including history). Hepatic failure (in the case of appointment of high doses). Pregnancy. Lactation. Children up to age 10 years.
Hepatic encephalopathy. Acute and chronic diseases of the peripheral and central nervous system (risk of worsening of neurological symptoms). Renal failure.
Dosing and Administration
Metronidazole is intended for oral administration, either before or after a meal. Wash down with plenty of water.
When intestinal amebiasis Flagyl apply within 7 days of 1500 mg per day for three meals. In acute amoebic dysentery - daily dose of 2250 mg, divided into three stages. Children from 10 to 15 years - 500 mg per day, divided into 2 doses. Liver abscesses and other forms of extra-intestinal amebiasis maximum daily dose is 2,500 mg, divided into 3 doses for 3-5 days, in combination with tetracycline antibiotics and other therapies. Children from 10 to 15 years - 500 mg per day, divided into 2 doses. If trichomoniasis in women (urethritis, and vaginitis) Flagyl prescribe a single dose of 2 g or as a course of treatment within 10 days: 1 tab. (250 mg), 2 times a day. If trichomoniasis in men (urethritis) Flagyl prescribe a single dose of 2 g or as a course of treatment for 10 days on 1 tab. (250 mg), 2 times a day.
Treatment of anaerobic infections usually start with an intravenous infusion, followed by the transition to the tablet. Adult Flagyl dose is 500 mg 3 times a day. The duration of treatment is up to 7 days.
For the treatment of pseudomembranous colitis prescribed 500 mg of the drug Flagyl (Table 2.) 3-4 times a day. The duration of treatment is determined by the doctor. Helicobacter pylori eradication appoint 500 mg of the drug Flagyl 3 times a day as part of combination therapy (eg, amoxicillin).
For the prevention of postoperative complications appoint 750-1500 mg per day in 3 divided doses for 3-4 days prior to surgery. After 1-2 days after operation (when it is allowed to ingestion) - 750 mg of the drug Flagyl daily for 7 days.
Possible side effects when using the drug
Violations by the gastrointestinal tract: Epigastric pain, nausea, vomiting, diarrhea.
Inflammation of the oral mucosa (glossitis, stomatitis), dysgeusia ("metallic" taste in the mouth), loss of appetite, anorexia, dryness of mucous membranes of the mouth, constipation.
Pancreatitis (reversible cases). Disorders of immune system Angioedema, anaphylactic shock. Disorders of the nervous system Peripheral sensory neuropathy. Headache, muscle cramps and dizziness.
Reported on the development of encephalopathy (eg, confusion) and subacute cerebellar syndrome (impaired coordination and synergy movements, ataxia, dysarthria, gait disturbance, nystagmus and tremor), which regress after discontinuation of Flagyl.
Aseptic meningitis. Psychotic disorders, including confusion, hallucinations. Depression, insomnia, irritability, excitability. Violations by the organ of sight Transient visual disturbances such as diplopia, myopia. Violations by the blood and lymphatic system Agranulocytosis, leukopenia, neutropenia, and thrombocytopenia. Violations of the liver and biliary tract Reported on the development of reversible disruption of laboratory parameters of liver function and cholestatic hepatitis, sometimes with jaundice. Violations of the skin and subcutaneous tissue Rash, itching, redness of the skin, urticaria. Pustular rash. Violations by the kidneys and urinary tract Perhaps staining urine reddish-brown color due to the presence in urine soluble metabolite of Flagyl. Dysuria, polyuria, cystitis, urinary incontinence, candidiasis. General disorders and injection site Fever, stuffy nose, arthralgia, weakness. Laboratory and instrumental data Flattening of the T wave on the ECG.
Precautions for use of the drug
Because simultaneous reception of Flagyl with alcohol can have an effect similar to disulfiram (hot flashes, vomiting, tachycardia), patients should be warned that during treatment with Flagyl should not drink alcohol or medicines that contain alcohol. Should carefully weigh the evidence for long-term use of the drug and no strict indications avoided long-term use. If you have a strict indications drug is used over a long time, what is generally recommended that treatment should be under the control of hematological parameters and adverse reactions, such as peripheral or central neuropathy (paresthesia, ataxia, dizziness, convulsions), when they appear, treatment should be discontinued . In the treatment of Trichomonas vaginitis in women and Trichomonas urethritis in men should refrain from sexual activity. Necessarily simultaneous treatment of sexual partners. Treatment does not stop during menstruation. After treatment of trichomoniasis should conduct test samples for 3 successive cycles before and after menstruation. It will be appreciated that Flagyl can be immobilized Treponema, which leads to false positive test Nelson.