Metonid™
Metronidazole 0.5% w/v
Intravenous Infusion BP
Presentation
Metonid™ 100 ml Intravenous Infusion: Each 100 ml solution contains Metronidazole BP 500 mg.
Description
Metronidazole is a nitroimidazole with antiprotozoal and antibacterial actions. It is highly effective against Trichomonas vaginalis, Entamoeba histolytica and Giardia lamblia. It has a bactericidal action against a wide range of pathogenic anaerobic microorganisms particularly species of Bacteroides, Fusobacteria, Clostridia, Eubacteria, Anaerobic Cocci and Gardnerella vaginalis.
Indications
Metonid™ is indicated in the prophylaxis and treatment of infections in which anaerobic bacteria have been identified or are suspected to be the causes. It is particularly suited for patients who can not retain oral medication and for patients in whom desired serum concentration have to be attained rapidly and reliably. Metonid is indicated:
1. In the prevention of post operative infections due to anaerobic bacteria
2. In the treatment of -
a. Intra abdominal infections - appendicitis, cholecystitis, peritonitis, liver abscess and post operative wound infections
b. Gynaecological and obstetrical infections - puerperal sepsis, pelvic cellulitis, pelvic peritonitis
c. Respiratory infections - necrotizing pneumonia, empyema and lung abscess
d. Central Nervous System infections - meningitis, brain abscess
e. Miscellaneous infections - septicaemia, bacteremia, osteomyelitis, gas gangrene
Dosage and Administration
Metonid™ may be diluted with appropriate volumes of normal saline, dextrose-saline, dextrose 5% w/v or potassium chloride (20 and 40 mmol) infusions.
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For prophylaxis & treatment of anaerobic infection |
Adult |
Children |
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Dose |
100 ml (500 mg) immediately before, during or after operation, repeated 8 hourly |
1.5 ml (7.5mg) per kg body weight every 8 hourly |
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Duration |
Treatment for 7 days should be satisfactory for most patients but depending on clinical and bacteriological assessment the physician may decide to prolong the treatment. |
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Infusion rate |
Metonid should be infused at an approximate rate of 5 ml/minute |
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Side Effects
Serious adverse reactions occur very rarely with standard recommended
regimens. Unpleasant tastes in the mouth, furred tongue, nausea, vomiting or
other gastrointestinal disturbances have been reported.
Contraindications
Known hypersensitivity to metronidazole.
Precautions & Warning
Regular clinical and laboratory monitoring are advised if administration of
MetonidTM for more than 10 days is considered to be necessary. Metronidazole
should be administered with caution to patients with hepatic encephalopathy.
Caution is advised in patients with active disease of the central nervous
system other than brain abscess. Infusion of fluid should be immediately
discontinued if rigor arises for any reason during the process. Do not use
if the solution is cloudy, contains particles or after expiry date.
Use in Pregnancy & Lactation: There is inadequate evidence of the safety of
metronidazole in pregnancy. Metronidazole is excreted in milk and no adverse
effects in the newborn have been reported. Metonid should therefore be given
during pregnancy or during lactation only when the physicians consider it
essential.
Drug Interactions
Alcohol: Metronidazole taken in combination with alcohol may produce
abdominal cramps, nausea, vomiting, headaches and flushing. Warfarin:
Metronidazole inhibits the breakdown of the more potent S-isomer of warfarin.
Therefore, the activity of warfarin is enhanced by metronidazole.
Phenobarbitone: Decreases the effect of metronidazole probably due to
increased metabolism. Cyclophosphamide and BCNU (Carmustine): Metronidazole
should be used with caution in patients who are receiving BCNU or
cyclophosphamide as a drug interaction shown in mice, leads to increased
toxicity.
Pharmaceutical Precaution
Metonid™ should be stored at controlled room temperature.
Commercial Pack
Metonid™ 100 ml IV Infusion: Available in 100 ml Polypropylene bag.
Administration Procedure
1. Check infusion set and infusion solution prior to use
2. Pull moderately to tear off the protective cover of the Eurohead
(Picture-1)
3. Hold lightly the Eurohead but not the bag (Picture-2)
4. Open the flow regulator fully and hold the giving set on the top white
area, but not the membrane venting region (Picture-2)
5. Insert the spike of the administration set to the Eurohead and fit the
connector of the administration set firmly to the needle
(Picture-2)
6. Gradually allow the fluid to flow down to the needle tip and close
7. Remove the protective cover of the needle
8. Locate the veinpuncture site and clean the site with an antiseptic
solution, and then insert the needle (Picture-3)
9. Securely tape the puncture site
10. Securely tape the wings and tubing
11. Start infusion while adjusting drip speed
