Metronidazole 250mg

Antibiotic, Amebicide, Antiprotozoal, Nitroimidazole

“ALERT: US Boxed Warning

Carcinogenic:

Metronidazole has been shown to be carcinogenic in mice and rats. Unnecessary use of the drug should be avoided. Its use should be reserved for the conditions for which this drug is indicated.”

CSA NA – FDA Approved – REMS (N) – Can Ship

Metronidazole/Flagyl enters microorganism cell through diffusion and interacts with DNA of susceptible targets causing strand breakage resulting in a loss of helical DNA structure which halts protein synthesis eventually leading to cell death.

Metronidazole/Flagyl is used on and off label for various infections depending on your common local bacterial strains for various infections and based on local resistance patterns.  Not all antibiotics work for all infections and efficacy can vary from area to area and vary with time.  It is common in North America for use in bite wounds, amebiasis, C. difficile (off-label), giardiasis (off-label), H. Pylori (off-label), intra-abdominal infections, trichomoniasis etc.

Before starting Metronidazole/Flagyl make sure your physician is aware of any allergies or medications you currently take, if you have blood dyscrasias, Cockayne syndrome, liver disease, kidney disease, a seizure disorder, if you are pregnant, or breastfeeding.

250-2000mg one to four times a day depending on the condition it is used for

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day unless otherwise directed, with food, store at room temperature

You Need to Avoid: Do not consume even small amounts of anything containing alcohol or propylene glycol within 3 days of this medication to avoid very serious adverse effects via the disulfiram reaction.

Headache, nausea, vaginitis, metallic taste, abdominal pain, diarrhea, dizziness

(Note this is not a complete list of side effects, only common ones)

1. Why would my physician prescribe a medication with such serious side effects?
   Bacterial resistance is becoming more of an issue and not all antibiotics work for all bacteria.  Certain antibiotics concentrate in different parts of the body which can also affect which ones work in which situations.  Your physician takes the most recent clinical guidelines and follows local resistance patterns to make evidence-based decisions that are reviewed and agreed upon by the medical community as to what agents should be used in which types of infections.  Your current medications, your allergies, age, cost of medication, side effects you experience from various antibiotics and many other factors will further complicate or limit which medications are appropriate.  This decision was not made lightly, however if you are concerned, ask your physician to clarify why they made their choice of antibiotic and they can let you know why this was the best option for this scenario.
2. What do I do if side effects are intolerable?
   If side effects are causing a lot of distress speak to your physician as soon as possible to discuss options.
3. What is the Disulfiram Reaction?
   The disulfiram reaction occurs when a chemical (such as disulfiram) inhibits acetaldehyde dehydrogenase which is a part of normal alcohol metabolism in the body.  Normally ethanol is converted to acetaldehyde which is then converted to acetic acid which is excreted.  Acetaldehyde build up is thought to be one of the main components contributing to the effects of a “hangover”.  Mixing even small amounts of alcohol or propylene glycol with a medication that inhibits acetaldehyde dehydrogenase can cause severe abdominal cramps, nausea, vomiting, headaches, flushing and in serious cases cause circulatory collapse.