Metronidazole + Miconazole Pharmacology

Metronidazole + Miconazole

About Metronidazole + Miconazole
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Mechanism of Action of Metronidazole + Miconazole
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Pharmacokinets of Metronidazole + Miconazole
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Onset of Action for Metronidazole + Miconazole
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Duration of Action for Metronidazole + Miconazole
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Half Life of Metronidazole + Miconazole
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Side Effects of Metronidazole + Miconazole
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Contra-indications of Metronidazole + Miconazole
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Special Precautions while taking Metronidazole + Miconazole
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Metronidazole + Miconazole
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Interactions for Metronidazole + Miconazole
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Typical Dosage for Metronidazole + Miconazole
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Schedule of Metronidazole + Miconazole
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Storage Requirements for Metronidazole + Miconazole
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Effects of Missed Dosage of Metronidazole + Miconazole
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Effects of Overdose of Metronidazole + Miconazole
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Metronidazole

About Metronidazole
A nitroimidazole antibiotic, Anti-infective, Antiprotozoal,amebicide.
Mechanism of Action of Metronidazole
Metronidazole is nitro imidazoles which have broad spectrum cidal activity against Protozoa and some anaerobic bacteria. Its selective toxicity to anaerobic microbes involves 1. Drug enters the cell by diffusion, 2. Nitro group of drug is reduced by redox proteins present only in anaerobic organisms to reactive nitro radical which exerts cytotoxic action by damaging DNA and other critical biomolecules. 3. DNA helix destabilization & strand breakage has been observed.
Pharmacokinets of Metronidazole
Absorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver by oxidation & glucuronide conjugation, Excretion: Excreted in urine.
Onset of Action for Metronidazole
1 to 2 days
Duration of Action for Metronidazole
8hours.
Half Life of Metronidazole
8 hours.
Side Effects of Metronidazole
1.Anorexia.
2.Metallic taste
3.Nausea
4.Vomiting
5.Diarrhoea
6.Headache
7.Looseness of stool.
8.Peripheral neuropathy &CNS effects.
9.Mutagenesis.
10.Radiosensitisation.
11.Transient leucopenia
12.Dry mouth
13.Abdominal distress
14.Dizziness
15.Vertigo
16.Thrombophlebitis at site of injection
17.Ototoxicity
Contra-indications of Metronidazole
1.Hypersensitivity to the drug
2.Blood dyscrasias
3.CNS disorders
Special Precautions while taking Metronidazole
1.Renal impairment
2.Hepatic impairment
3.Alcoholic cirrhosis
4.Use cautiously along with other hepatotoxic drugs & In visual field changes
Pregnancy Related Information
Use with caution
First trimester:contra indicated
Old Age Related Information
May be used.
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Neonates: Contraindicated
Indications for Metronidazole
1.Amoebiasis
2.Giardiasis
3.Trichomonas vaginitis
4.Pseudo membranous enterocolitis
5.Anaerobic bacterial infections after surgery, Brain abscess, & Endocarditis
6.Helicobacter pylori infections
7.Ulcerative gingivitis
Interactions for Metronidazole
Warfarin & other coumarin anticoagulants: Potentiates the anticoagulant effect resulting in increased prothrombin time.
Alcohol: A disulfiram-like reaction. Abdominal cramps, nausea, vomiting, headache & flushing.
Disulfiram: Acute psychotic reaction or confusional state.
Phenobarbital & Phenytoin: Increased metabolism of metronidazole resulting in decreased efficacy.
Lithium: Increased lithium levels and toxicity.
Flurouracil: Increased toxicity of flurouracil.
Lab tests: May interfere with chemical analysis for AST,SGOT, ALT, SGPT, LDH, triglycerides and hexokinase glucose. Zero values may occur.
Typical Dosage for Metronidazole
Adult
Amoebiasis:400 to 800 mg 8hourly for 5 to 10days depending up on the severity of infection
In severe infections and liver abscess: 1gm as slow I.V. infusion followed by 0.5 gm twice daily till oral therapy is started
Giardiasis:200mg 8hourly for 1week or 2gm/day for 3days or I.V.500mg thrice daily
Trichomonas vaginitis: 400mg 8 hourly for a week or 2gm once daily for a week.
Male partner should be concurrently treated with the drug
Pseudo membranous enterocolitis:800 mg 8hourly
Anaerobic bacterial infections after surgery, Brain abscess, & Endocarditis:400 to 800 mg 8hourly
In severe cases: 15mg/kg I.V. infusion for 1hour followed by 7.5mg/kg 4 times daily till oral therapy is substituted
Helicobacter pylori infections:400mg 8hourly along with amoxicillin/clarithromycin and a proton pump inhibitor
Ulcerative gingivitis:200 to 800mg 8hourly
Children
Amoebiasis: 30 to 50mg/kg/day for 5to10 days.
Giardiasis:10 to 15mg/kg/day thrice daily
Children (below 12years): 7.5mg/kg I.V.
Schedule of Metronidazole
H
Storage Requirements for Metronidazole
Store in a well closed container in a cool dark place. Keep out of the reach of children.
Effects of Missed Dosage of Metronidazole
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Metronidazole
Treatment is supportive & symptomatic. Drug is removed by induced emesis, gastric lavage, and administration of activated charcoal & use of cathartics. For controlling seizures diazepam & phenytoin may be used.

Miconazole

About Miconazole
An imidazole derivative, Broad spectrum Antifungal.
Mechanism of Action of Miconazole
Miconazole is fungicidal or fungistatic depending on the drug concentrations. I t inhibits the conversion of Lanosterol to 14 demethyl Lanosterol by inhibiting the cytochromeP450 enzyme 14 alpha demethylase and impair ergosterol synthesis
Pharmacokinets of Miconazole
Absorption: Oral absorption of Miconazole is poor. Distribution: It is distributed in the body in protein bound form Metabolism: It undergoes metabolism in the liver. Excretion: It is excreted in urine and faeces.
Onset of Action for Miconazole
N/A
Duration of Action for Miconazole
N/A
Half Life of Miconazole
1 day
Side Effects of Miconazole
1.Vulvovaginal burning
2.Burning
3.Irritation
4.Pruritis
5.Maceration
6.Dermatitis
Contra-indications of Miconazole
1.Hypersensitivity to Miconazole and other Azole antifungals
Special Precautions while taking Miconazole
1.Hepatic dysfunction
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
NEONATES: contraindicated
Indications for Miconazole
1.Tinea versicolor
2.Vulvovaginal candidiasis
3.Tinea pedis
4.Tinea corporis
5.Tinea cruris
6.Otomycosis
7.Onychomycosis
8.Oral candidiasis
9.Intestinal candidiasis
10.Diaper dermatitis
Interactions for Miconazole
Benzoyl peroxide: Antibacterial synergism.
Typical Dosage for Miconazole
Adult: Topical use:
Cutaneous infections: Apply the cream twice daily on the affected part for about 1 month
Tinea versicolor: Apply the cream once daily on the affected part
Vaginal use: Insert 300 mg suppository at bed time for 3 days or Insert 100 mg suppository at bed time for 7 days

CHILDREN:
Topical use:
Cutaneous infections: Apply the cream twice daily on the affected part for about 1 month
Tinea vericolor: Apply the cream once daily on the affected part

Schedule of Miconazole
H
Storage Requirements for Miconazole
The drug should be stored at 15 - 30 degree C.
Effects of Missed Dosage of Miconazole
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Miconazole
Give supportive measures and treatment.

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Metronidazole + Miconazole is a generic medicine name and there are several brands available for it. Some of the brands for metronidazole + miconazole might be better known than metronidazole + miconazole itself. If the pharmacy that's willing to deliver medicines to your home doesn't have metronidazole + miconazole in stock, you can ask for one of the branded alternatives for metronidazole + miconazole.