'''Metronidazole''' (Flagyl,FILMET and others) is a [[nitroimidazole]] [[antibiotic]] medication used particularly for [[anaerobe|anaerobic]] [[bacterium|bacteria]] and [[protozoa]]. Metronidazole is an antibiotic, amebicide, and antiprotozoal.
It is the drug of choice for first episodes of mild-to-moderate ''[[Clostridium difficile]]'' infection.
It is marketed in the [[United States]] by [[Pfizer]] and globally by [[Sanofi]] under the trade name '''Flagyl''', and is also sold under other brand names. In Bangladesh it is marketed by [[Beximco Pharma]] under the trade name of Filmet. Metronidazole was developed in 1960.
Metronidazole is used also as a gel preparation in the treatment of the [[dermatology|dermatological]] conditions such as [[rosacea]] ('''Rozex''' and '''MetroGel''' by [[Galderma]]) and [[neoplasia|fungating]] [[tumour]]s ('''Anabact''', Cambridge Healthcare Supplies).
'''| [[Metronidazole dosage and administration|Dosage and Administration]]'''
'''| [[Metronidazole how supplied|How Supplied]]'''
'''| [[Metronidazole labels and packages|Labels and Packages]]'''
==Mechanism of action==
a
Metronidazole, taken up by diffusion, is selectively absorbed by [[anaerobic bacteria]] and sensitive [[protozoa]]. Once taken up by anaerobes, it is non-enzymatically reduced by reacting with reduced [[ferredoxin]], which is generated by [[pyruvate oxido-reductase]]. Many of the reduced [[nitroso]] intermediates will form [[sulfinamide]]s and thioether linkages with cysteine-bearing enzymes, thereby deactivating these critical enzymes. As many as 150 separate enzymes are affected.
In addition or alternatively, the metronidazole metabolites are taken up into bacterial DNA, and form unstable molecules. This function only occurs when metronidazole is partially reduced, and because this reduction usually happens only in anaerobic cells, it has relatively little effect upon human cells or [[aerobic bacteria]].<ref>
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{{cite book | first1 = B. I. | last1 = Eisenstein | first2 = M. | last2 = Schaechter | chapter = DNA and Chromosome Mechanics | chapterurl = http://books.google.com/books?id=1Zl70SLDU3oC&pg=PA28 | editor1-first = M. | editor1-last = Schaechter | editor2-first = N. C. | editor2-last = Engleberg | editor3-first = V. J. | editor3-last = DiRita | editor4-first = T. | editor4-last = Dermody | title = Schaechter's Mechanisms of Microbial Disease | publisher = Lippincott Williams & Wilkins | location = Hagerstown, MD | year = 2007 | page = 28 | isbn = 978-0-7817-5342-5 }}</ref>
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Black Box Warning
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See full prescribing information for complete Boxed Warning.
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Overview
Metronidazole is a that is FDA approved for the {{{indicationType}}} of . There is a Black Box Warning for this drug as shown here. Common adverse reactions include .
Adult Indications and Dosage
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Off-Label Use and Dosage (Adult)
Guideline-Supported Use
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There is limited information regarding Off-Label Guideline-Supported Use of Metronidazole in adult patients.
Non–Guideline-Supported Use
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There is limited information regarding Off-Label Non–Guideline-Supported Use of Metronidazole in adult patients.
Pediatric Indications and Dosage
FDA-Labeled Indications and Dosage (Pediatric)
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There is limited information regarding FDA-Labeled Use of Metronidazole in pediatric patients.
Off-Label Use and Dosage (Pediatric)
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There is limited information regarding Off-Label Guideline-Supported Use of Metronidazole in pediatric patients.
Non–Guideline-Supported Use
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There is limited information regarding Off-Label Non–Guideline-Supported Use of Metronidazole in pediatric patients.
Contraindications
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Clinical Trials Experience
There is limited information regarding Clinical Trial Experience of Metronidazole in the drug label.
Body as a Whole
Cardiovascular
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Musculoskeletal
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Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous
Postmarketing Experience
There is limited information regarding Postmarketing Experience of Metronidazole in the drug label.