Metronidazole oral suspension storage
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In most cases neuropathy disappeared after treatment was stopped or when dosage was reduced. Anaerobically infected leg ulcers and pressure sores. Symptoms were limited to vomiting, ataxia and slight disorientation.
Consideration should be given to official guidance on the appropriate use of antibacterial agents. The daily dosage may be reduced to one third and may be administered once daily. Cases of liver failure requiring liver transplant have been reported in patients treated with metronidazole in combination with other antibiotic drugs.
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Significant cumulation may occur in patients with hepatic encephalopathy and the resulting high plasma concentrations of metronidazole may contribute to the symptoms of encephalopathy. Half life in plasma is about 8-10 hours. No relevant information additional to that contained elsewhere in the Summary of Product Characteristics. The major site of action is believed to be DNA, where it causes loss of the helical structure and inhibits synthesis. Patients should be warned about the potential for drowsiness, dizziness, confusion, hallucinations, convulsions or transient visual disorders, and advised not to drive or operate machinery if these symptoms occur. Keep out of reach and sight of children.
The treatment of septicaemia, bacteraemia, brain abscess, necrotising pneumonia, osteomyelitis, puerperal sepsis, pelvic abscess, pelvic cellulitis, peritonitis and post-operative wound infections from which one or more pathogenic anaerobes have been isolated. Patients should be warned that metronidazole may darken urine. It is readily absorbed from the gastro-intestinal tract and widely distributed in body tissues. As it is not known whether mebendazole is excreted in human milk, it is not advisable to breast feed following administration of Vermox. Stevens-Johnson syndrome or toxic epidermal necrolysis.
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Duration of treatment is usually 7 days. Patients with Cockayne syndrome should be advised to immediately report any symptoms of potential liver injury to their physician and stop taking metronidazole. Metronidazole Oral Suspension is indicated in the prophylaxis and treatment of infections in which anaerobic bacteria have been identified or are suspected as the pathogen. Frequency, type and severity of adverse reactions in children are the same as in adults. To email a medicine you must be a registered user.
It is highly recommended that a second dose is taken after 2 weeks, if reinfection is suspected. Dosage: 400mg at 8 hourly intervals during the 24 hours preceding the operation followed by postoperative intravenous or rectal administration until the patient is able to take Metronidazole Oral Suspension by mouth. In studies conducted in mammalian cells in vitro as well as in rodent or humans in vivo, there was inadequate evidence of a mutagenic effect of metronidazole, with some studies reporting mutagenic effects, while others studies were negative. In the event of accidental overdosage, abdominal cramps, nausea, vomiting and diarrhoea may occur. There is inadequate evidence of the safety of metronidazole in pregnancy.
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Reporting suspected adverse reactions after authorisation of the medicinal product is important. In patients undergoing haemodialysis, metronidazole and metabolites are efficiently removed during an eight-hour period of dialysis. Dosage of the anticoagulant may require reducing.
Serious adverse reactions occur very rarely with standard recommended regimens. Metronidazole has been shown to be carcinogenic in the mouse and in the rat following chronic oral administration however similar studies in the hamster have given negative results. HDPE, EPE wadded, tamper evident, child resistant. Concomitant treatment with cimetidine may inhibit the metabolism of mebendazole in the liver, resulting in increased plasma concentrations of the drug.
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Children and babies weighing less than 10Kg should receive proportionally smaller doses. The prevention of post-operative infections caused by anaerobic bacteria particularly species of bacteroides and anaerobic streptococci. Keep out of the reach of children.
Not recommended in the treatment of children under 2 years. The elimination half-life of metronidazole remains unchanged in the presence of renal failure. The selective action of this compound against anaerobes and anoxic and hypoxic cells is due to the mode of action. Dosage is given in terms of metronidazole or metronidazole equivalent.
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Throughout this section adverse reactions are reported. Although there are no additional data on this potential interaction, concomitant use of mebendazole and metronidazole should be avoided. Metronidazole for longer treatment than usually required should be carefully considered. Metronidazole should not therefore be given during pregnancy or during lactation unless the physician considers it essential, in these circumstances short, high dosage regimes are not recommended.
There is no specific antidote for metronidazole overdosage. A causal relationship with Vermox cannot be reliably established in individual cases. Substantial impairment of metronidazole clearance may occur in the presence of advanced hepatic insufficiency. This produces biochemical lesions in the cells, thus causing death. This could give a bitter taste to the milk. The nitro group of metronidazole acts as electron acceptor and is thus reduced to a chemically reactive drug form.
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Vermox is contraindicated in pregnancy and in patients who have shown hypersensitivity to the product or any components. Metronidazole Oral Suspension is active against a wide range of pathogenic micro-organisms, notably Trichomonas vaginalis, Entamoeba histolytica, Giardia lamblia, Balantidium coli and other species of bacteroides, fusobacteria, eubacteria, clostridia and anaerobic cocci. Note: frequencies differ from those reported in the August 2009 CCDS, as these were not calculated using the formula detailed in the SmPC guideline 2009. No interactions have been reported of the heparin type. Increased serum carbamazepine levels and toxicity have been seen in patients given concomitant metronidazole.
Metronidazole has been shown to be mutagenic in bacteria in vitro. Metronidazole is mainly metabolised by hepatic oxidation. The glucose and sucrose content should be taken into account in patients with diabetes mellitus.
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If a dose of under 5ml is required, the suspension should be administered using an oral dosing device. Patients with hereditary fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. Metronidazole is well tolerated by the elderly, but a pharmacokinetic study suggests cautious use of high dosage regimen in this age group. 800mg followed by 400mg at 8 hourly intervals. Such patients however, retain the metabolites of metronidazole. Clinicians who contemplate continuous therapy for the relief of chronic conditions, for periods no longer than those recommended, are advised to consider the possible therapeutic benefit against the risk of peripheral neuropathy.
Elderly: Caution is advised in the elderly, particularly at high doses, although there is limited information available on modification of drug. Cockayne syndrome have been reported with products containing metronidazole for systemic use. In this population, metronidazole should therefore be used after careful benefit-risk assessment and only if no alternative treatment is available. Metronidazole Oral Suspension contains glucose, sucrose and sorbitol. To bookmark a medicine you must be a registered user. Lithium treatment should be tapered or withdrawn before administering metronidazole.
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Inhibition of glucose uptake appears to lead to endogenous depletion of glycogen stores within the helminth. In patients treated at dosages substantially higher than recommended or for prolonged periods of time, the following adverse reactions have been reported rarely: alopecia, reversible liver function disturbances, hepatitis, agranulocytosis, neutropenia and glomerulonephritis. There is the possibility that after Trichomonas vaginalis has been eliminated a gonococcal infection might persist.
Unchanged metronidazole and several metabolites are excreted in the urine, the liver is the main site of metabolism and the major metabolites are as a result of side chain oxidation, forming glucuronides. Aspartate amino transferase assays may give spuriously low values in patients taking metronidazole, depending on the method used. To bookmark a medicine you must be a registered user. It may also be harmful to teeth.
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A significant amount of metronidazole is found in breast milk and breast feeding should be avoided after a large dose. It penetrates well into body tissues and fluids, including vaginal secretions, seminal fluid, saliva and breast milk. Plasma concentration of lithium, creatinine and electrolytes should be monitored in patients under treatment with lithium while they receive metronidazole. Patients receiving phenobarbital metabolise metronidazole at a much greater rate than normally, reducing the half life to approximately three hours. Some potentiation of anticoagulant therapy has been reported when metronidazole has been used with the warfarin type oral anti-coagulants. Dispersible cellulose, colloidal silicon dioxide, sucrose, glucose, sorbitol solution, glycerine, polysorbate 80, methyl hydroxybenzoate, ethyl hydroxybenzoate, propyl hydroxybenzoate, propylene glycol, lemon flavour, orange flavour and purified water.
Single oral doses of metronidazole, up to 12g have been reported in suicide attempts and accidental overdoses. Not all pack sizes may be marketed. Plasma levels of busulfan may be increased by metronidazole which may lead to severe busulfan toxicity. Metronidazole should therefore, be re-administered immediately after haemodialysis. Child-resistant polypropylene screw cap, lined inside with a LDPE insert. For a full list of excipients, see section 6.