Flagyl, 250 mg 20 pcs.

Flagil is an antiprotozoal and antimicrobial drug, a derivative of 5-nitroimidazole.

The mechanism of action consists in biochemical reduction of the 5-nitrogroup of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitrogroup of metronidazole interacts with the DNA of the microbial cell, inhibiting the synthesis of their nucleic acids, which leads to the death of the bacteria.

It is active against Trichomonas vaginalis, Entamoeba histolytica, Gardnerella vaginalis, Giardia intestinalis, Lamblia spp, as well as obligate anaerobes Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus), Fusobacterium spp, Veillonella spp., Prevotella (Prevotella bivia, Prevotella buccae, Prevotella disiens) and some gram-positive microorganisms (Eubacter spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp.)

The MPC for these strains is 0.125-6.25 µg/ml. In combination with amoxicillin it shows activity against Helicobacter pylori (amoxicillin suppresses the development of resistance to metronidazole).

Metronidazole is insensitive to aerobic microorganisms and facultative anaerobes, but in the presence of mixed flora (aerobes and anaerobes) metronidazole acts synergistically with antibiotics effective against common aerobes.

It increases the sensitivity of tumors to radiation, causes disulfiram-like reactions, and stimulates reparative processes.

Indications

Protozoal infections: Extraintestinal amoebiasis, including amebic liver abscess, intestinal amoebiasis (amebic dysentery), trichomoniasis, giardiasis, balanceidiasis, giardiasis, cutaneous leishmaniasis, trichomonadic vaginitis, trichomonadic urethritis.

Infections caused by Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus): infections of bones and joints, CNS infections, including meningitis, abscesses.including meningitis, brain abscess, bacterial endocarditis, pneumonia, pulmonary empyema and abscess, sepsis.

Infections caused by species of Clostridium spp., Peptococcus and Peptostreptococcus: abdominal infections (peritonitis, liver abscess), pelvic infections (endometritis, abscess of fallopian tubes and ovaries, infections of the vaginal roof). Pseudomembranous colitis (associated with the use of antibiotics).

Gastritis or duodenal ulcer associated with Helicobacter pylori. Prevention of postoperative complications (especially interventions on the colon, perirectal area, apendectomy, gynecological operations).

The radiotherapy of patients with tumors – as a radiosensitizing drug in cases when the tumor resistance is caused by hypoxia in the tumor cells.

Active ingredient

Composition

Active ingredient:

Metronidazole

Associates:

wheat starch 82.15 mg,

povidone 17.5 mg,

magnesium stearate 350 µg,

hypromellose 2.1 mg,

macrogol 20000 700 µg.

How to take, the dosage

Overly, with or after a meal (or with milk), without chewing.

In trichomoniasis – 250 mg 2 times a day for 10 days or 400 mg 2 times a day for 5-8 days.

Interaction

Compatible with sulfonamides and antibiotics.

The combination with disulfiram, indirect anticoagulants and nondepolarizing myorelaxants is undesirable.

Incompatible with alcoholic beverages.

Increases the concentration of lithium in the plasma.

Special Instructions

Long-term treatment should preferably be performed under control of blood formulas.

Possible false-positive Nelson’s test because treponemes are immobilized.

Cautiously combine with indirect anticoagulants, nondepolarizing myorelaxants.

All alcoholic beverages should be avoided during treatment.

Contraindications

Hypersensitivity, leukopenia (including anamnesis), organic CNS lesions (including epilepsy), hepatic insufficiency (in case of high doses), pregnancy (I trimester), lactation.

With caution. Pregnancy (II-III trimesters), renal/liver failure.

Side effects

Nausea, metallic taste in the mouth, anorexia, epigastric pain, vomiting, diarrhea, headache, dizziness, allergic reactions (urticaria, itching), leukopenia, peripheral neuropathy, with long-term treatment of high doses, brownish-reddish staining of urine is possible.

Similarities