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 amebiasis, including amoebic liver abscess, intestinal amebiasis (amebic dysentery), trichomoniasis, giardiasis, balantidiasis, giardiasis, cutaneous leishmaniasis, trichomonas vaginitis, trichomonas urethritis.

Infections caused by Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus): infections of bones and joints, infections of the central nervous system, incl. meningitis, brain abscess, bacterial endocarditis, pneumonia, empyema and lung abscess, sepsis.

Infections caused by Clostridium spp., Peptococcus and Peptostreptococcus species: abdominal infections (peritonitis, liver abscess), pelvic infections (endometritis, fallopian tube and ovarian abscess, vaginal vault infections). Pseudomembranous colitis (associated with antibiotic use).

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

Radiation therapy for patients with tumors – as a radiosensitizing drug in cases where tumor resistance is due to hypoxia in tumor cells.

Pharmacological effect

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

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

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

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

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

Special instructions

Long-term treatment should preferably be carried out under the control of the blood count.

A false positive Nelson test is possible because treponemes are immobilized.

Combine with caution with indirect anticoagulants and non-depolarizing muscle relaxants.

During treatment you should avoid drinking alcoholic beverages.

Active ingredient

Metronidazole

Composition

Active ingredient:

Metronidazole

Excipients:

wheat starch 82.15 mg,

povidone 17.5 mg,

magnesium stearate 350 mcg,

hypromellose 2.1 mg,

macrogol 20000 700 mcg.

Contraindications

Hypersensitivity, leukopenia (including history), organic lesions of the central nervous system (including epilepsy), liver failure (in case of high doses), pregnancy (first trimester), lactation period.

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 neuropathies; with long-term treatment in large doses, brownish-reddish coloration of urine is possible.

Interaction

Compatible with sulfonamides and antibiotics.

Combination with disulfiram, indirect anticoagulants and non-depolarizing muscle relaxants is undesirable.

Incompatible with alcoholic beverages.

Increases plasma lithium concentration.

Storage conditions

At a temperature not exceeding 25 °C

Shelf life

5 years

Manufacturer

Sanofi-Aventis S.A., Spain