Metrogil Plus, vaginal gel 50 g 1 piece + applicator

Metronidazole is active against protozoa: Entamoeba histolytica, Giardia lamblia, Trichomonas vaginalis, as well as against Gram-negative anaerobes: Bacteroides fragilis, Fusobacterium spp., Prevotella spp. (Prevotella bivia, Prevotella buccae, Prevotella disiens), Gardnerella vaginalis and some Gram-positive microorganisms: Clostridium perffringens, Clostridium difficile, Peptococcus spp., Peptostreptococcus spp. MAC for these strains is 0.125-6.25 µg/ml.

Clotrimazole has fungicidal and bactericidal action. Inhibits the biosynthesis of ergosterol, which regulates the permeability of the cell wall of microorganisms. In low concentrations it is fungistatic, but in high concentrations it is fungicidal. In fungicidal concentrations it interacts with peroxidases and mitochondrial enzymes, resulting in the increase of hydrogen peroxide concentration to toxic levels, which also leads to the death of fungi.

It has high activity against fungi: Blastomyces dermatitidis, Candida spp, Coccidioides immitis, Cryptococcus neoformans, dermatophytes (Trichophyton mentagrophytes, Microsporum canis, Epidermophyton foccosum), Histoplasma capsulatum, Paracoccidioides brasiliensis, Sporothrix schenckii; protozoa: Trichomonas vaginalis; Gram-positive bacteria: Streptococcus spp, Staphylococcus spp., Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis.

Indications

Bacterial vaginosis of various etiologies, confirmed by clinical and microbiological data; Candida vulvovaginitis and vulvovaginitis, urogenital trichomoniasis.

Composition

1 g – metronidazole 10 mg,

clotrimazole 20 mg.

Auxiliary substances:

methylhydroxybenzoate,

propyl hydroxybenzoate,

dinatrium edetate,

propylene glycol,

carbomer-940,

benzyl alcohol,

sodium hydroxide,

purified water.

How to take, the dosage

Intravaginally.

The recommended dose is 5 g (one full applicator) 2 times a day (morning and evening).

The course of treatment is 5 days. If necessary, the course of treatment can be repeated in 2 weeks.

Interaction

Similar to disulfiram causes ethanol intolerance.

It increases the effect of indirect anticoagulants, it is not recommended to combine with nondepolarizing myorelaxants (vecuronium).
Concomitant use with lithium preparations may increase the concentration of lithium in the blood plasma.

Phenobarbital accelerates metabolism of metronidazole due to induction of microsomal liver enzymes, cimitidine decreases it.
Amphotericin B, nystatin, natamycin decrease the effectiveness of clotrimazole when used simultaneously.

Special Instructions

Alcohol use is contraindicated when using the drug (development of disulfiram-like reaction is possible: spastic abdominal pain, nausea, vomiting, headache, sudden rush of blood to the face).

Metronidazole may immobilize treponemes and lead to a false positive Nelson’s test.

The drug is intended for intravaginal use only. Eye contact with the drug should be avoided.

During the course of therapy it is necessary to refrain from sexual activity.

Contraindications

Hypersensitivity to the drug components. Leukopenia (including in anamnesis), organic lesion of the central nervous system (including epilepsy), hepatic insufficiency. Pregnancy in the first trimester.

Side effects

Local reactions:A burning sensation or rapid urination; in the sexual partner, a burning sensation or irritation of the penis.

Systemic reactions: possible dizziness, headache, nausea, spastic abdominal pain.

Allergic reactions: skin rash, urticaria.

The patient should be warned to stop using the drug and consult a physician if any unwanted side effects occur.

Overdose

There have been no cases of overdose of the drug when administered in the recommended doses.