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; candidiasis vulvitis and vulvovaginitis, urogenital trichomoniasis.

Pharmacological effect

A combined drug for intravaginal use, the effectiveness of which is due to the presence of two components in its composition: metronidazole and clotrimazole.

Metronidazole is active against protozoa: Entamoeba histolytica, Giardia lamblia, Trichomonas vaginalis, as well as 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. The MIC for these strains is 0.125-6.25 μg/ml.

Clotrimazole has a fungicidal and bactericidal effect. Inhibits the biosynthesis of ergosterol, which regulates the permeability of the cell wall of microorganisms. In small concentrations it acts fungistatically, and in large concentrations it is fungicidal. At fungicidal concentrations, it interacts with peroxidases and mitochondrial enzymes, resulting in an increase in the concentration of hydrogen peroxide to a toxic level, which also leads to the death of fungi.

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.

Special instructions

When using the drug, alcohol consumption is contraindicated (a disulfiram-like reaction may develop: cramping abdominal pain, nausea, vomiting, headache, sudden rush of blood to the face).

Metronidazole can immobilize treponemes and lead to a false-positive Nelson test.

The drug is intended for intravaginal use only. Avoid contact of the drug with the eyes.

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

Active ingredient

Clotrimazole, Metronidazole

Composition

1 g – metronidazole 10 mg,

clotrimazole 20 mg.

Excipients:

methylhydroxybenzoate,

propylhydroxybenzoate,

disodium edetate,

propylene glycol,

carbomer-940,

benzyl alcohol,

sodium hydroxide,

purified water.

Contraindications

Hypersensitivity to the components of the drug. Leukopenia (including a history), organic damage to the central nervous system (including epilepsy), liver failure. Pregnancy 1st trimester.

Side Effects

Local reactions: burning sensation or increased urination; in the sexual partner – a burning sensation or irritation of the penis.

Systemic reactions: possible dizziness, headache, nausea, cramping pain in the abdominal cavity.

Allergic reactions: skin rash, urticaria.

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

Interaction

Similar to disulfiram, it causes ethanol intolerance.

Enhances the effect of indirect anticoagulants; it is not recommended to combine with non-depolarizing muscle relaxants (vecuronium).
When taken simultaneously with lithium preparations, the concentration of lithium in the blood plasma may increase.

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

Overdose

There were no cases of drug overdose when prescribed in recommended doses.

Manufacturer

Unique Pharmaceutical Laboratories, India