Sign Out
Metronidazole should be used with great care in patients with blood dyscrasias or with active disease of the central nervous system. All patients receiving metronidazole for more than 10 days should be monitored and treatment discontinued if signs of peripheral neuropathy or CNS toxicity develop. Doses should be reduced in patients with severe liver disease.
In Trichomonas vaginalis infections, microscopic examination of the vaginal secretion should be performed to exclude the possibility of gonorrhoea.
An accompanying gonococcal infection may persist in a symptom-less form after Trichomonas vaginalis has been eliminated.
In patients undergoing haemodialysis, metronidazole and metabolites are efficiently removed during an 8-hour period of dialysis. Metronidazole therefore should be re-administered immediately after haemodialysis.
Use in Pregnancy/Reproduction: Studies in rats have not shown that metronidazole cause impaired fertility or birth defect in the foetus. Metronidazole, administered intraperitoneally to pregnant mice, has been shown to cause foeto-toxicity. When administered orally, no foetotoxicity was seen in pregnant mice. However, the use of metronidazole in the treatment of trichomoniasis is not recommended during the first trimester. Also, the 1-day course of therapy should not be used since this results in higher maternal and foetal serum concentrations.
Use in Lactation: Use is not recommended in nursing mothers since some studies in rats and mice have shown that metronidazole is carcinogenic and may cause adverse effects in the infant. However, use in the treatment of anaerobic bacterial infections or a short course of treatment with metronidazole for amoebiasis, severe periodontal infections, or trichomoniasis may be necessary in nursing mothers. During treatment with metronidazole, the breast milk should be expressed and discarded. Breast-feeding may be resumed 24 to 48 hours after treatment is completed.
