Metrolex Dosage/Direction for Use

Dosage and duration of therapy depend on severity of infection and patient's condition.
Administration in renal impairment: Dosage reductions are not usually recommended for patient with renal impairment who undergoing peritoneal dialysis because Metronidazole is removed during 8 hours of hemodialysis. Metronidazole should therefore be re-administered immediately after hemodialysis.
Administration in hepatic impairment: Metronidazole is metabolized by liver; so patients with hepatic impairment should use METROLEX with caution because accumulation of the drug is likely in patients with impaired hepatic function especially patient with hepatic encephalopathy. Metronidazole may increase symptoms of encephalopathy. One-third of the usual daily dose may be given once daily in these patients. Moreover, signs of Metronidazole toxicity and plasma concentrations of the drug should be monitored.
Metronidazole tablets should be swallowed with plenty of water. It is recommended that the tablets should be taken during or after a meal.
Prophylaxis against anaerobic bacterial infections, in the context of abdominal and gynaecological surgery: Adults: 400 mg every 8 hours for 3-4 days followed by postoperative intravenous until the patient is able to take tablets. Shorter preoperative course and higher oral dose (up to 1 g) have been used.
Children: 7.5 mg/kg every 8 hours.
Treatment of established anaerobic bacterial infection: Adults: 800 mg initially followed by 400 mg every 8 hours.
Children: 7.5 mg/kg every 8 hours.
Duration of action is approximately 7-10 days based on patient symptom and severity of disease.
Urogenital trichomoniasis (the consort should receive a similar course of treatment concurrently to prevent re-infection): Adults and children over 10 years: 200 mg three times daily for 7 days or 400 mg twice daily for 7 days or 800 mg in the morning and 1200 mg in the evening for 2 days; 2 g as a single dose for 1 day.
*Children 7-10 years: 100 mg three times daily for 7 days; 3-7 years: 100 mg twice daily for 7 days; 1-3 years: 50 mg three times daily for 5-10 days.
Bacterial vaginosis: Adults and children over 10 years: 400 mg twice daily for 7 days or 2 g as a single dose for 1 day.
Amoebiasis: Invasive intestinal disease in susceptible subject: Adults and children over 10 years: 800 mg three times daily for 5 days.
*Children 7-10 years: 400 mg three times daily for 5 days; 3-7 years: 200 mg four times daily for 5 days; 1-3 years: 200 mg three times daily for 5 days.
Intestinal disease in less susceptible subjects and chronic amoebic hepatitis: Adults and children over 10 years: 400 mg three times daily for 5-10 days.
*Children 7-10 years: 200 mg three times daily for 5-10 days; 3-7 years: 100 mg four times daily for 5-10 days; 1-3 years: 100 mg three times daily for 5-10 days.
Symptomless cyst passers: Adults and children over 10 years: 400-800 mg three times daily for 5-10 days.
*Children 7-10 years: 200-400 mg three times daily for 5-10 days; 3-7 years: 100-200 mg four times daily for 5-10 days; 1-3 years: 100-200 mg three times daily for 5-10 days.
Giardiasis: Adults and children over 10 years: 2 g once daily for 3 days.
*Children 7-10 years: 1 g once daily for 3 days; 3-7 years: 600 to 800 mg once daily for 3 days; 1-3 years: 500 mg once daily for 3 days.
Acute ulcerative gingivitis: Adults and children over 10 years: 200 mg three times daily for 3 days.
*Children 7-10 years: 100 mg three times daily for 3 days; 3-7 years: 100 mg twice daily for 3 days; 1-3 years: 50 mg three times daily for 3 days.
Acute dental infections: Adults and children over 10 years: 200 mg three times daily for 3-7 days.
Leg ulcers and pressure sores: Adults and children over 10 years: 400 mg three times daily for 7 days.
*Children and infants weighing less than 10 kg should receive proportionately smaller dosages.
Injection: The usual duration of therapy is 7-10 days.
Anaerobic bacterial infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment.
Prophylactic use of Metronidazole during and after surgery should not be continued for more than 12 hours after surgery.
Metronidazole is administered by continuous or intermittent IV infusion.
Metronidazole should not be mixed with solution containing other drugs. And avoid contact drug solution with equipment or container containing aluminum.
IV infusions are usually given over 1 hour.
METROLEX injection is a ready-to-use isotonic solution that dilution is not required before IV infusion.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. With concern of microbial contamination, the drug should be used promptly after the preparation and use within 24 hours and the remaining unused solution should be discarded.
For the treatment of severe anaerobic bacterial infection: Adults: Adults should receive an initial METROLEX IV loading dose of 15 mg/kg, IV infusions are usually given over 1 hour (approximately 1 g for a 70 kg adult). After 6 hours of first infusion followed by IV maintenance doses of 7.5 mg/kg every 6 hours (approximately 500 mg for a 70 kg adult).
IV infusions are usually given over 1 hour.
The maximum adult dose within 24 hours is 4 g.
Oral Metronidazole is substituted when the condition of the patient warrants, based upon the severity of the disease and the patient's condition. The usual adult oral dosage is 7.5 mg/kg every 6 hours (METROLEX TABLET 400 mg three times a day for 7 days).
For perioperative and postoperative prophylaxis: One hour prior to the procedure, adults receive METROLEX injection 15 mg/kg by IV infusion over 30-60 minutes. The initial preoperative dose must be completely infused approximately 1 hour prior to surgery to ensure adequate serum and tissue concentrations of Metronidazole. After that, patients receive 7.5 mg/kg by IV infusion over 30-60 minutes at 6 and 12 hours after initial dose.
Oral Metronidazole is substituted when the condition of the patient warrants, based upon the severity of the disease and the patient's condition. The usual adult oral dosage is 7.5 mg/kg every 6 hours (METROLEX TABLET 400 mg three times a day for 7 days).