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METRONIDAZOLE 400 MG TABLETS - patient leaflet, side effects, dosage

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Patient leaflet - METRONIDAZOLE 400 MG TABLETS

Metronidazole 200mg Tablets Metronidazole 400mg Tablets

Read all of this leaflet carefully before you start taking this medicine.

  • Keep this leaflet. You may need to read it again.
  • If you have further questions, please ask your doctor or pharmacist.
  • This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
  • If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
  • 1. What Metronidazole tablets are and what they are used for

  • 2. What you need to know before you take Metronidazole tablets

  • 3. How to take Metronidazole tablets

  • 4. Possible side effects

  • 5. How to store Metronidazole tablets

  • 6. Contents of the pack and other information

1. what metronidazole tablets is and what it is used for

The name of this medicinal product is Metronidazole tablets and contains the active substance metronidazole. Metronidazole belongs to a group of medicines called antibiotics.

It works by killing bacteria and parasites that cause infections in your body. It can be used to

  • Treat infections of the blood, brain, lung, bones, genital tract, pelvic area, stomach and intestines
  • Treat gum ulcers and other dental infections
  • Treat infected leg ulcers and pressure sores
  • Prevent infections after surgery

If you need any further information on your illness, speak to your doctor.

2. what you need to know before you take metronidazole tablets do not takemetronidazole tablets if:

You are allergic (hypersensitive) to metronidazole, nitroimidazoles (e.g. tinidazole) or any of the other ingredients in your medicine (listed in Section 6: Contents of the pack and other information).

Signs of an allergic reaction include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue.

Do not take metronidazole if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking metronidazole.

Warnings and precautions

Talk to your doctor or pharmacist before taking Metronidazole tablets if:

  • You have or have ever had a liver problem.
  • You are having kidney dialysis (see section 3: ‚People having kidney dialysis‘)
  • You have a disease of the nervous system

If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking your medicine.

Do this even if they have applied in the past.

Cases of severe liver toxicity/acute liver failure, including cases with a fatal outcome, in patients with Cockayne syndrome have been reported with products containing metronidazole.

If you are affected by Cockayne syndrome, your doctor should also monitor your liver function frequently while you are being treated with metronidazole and afterwards.

Serious skin reactions including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP) have been reported with the use of metronidazole.

  • SJS/TEN can appear initially as reddish target-like spots or circular patches often with central blisters on the trunk. Also, ulcers of the mouth, throat, nose, genitals and eyes (red and swollen eyes) can occur. These serious skin rashes are often preceded by fever and/or flu-like symptoms. The rashes may progress to widespread peeling of the skin and life- threatening complications or be fatal.
  • AGEP appears at the initiation of treatment as a red, scaly widespread rash with bumps under the skin and blisters accompanied by fever. The most common location: mainly localised on the skin folds, trunk, and upper extremities.

The highest risk for occurrence of serious skin reactions is within one week, typically, within 48 hours after start of treatment. If you develop a serious rash or another of these skin symptoms, stop taking metronidazole and contact your doctor or seek medical attention immediately.

Tell your doctor immediately and stop taking metronidazole if you develop:

  • Stomach pain, annorexia, nausea, vomiting, fever, malaise, fatigue, jaundice, dark urine, putty or mastic coloured stools or itching.

Other medicines and Metronidazole tablets

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription, including herbal medicines. This is because metronidazole can affect the way some other medicines work. Also, some other medicines can affect the way metronidazole wor­ks.

In particular, tell your doctor if you are taking any of the following medicines:

  • Anti-coagulants (blood thinning agents), such as warfarin. The dosage of warfarin may need to be reduced when you are taking this drug.
  • Lithium for mental illness
  • Medicines used to treat epilepsy, such as phenobarbital, phenytoin, primidone
  • 5 fluorouracil for cancer
  • Busulfan for leukemia (cancer of the blood cells)
  • Ciclosporin – to prevent the rejection of organs after transplant
  • Disulfiram for alcoholism

If you are not sure, talk to your doctor or pharmacist before taking Metronidazole tablets.

Metronidazole tablets with food and drink

Do not drink any alcohol while you are taking metronidazole and for 48 hours after finishing your course. Drinking alcohol while using metronidazole might cause unpleasant side effects, such as feeling sick (nausea), being sick (vomiting), stomach pain, hot flushes, very fast or uneven heartbeat (palpitations) and headache.

Pregnancy, breast-feeding and fertility

Tell your doctor before using metronidazole if:

  • You are pregnant, might become pregnant or think you may be pregnant. Metronidazole should not be taken during pregnancy unless considered absolutely necessary.
  • You are breast-feeding. It is better not to use metronidazole if you are breast-feeding. This is because small amounts may pass into the mother's milk.

Driving and using machines

While taking metronidazole you may feel sleepy, dizzy, confused, see or hear things that are not there (hallucinations), have fits (convulsions) or temporary eyesight problems (such as blurred or double vision). If this happens, do not drive or use any machinery or tools.

Tests

Your doctor may wish to carry out some tests if you have been using this medicine for more than 10 days.

3. how to take metronidazole tabletstaking your medicinealways take metronidazole tablet exactly as your doctor has told you. it is important to finish a full course of treatment. the length of a course will depend on your needs and the illness being treated.

Check with your doctor or pharmacist if you are not sure.

  • Swallow the tablets whole with a drink of water
  • Do not crush or chew the tablets
  • Take these tablets during or just after a meal
  • The dose of metronidazole will depend on your needs and the illness being treated
  • The length of your treatment will depend on the type of illness you have and how bad it is

The usual dose for adults and children is given below:

To treat bacterial infection

Adults

  • The initial dose is 800 mg
  • After 8 hours take another dose of 400 mg and repeat this dose every 8 hours
  • Your doctor will work out how much your child should take depending on their weight
  • Repeat the dose every 8 hours
  • If your child is a baby under 8 weeks of age, your doctor will give them one daily dose or two separate doses 12 hourly
  • Start taking Metronidazole 24 hours before your operation
  • Take 400 mg of metronidazole every 8 hours
  • After the operation you may be given metronidazole either through a drip into a vein or rectally as a suppository until you are able to take tablets again

PHARMACODE

Children

  • Give your child metronidazole 1–2 hours before their operation
  • Your doctor will work out how much your child should take depending on their weight
  • After the operation your child may be given metronidazole either through a drip into a vein or rectally as a suppository until they are able to take tablets again

Other types of infections

For treatment of other infections caused by parasites and some bacteria your doctor will decide how much metronidazole you need to take and how often. This will depend on your illness and how bad it is. The pharmacist's label on the packaging will tell you how many tablets to take and how often to take them.

People having kidney dialysis

Kidney dialysis removes metronidazole from your blood. If you are having kidney dialysis you must take this medicine after your dialysis treatment.

People with liver problems

Your doctor may tell you to use a lower dose or to use the medicine less often.

If you take more Metronidazole tablets than you should

If you take more metronidazole than you should, tell your doctor or go to your nearest hospital casualty department straight away. Take the pack and any tablets left with you. This is so the doctor knows what you have taken.

If you forget to take Metronidazole tablets

If you miss a dose, take it as soon as you remember and carry on as before. If it is almost time for your next dose, skip the forgotten dose and continue as usual. Do not take a double dose to make up for a forgotten dose.

If you have any further questions on the use of this medicine, ask your doctor or pharmacist.

4. possible side effects

Like all medicines, Metronidazole tablets can cause side effects, although not everybody gets them.

Stop taking metronidazole and see a doctor or go to a hospital straight away if:

  • You get swelling of the hands, feet, ankles, face, lips or throat which may cause difficulty in swallowing or breathing. You could also notice an itchy, lumpy rash (hives) or nettle rash (urticaria) This may mean you are having an allergic reaction to metronidazole.
  • A serious but very rare side effect is a brain disease (encephalopathy). Symptoms vary but you might get a fever, stiff neck, headache, see or hear things that aren't there. You might also have problems using your arms and legs, problems with speaking or feel confused.
  • You develop skin rashes including Stevens-Johnson syndrome or toxic epidermal necrolysis. These can appear as reddish target-like spots or circular patches often with central blisters on the trunk, skin peeling, ulcers of the mouth, throat, nose, genitals and eyes and can be preceded by fever and flu-like symptoms. Stop using Metronidazole if you develop these symptoms and contact your doctor or seek medical attention immediately. See also section 2.
  • You develop a red, scaly widespread rash with bumps under the skin and blisters accompanied by fever at the initiation of treatment (acute generalised exanthematous pustulosis). Stop using metronidazole if you develop these symptoms and contact your doctor or seek medical attention immediately. See also section 2.
  • Yellowing of the skin and eyes. This could be due to a liver problem (jaundice).
  • Unexpected infections, mouth ulcers, bruising, bleeding gums, or severe tiredness. This could be caused by a blood problem.
  • Severe stomach pain which may reach through to your back (pancreatitis)

Tell your doctor or pharmacist if you notice any of the following side effects:

Very rare (affects less than 1 in 10000 people)

  • Fits (convulsions)
  • Mental problems such as feeling confused and seeing or hearing things that are not there (hallucinations)
  • Problems with your eyesight such as blurred or double vision
  • Skin rash or flushing
  • Headache
  • Darkening of the urine
  • Feeling sleepy or dizzy
  • Pains in the muscles or joints
  • Liver problems including life-threatening liver failure (hepatocellular liver injury)
  • Numbness, tingling, pain, or a feeling of weakness, in the arms or legs
  • Unpleasant taste in the mouth
  • Furred tongue
  • Feeling sick (nausea), being sick (vomiting), upset stomach, stomach pain or diarrhoea
  • Loss of appetite
  • Fever
  • Feeling depressed
  • Pain in your eyes (optic neuritis)
  • A group of symptoms together including: fever, nausea, vomiting, headache, stiff neck and extreme sensitivity to bright light. This may be caused by an inflammation of the membranes that cover the brain and spinal cord (meningitis)
  • Hearing impairment/ hearing loss
  • Ringing in the ears (tinnitus)
  • You get a rash or skin discolouration with or without raised areas which often reoccurs at the same location each time the drug is taken

5. how to store metronidazole tablets

Keep your medicine in a safe place and out of the sight and reach of children.

No special storage condition is required.

Do not use this medicine after the expiry date shown on the pack.

Ask your pharmacist how to dispose of medicines no longer required. Do not dispose of medicines by flushing down a toilet or sink or by throwing out with your normal household rubbish. This will help protect the environment.

6. contents of the pack and other informationwhat metronidazole tablets contain:each tablet contains 200 mg, 400 mg or 500 mg of metronidazole as the active substance.

The other ingredients are: anhydrous calcium hydrogenphosphate, pregelatinized maize starch, povidone (PVP K30), maize starch, crospovidone, cellulose microcrystalline, silica colloidal anhydrous and magnesium stearate

The coating of the tablets contains: hypromellose, polyethylene glycol 400

What Metronidazole tablets look like and contents of the pack:

Metronidazole 200mg Tablets are white to off white coloured, caplet shaped (aprox. 14.20 mm x 5.70mm) film coated tablets, debossed “200” on one side & plain on other side.

Metronidazole 400mg Tablets are white to off white coloured, caplet shaped (approx. 17.00mm x 6.00mm) film coated tablets, debossed “400” on one side & plain on other side.

Metronidazole 200mg and 400mg tablets are available in aluminium/PVC blister pack of 14, 21 & 100 tablets.

Marketing Authorisation Holder:

DAWA Limited, 5 Sandridge Close, Harrow, Middlesex, HA1 1XD, UK

Manufacturer:

Drugsrus Limited, 5 Sandridge Close, Harrow, Middlesex, HA1 1XD, UK

This leaflet was last updated in November 2019.

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Frequently Asked Questions

What is Metronidazole 400 mg used for?

Metronidazole 400 mg tablets are commonly used to treat various infections caused by bacteria and parasites, including bacterial vaginosis, trichomoniasis, and certain types of gastrointestinal infections.

How should I take Metronidazole 400 mg tablets?

You should take Metronidazole 400 mg tablets as prescribed by your doctor, typically with a full glass of water. It's important to follow the dosage instructions and complete the course of medication.

Can I drink alcohol while taking Metronidazole?

No, you should avoid alcohol during treatment with Metronidazole and for at least 48 hours after finishing the medication, as it can cause unpleasant reactions.

What are the possible side effects of Metronidazole 400 mg?

Common side effects may include nausea, headaches, a metallic taste in your mouth, or mild stomach upset. If you experience severe side effects, contact your doctor immediately.

Is it safe to use Metronidazole during pregnancy?

Metronidazole is generally not recommended during the first trimester of pregnancy. Always consult your healthcare provider before taking any medication while pregnant.

Can I take Metronidazole if I'm breastfeeding?

Metronidazole can pass into breast milk. Consult your doctor before using it while breastfeeding to discuss any potential risks.

How long does it take for Metronidazole to work?

Many patients start to feel better within a few days of starting treatment with Metronidazole. However, it's important to complete the entire course as prescribed.

What should I do if I miss a dose of Metronidazole?

If you miss a dose of Metronidazole, take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and return to your regular schedule. Do not double up on doses.

Are there any interactions between Metronidazole and other medications?

Yes, some medications can interact with Metronidazole. Always inform your doctor about all other medications you're taking to avoid potential interactions.

Can children take Metronidazole 400 mg tablets?

Metronidazole can be prescribed for children; however, the dosage will typically be adjusted based on their weight and age. Always follow your healthcare provider's instructions.

What happens if I overdose on Metronidazole?

Overdosing on Metronidazole can cause symptoms such as nausea, vomiting, and confusion. If you suspect an overdose, seek medical attention immediately.

Can I take pain relievers while on Metronidazole?

Generally, over-the-counter pain relievers like acetaminophen or ibuprofen can be taken with Metronidazole. However, check with your healthcare provider first.

Does Metronidazole affect birth control pills?

There is some evidence that antibiotics like Metronidazole may reduce the effectiveness of hormonal birth control methods. Consult your doctor about additional contraceptive measures.

Why does Metronidazole cause a metallic taste?

A metallic taste is a common side effect of Metronidazole and occurs due to its chemical composition affecting taste receptors.

Is it necessary to finish the entire course of Metronidazole treatment?

Yes, it is crucial to complete the full course of treatment even if you start feeling better earlier; stopping early can lead to antibiotic resistance and recurrence of infection.

Can I crush or chew my Metronidazole tablets?

You should swallow Metronidazole tablets whole unless advised otherwise by your healthcare provider. Crushing or chewing may affect how the drug works in your body.

What is the shelf life of Metronidazole tablets?

Metronidazole tablets typically have a shelf life of about 2-3 years from the date of manufacture but always check expiry dates on packaging before use.

Will I experience withdrawal symptoms after stopping Metronidazole?

No withdrawal symptoms are expected after discontinuing Metronidazole; however, if you have concerns about stopping any medication, consult your healthcare provider.

Can I use topical treatments while taking oral Metronidazole?

Yes, topical treatments can usually be used alongside oral Metronidazole; however, consult with your doctor if you're unsure about specific products.