The average daily dose was 719 mg and the average cumulative dose of metronidazole was 93.4 grams. 4.5 Interaction with other medicinal products and other forms of interaction6.6 Special precautions for disposal and other handling9. A majority of cases (86%) show a characteristic pattern of bilateral symmetric involvement of the dentate nuclei, After discontinuation of metronidazole the majority of cases either improve (29%) or have complete resolution of symptoms (65%). Date of first authorisation/renewal of the authorisationStart typing to retrieve search suggestions. Significant cumulation may occur in patients with hepatic encephalopathy and the resulting high plasma concentrations of metronidazole may contribute to the symptoms of the encephalopathy. Symptoms are limited to vomiting, ataxia and slight disorientation. Such patients however retain the metabolites of metronidazole. 76. Liver function tests must be performed just prior to the start of therapy, throughout and after end of treatment until liver function is within normal ranges, or until the baseline values are reached. Adverse effects are not commonly associated with metronidazole. However, prolonged high doses of metronidazole may result in optic neuropathy, 73 peripheral neuropathy 74, 75 and encephalopathy. If the liver function tests become markedly elevated during treatment, the drug should be discontinued.Patients with Cockayne syndrome should be advised to immediately report any symptoms of potential liver injury to their physician and stop taking metronidazole.Cases of severe bullous skin reactions such as Stevens Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) or acute generalised exanthematous pustulosis (AGEP) have been reported with metronidazole. Official guidelines should be consulted before initiating therapy.Metronidazole Tablets 200mg should be swallowed without chewing, with half a glassful of water, during or after meals.Hypersensitivity to nitroimidazoles, metronidazole or any of the excipients.Regular clinical and laboratory monitoring (especially leukocyte count) are advised if administration of Metronidazole Tablets 200mg for more than 10 days is considered to be necessary and patients should be monitored for adverse reactions such as peripheral or central neuropathy (such as paraesthesia, ataxia, dizziness, convulsive seizures).Metronidazole should be used with caution in patients with active or chronic severe peripheral and central nervous system disease due to the risk of neurological aggravation.The possibility that an accompanying gonococcal infection might persist in a symptomatic state after The elimination half-life of metronidazole remains unchanged in the presence of renal failure. Clinical presentation. Such patients however retain the metabolites of metronidazole. 62, 67, 80 Metabolites of metronidazole proposed to exert cytotoxicity are underlined. Metronidazole is an antibiotic. Soon after the discontinuation of metronidazole, dysarthria and dysmetria improved; however, neuropathy continued and gabapentin was started. confusion, fever, headache, hallucinations, paralysis, light sensitivity, disturbances in sight and movement, stiff neck) and subacute cerebellar syndrome (e.g. This site uses cookies. The potential for neurotoxicity of metronidazole has been recognized for some time 2. The average daily dose was 719 mg and the average cumulative dose of metronidazole was 93.4 grams.It presents as cerebellar dysfunction (75% of cases), altered mental state (33%) and/or seizures (13%) Among patients with cerebellar dysfunction, dysarthria (66%) and ataxia (56%) are common; dysmetria (33%) nystagmus (8%) less so.

These are more common at higher doses and may be reduced by taking metronidazole with food. If symptoms/signs are present, treatment must be immediately discontinued. If it is used, then short-term high dosage therapy is Patients should be warned about the potential for drowsiness, dizziness, confusion, hallucinations, convulsions or transient visual disorders, and advised not to drive or operate machinery if these symptoms occurThe frequency of adverse events listed below is defined using the following convention: very common (≥1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1,000 to < 1/100); rare (≥ 1/10,000 to < 1/1000); very rare (< 1/10,000); not known ( cannot be estimated from the available data).Serious adverse reactions occur rarely with standard recommended regimens.

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