英文药名: Flagyl (Metronidazole ER Tablets)

中文药名: 灭滴灵（甲硝唑缓释片）

生产厂家: Ferring Pharmaceuticals Inc

药品名称

药物名称: 甲硝唑
药物别名: 甲硝基羟乙唑，灭滴灵，灭滴唑，FLAGYL
英文名称: Metronidazole
规格

甲硝唑片及胶囊：每片/粒 200mg, 250mg, 400mg, 500mg。甲硝唑霜：10% X 60 grams。
药理毒理　　

本品为硝基咪唑衍生物，可抑制阿米巴原虫的氧化还原反应，使原虫氮链发生断裂。体外试验证明，药物浓度为1～2mg/L时，溶组织阿米巴于6～20小时即可发生形态改变，24小时内全部被杀灭，浓度为0.2mg/L时，72小时内可杀死溶组织阿米巴。本品有强大的杀灭滴虫的作用，其机理未明。
甲硝唑对厌氧微生物有杀灭作用，它在人体中还原时生成的代谢物也具有抗厌氧菌作用，抑制细菌的脱氧核糖核酸的合成，从而干扰细菌的生长、繁殖，最终致细菌死亡。
对某些动物有致癌作用。

药代动力学　　

口服或直肠给药后能迅速而完全吸收，蛋白结合率＜5%，吸收后广泛分布于各组织和体液中，且能通过血脑屏障，药物有效浓度能够出现在唾液、胎盘、胆汁、乳汁、羊水、精液、尿液、脓液和脑脊液中。有报道，药物在胎盘、乳汁、胆汁的浓度与血药浓度相似。健康人脑脊液中血药浓度为同期血药浓度的43%。少数脑脓肿患者，每日服用1.2～1.8g后，脓液的药浓度（34～45mg/L）高于同期的血药浓度（11～35mg/L）。耳内感染后其脓液内的药物浓度在8.5mg/L以上。口服后1～2小时血药浓度达高峰，有效浓度能维持12小时。口服0.25g、0.4g、0.5g 、2g后的血药浓度分别为6 mg/L、9 mg/L、12 mg/L、40 mg/L。本品经肾排出60%～80%，约20%的原形药从尿中排出，其余以代谢产物（25%为葡萄糖醛酸结合物，14%为其他代谢结合物）形式由尿排出，10%随粪便排出，14%从皮肤排泄。
 
适应症

本品有强大的杀灭滴虫作用，为治疗阴道滴虫病的首选药物。此外对肠道及组织内阿米巴原虫也有杀灭作用，可用于治疗阿米巴痢和阿米巴肝脓肿，疗效与依米丁相仿。其优点是毒性小、疗效高、口服方便、适应范围广。
本品有抗厌氧菌作用，可用于治疗厌氧杆菌引起的产后盆腔炎、败血症、牙周炎等。还可用于治疗贾第氏鞭毛虫病、酒糟鼻。用于阑尾、结肠手术、妇产科手术，可降低或避免手术感染。
本品口服吸收良好，生物利用度可达90％～100％，Cmax为1～2小时，Vd为0.6～0.7L／kg，血浆蛋白结合率约为10％～20％。有效血浓度可维持12小时，药物可以原形由尿排出，亦由阴道分泌液、乳汁、唾液中排出。t1/2为8～14小时。
用法用量

（1）治滴虫病: 成人1日3次，每次服200mg，另每晚以200mg栓剂放入阴道内，连用7～10日。为保证疗效，须男女同治。
（2）治阿米巴病：成人1日3次，每次400～800mg（大剂量宜慎用），5～7日为1疗程。
（3）治贾第氏鞭毛虫病: 常用量每次400～300mg，1日3次口服，疗程5日。
（4）治疗由厌氧菌引起的产后盆腔感染、败血症、骨髓炎等：一般口服200～400mg，1日600～1200mg。也可静脉滴注。
（5）治酒糟鼻: 口服200mg，1日2～3次。配合2％灭滴灵霜外搽，1日3次。1疗程3周。
任何疑问，请遵医嘱！
不良反应　　

15%～30%病例出现不良反应，以消化道反应最为常见，包括恶心、呕吐、食欲不振、腹部绞痛，一般不影响治疗；神经系统症状有头痛、眩晕，偶有感觉异常、肢体麻木、共济失调、多发性神经炎等，大剂量可致抽搐。少数病例发生荨麻疹、潮红、瘙痒、膀胱炎、排尿困难、口中金属味及白细胞减少等，均属可逆性，停药后自行恢复。
禁忌　　

有活动性中枢神经系统疾患和血液病者禁用。
注意事项

（1）可有食欲不振、恶心、呕吐等反应，少数有腹泻，此外可偶见头痛、失眠、皮疹、白细胞减少等。少数病例有膀胱炎、排尿困难、肢体麻木及感觉异常，停药后可迅速恢复。
（2）哺乳期妇女及妊娠3个月以内的妇女、中枢神经疾病和血液病患者禁用。
（3）出现运动失调及其他中枢神经症状时应停药。
（4）服药期间应每日更换内裤，注意洗涤用具的消毒，防止重复感染。
（5）对某些细菌有诱变性，但一般认为对人的致癌、致畸的危险很小。
药物相互作用　　

本品能增强华法林等抗凝药物的作用。与土霉素合用可干扰甲硝唑清除阴道滴虫的作用。

Generic Flagyl Description
Generic Flagyl is a synthetic medication prescribed to be taken by mouth for control of bacteria and protozoa activity. Generic Flagyl comes under various brand names like, Flagyl ER, Flagyl 375, Helidac Therapy and is available in different strengths like 375mg, 200mg, 250mg, 400mg, 500mg etc. Metronidazole acts with a unique action: once it gets dissolved in the blood, it reacts with the proteins in the blood and free particles are created. These react with the external microbe cellular parts thus resulting in their elimination. Flagyl works against certain Gram-positive and Gram-negative anaerobes as well as certain Protozoa parasites.
Flagyl Side Effect
Just like any other medication, Flagyl may also have side effects. Yet users must understand that Physicians suggest prescription drugs like Flagyl only after diagnosing patient carefully and determining that Flagyl benefits far outweigh the associated risks.

Following are some of the severe side effects observed in Flagyl users:
- Vomiting Throwing up
- Diarrhea loose motions
- Diminished urge to eat
- Peculiar taste sensation
- Dark colored urine
- Tongue – mouth problem
- Loss of feeling or jittery feeling in limbs

Other Flagyl side effect may include:
- Skin problems
- Urge to scratch
- Blocked nasal cavity
- High temperature
- Aching joints

Flagyl Interaction
Users should buy flagyl online or at local drugstore only after they discuss its actual use and necessity with the Physician. Medications that may interact with Flagyl include: Warfarin like Coumarin Anticoagulants; Phenytoin; Phenobarbital; Disulfiram’ etc. Users should seek advice from Physicians/Pharmacists for the entire list of drugs that interact with Flagyl. For patients using lithium in high quantity, Flagyl users may face lithium poisoning
Flagyl Over Dose
In case of Flagyl overdose, users should immediately call local poison control center at 1-800-222-1222. In case of serious reaction like lack of breathing or losing consciousness, immediately intimate local emergency services at 911.
Uneasiness, Throwing up and lack of coordination in body movements are the main indication of Flagyl Overdose.
Flagyl Missed Dose
Take Flagyl dose at the same time everyday. In case of realizing that any Flagyl dose has been missed, take the next one immediately. In case the user realizes missed dose just prior to the next one, skip the dose and take the usual one. Do not increase Flagyl dose to make up for the missed dose. Discuss with physician in case of any confusion.

Flagyl Notes
Users should discuss Flagyl benefits and risks with Physician. Discuss with Physician about all ongoing medications, therapies, supplement use as well as dietary /lifestyle changes to be done before actual Flagyl use.

Avoid unnecessary use of Flagyl (Metronidazole) to reduce drug-resistance of bacteria as well as to maintain Metronidazole and other such antibacterial drug effectiveness

Avoid alcohol or alcoholic beverages during or immediately after completion of Flagyl Therapy as it may increase risks of side effects.

Flagyl may have interaction with certain serums used in carrying out various medical tests such as Aspartate Aminotransferase (AST, SGOT), Alanine Aminotransferase (ALT, SGPT) etc.

Metronidazole has show carcinogenic activity in rats and mice, so discuss its use with Physician.
Flagyl Other Uses
Physicians may possibly suggest other Flagyl uses apart from the ones mentioned earlier.

Flagyl Uses
Generic Flagyl (Metronidazole) is prescribed for treating bacterial infections. It is very effective against microbes that are responsible for reproductive system diseases, skin and vagina problems, gastrointestinal tract problems etc. Following are some of the key afflictions for which Flagyl can be prescribed:
1) Symptomatic and Asymptomatic Trichomoniasis
2) Treatment of Asymptomatic Consorts
3) Amebiasis
4) Bacterial Infections in absence of direct air
5) Intra‑Abdominal Infections, including peritonitis, intra‑abdominal abscess, and liver abscess
6) Skin and Skin Structure Infections
7) Gynecologic Infections, including endometritis, endomyometritis, tubo‑ovarian abscess, and postsurgical vaginal cuff infection
8) Bacterial Septicemia
9) As adjunctive therapy for Bone and Joint Infections,
10) Central Nervous System Infections including meningitis and brain abscess
11) Lower Respiratory Tract Infections including pneumonia, empyema, and lung abscess
12) Endocarditis.

Users should not buy Flagyl, before consulting their Physician and understanding all related Flagyl benefits and risks. Users can order Flagyl 200mg and Flagyl 400mg over here.