Flagyl (metronidazole) possesses direct tri-chomonacidal and amebacidal activity against Trichomonas vaginalis, Giardia intestinalis, Entamoeba histolytica and anaerobic bacteria: Bacteroides species including the Bacteroides fragilis group (B. fragilis, B. distasonis, B. ovatus, B. thetaiotaomicron, and B. vulgatus) Fusobacterium species, and Helicobacter pylori (adjuvant).

Metronidazole works by entering bacterial and protozoal cells and interfering with their genetic material (DNA). It damages the Deoxyribonucleic acid (DNA) and also prevents the bacteria and protozoa from forming new DNA. This ultimately results in metronidazole killing the micro-organisms. Metronidazol can be used to treat the chronic alcoholism.

Flagyl is contraindicated in patients with a prior history of hypersensitivity to metronidazole or other nitroimidazole derivatives.

Flagyl is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria (Bacteroides fragilis), lower respiratory tract infections, including pneumonia, empyema, and lung abscess, meningitis and brain abscess, intra-abdominal abscess, including peritonitis, gynecologic infections, including endo-metritis, tubo-ovarian abscess, bacterial septicemia and postsurgical vaginal cuff infection, caused by Bacteroides fragilis, gastric ulcer caused by Helicobacter pylori, pseudomembranous colitis, amoeba dysentery, giardia (lamblia), urethritis, vaginitis caused by Trichomonas vaginalis.

Flagyl also can be used in postnatal fever, gas gangrene, in the treatment and prophylaxis of wounds and in postsurgical infections. Metronidazole Vaginal Gel is used in: vaginitis caused by Trichomonas vaginalis, Gardnerella vaginalis, Chlamydia trachomatis, Candida albicans, and vaginitis caused by Anaerobic Bacteria. Antiacne Gel for external and local application: pink and vulgar acnes, it is long not healing wounds, trophic ulcers.

Metronidazole has been reported to potentiate coumarin anticoagulants effect. Psychotic reactions have been reported in alcoholic patients who are using metronidazole and disulfiram concurrently.

In Trichomoniasis: the adult- 500mg/day for 10 days, women - 2 grams of Flagyl, taken as a single dose; in bacterial vaginosis: 2 grams of Flagyl in the first and the third day; in lambliasis: the adult- 750-1000 mg/day, to children-2-5 years-250 milligram/day, 5-10 years -375 milligram/day, 10-15 years - 500 milligram/day within 5 day; in anaerobic infections-1-1,5 g/day, to children- 20-30mg/kg/day.

Flagyl also is used in surgical chemoprophylaxis-500mg 3 times per day, to children-20-30mg/kg/day, in intravenous perfusion - 1-1,5g/day. The infusion is carried out with rate of 5 mls / mines, to children-20-30mg/kg/day. Flagyl can be used in combination with other antibacterial drugs. The maximum dosage of the drug is 4g/day. For vaginal gel: 5g (one applicatorful), inserted into the vagina two times a day for 5 days. Avoid vaginal intercourse during treatment. Apply a thin layer of antiacne gel to the affected area, twice daily.

In case of overdose the patients can have an attempt of nausea, vomiting, and ataxia. The treatment: symptomatic therapy.

The most frequent side effects of Flagyl preparations are: convulsive seizures and peripheral neuropathy, ataxia, nausea, vomiting, diarrhea, and unpleasant metallic taste.

Should be avoided alcohol during the treatment period with metronidazole. Metronidazole is not used in early pregnancy. Metronidazole is excreted in breast milk. Nursing mothers, because of potential adverse effects on the newborn, should not use Metronidazole.