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Combined preparation for intravaginal use, the effectiveness of which is due to the presence in its composition of two components: metronidazole and clotrimazole.
Metronidazole is active against the simplest: Entamoeba histolytica, Giardia lamblia, Trichomonas vaginalis, as well as gram-negative anaerobes: Bacteroides fragilis, Fusobacterium spp., Prevotella spp. (Prevotella bivia, Prevotella buccae, Prevotella disiens), Gardnerella vaginalis and some gram-positive microorganisms: Clostridium perffringens, Clostridium difficile, Peptococcus spp., Peptostreptococcus spp. The BMD for these strains is 0.125-6.25 mcg / ml.
Clotrimazole has a fungicidal and bactericidal effect. It inhibits the biosynthesis of ergosterol, which regulates the permeability of the cell wall of microorganisms. It acts fungistatically in low concentrations and fungicidely in large concentrations. In fungicidal concentrations, it interacts with peroxidases and mitochondrial enzymes, resulting in an increase in the concentration of hydrogen peroxide to a toxic level, which also leads to the death of fungi. It has a high activity against fungi: Blastomyces dermatitidis, Candida spp., Coccidioides immitis, Cryptococcus neoformans, dermatophytes (Trichophyton mentagrophytes, Microsporum canis, Epidermophyton foccosum), Histoplasma capsulatum, Pidocidae, demidium, citrus, medication, citrus, medication, citrus, medication, citrus, citrus, citrus, pathogenicus, pathogeny, anthromatitis, Mushrooms, and protozoa: Trichomonas vaginalis; Gram-positive bacteria: Streptococcus spp., Staphylococcus spp., Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Proteus mirabilis.
- bacterial vaginosis of various etiologies, confirmed by clinical and microbiological data;
- Candida vulvitis and vulvovaginitis;
- urogenital trichomoniasis
One gram of gel contains:
Metronidazole 10 mg
Clotrimazole 20 mg
and auxiliary substances: methylhydroxybenzoate, propylhydroxybenzoate, disodium edetate, propylene glycol, carbomer-940, benzyl alcohol, sodium hydroxide, purified water
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Dosage and Administration
Intravaginally. The recommended dose is 5 g (one full applicator) 2 times a day (morning and evening). The course of treatment is 5 days. If necessary, the treatment can be repeated after 2 weeks.
Local reactions: burning sensation or frequent urination; the sexual partner has a burning sensation or irritation of the penis.
Systemic reactions: possible dizziness, headache, nausea, abdominal cramping.
Allergic reactions: skin rash, urticaria.
The patient should be warned about the need to stop the use of the drug and consult a doctor if any undesirable side effects occur.
- leukopenia (including in history);
- organic lesion of the central nervous system (including epilepsy);
- liver failure;
- I trimester of pregnancy;
- Hypersensitivity to the drug.
Use during pregnancy and lactation
The drug is contraindicated in the first trimester of pregnancy. The use of the drug in the II and III trimester of pregnancy is possible only under strict medical indications and under the supervision of a physician (without the use of an applicator).
When prescribing the drug during lactation, you must stop breastfeeding.
Application for violations of the liver
Contraindicated in liver failure.
With simultaneous use of the drug enhances the effect of indirect anticoagulants.
Combined use with non-depolarizing muscle relaxants (vecuronium) is not recommended.
With simultaneous use with lithium preparations may increase the concentration of lithium in the blood plasma.
Phenobarbital accelerates the metabolism of metronidazole due to the induction of microsomal liver enzymes, cimetidine - reduces.
Amphotericin B, nystatin, natamycin reduce the effectiveness of clotrimazole with simultaneous use.
When used simultaneously with ethanol, the drug may cause disulfiram-like reactions.
When using the drug, alcohol is contraindicated (a disulfiram-like reaction may develop: spastic abdominal pain, nausea, vomiting, headache, sudden flushing).
Metronidazole can immobilize treponema and lead to a false-positive Nelson test.
The drug is intended for intravaginal use only. Avoid contact with eyes.
During the course of therapy it is necessary to refrain from sexual activity.
Cases of drug overdose when prescribed at recommended doses was not observed.
- Brand name: Metrogyl Plus
- Active ingredient: Metronidazole, Clotrimazole
- Dosage form: Vaginal gel
- Manufacturer: Yunik Pharmaceutical
- Country of Origin: India