Flagyl ER is a drug that belongs to antiprotozoal drugs with antibacterial activity. Flagyl ER is used for etiotropic therapy (treatment aimed at destroying the causative agent of an infectious pathological process) of infectious diseases of various localization caused by pathogenic microorganisms sensitive to the active substance of the drug.
What is Flagyl ER used for?
Flagyl ER is indicated for etiotropic therapy of infectious diseases caused by pathogenic microorganisms sensitive to the drug:
- Protozoal infectious diseases caused by the simplest unicellular microorganisms - trichomoniasis (urinary tract infection), gastrointestinal amebiasis (a colon inflammation caused by pathogenic amoeba), extraintestinal amebiasis, including the liver damage with abscess formation (limited cavity filled with pus).
- Limited cavity filled with infections caused by anaerobic bacteria, in particular bacteroids (Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus) – bone tissue infections, abscessing pathological processes of the structures of the central nervous system, meningitis (inflammation of the brain and spinal cord lining), endocarditis (infectious inflammation of the inner layer of the heart walls), pneumonia (lung inflammation), lung abscess and sepsis (blood poisoning).
- Infectious processes caused by anaerobic microorganisms, namely clostridia and peptostreptococci (Clostridium spp., Peptococcus niger and Peptostreptococcus) – pathology of the abdominal organs, including peritonitis, liver abscess, and damage to the pelvic organs (endometritis with an inflammatory reaction of the inner layer of the walls of the uterus in women, abscess of the ovaries and fallopian tubes and vaginal vault infection).
- Complex therapy of gastric and duodenal ulcer caused by Helicobacter pylori.
- Prevention of infectious complications after colon surgery.
- Pseudomembranous colitis- an inflammation of the colon wall, often provoked by the long-term use of antibiotics.
In addition, Flagyl ER is used in the complex therapy of tumor diseases requiring radiation exposure.
Way of use and dosage
Flagyl ER is taken orally during or immediately after a meal. They aren't chewed and washed down with a sufficient amount of liquid (preferably milk). The average dosage for the treatment of trichomoniasis is 250 mg (1 pill) for 10 days or 400 mg twice a day for 5-8 days. In case of severe infection, the course of treatment with Flagyl ER tablets can be repeated, increasing the daily dose to 1 g (1000 mg). The break between the drug treatment courses must be about 3-4 weeks. The dosage of Flagyl ER pills for the treatment of trichomoniasis also depends on the patient's age:
- Children under 1 year – 125 mg per day.
- Children aged 2-4 years – 250 mg per day.
- Children aged 5-8 years – 375 mg per day.
- Children over 8 years – 500 mg per day (divided into 2 intakes).
The use of Flagyl ER can lead to the development of adverse reactions from various organs and systems:
- Digestive system - sickness, vomiting, diarrhea or constipation, intestinal colic, dryness and metallic taste in the mouth, inflammation of the oral mucosa (stomatitis), gums (gingivitis) and tongue (glossitis).
- Nervous system – vertigo, headache, uncoordinated movements, increased excitability and irritability, depression (significant and prolonged low mood), insomnia, generalized weakness, reduced working capacity, confusion, hallucinations, and cramps.
- Blood and bone marrow –decrease in the number of neutrophils (neutropenia) and leukocytes (leukopenia).
- Genitourinary system – candidiasis (activation of opportunistic fungal infection), cystitis (the inflammation of the bladder), polyuria (excessive urination volume), urinary incontinence and red-brown urine.
- Allergic reactions – skin rash, itching, urticaria (the skin looks like a nettle-sting), allergic fever (increased body temperature), arthralgia (joint pain) and nasal congestion.
- In case of development of side effects, the drug can be withdrawn (particularly if they're pronounced).
During pregnancy and lactation
At the early stage of pregnancy (I trimester), the drug is contraindicated. Later on, it can be prescribed at the doctor's discretion. The most common cause of treatment with Metronidazole is bacterial vaginosis (specific and non-specific). The drug crosses the placenta; therefore, it should be taken carefully during gestation.
During lactation (if there is an urgent need for therapy with the described agent), the child must be temporarily weaned. Flagyl ER not only gives a bitter taste to the breast milk but also penetrates into it in the doses comparable to its concentration in the mother's plasma.
Before starting to take Flagyl ER, you should carefully read the instructions for this drug. There are a number of particular indications that you need to take into account. These include:
- Alcohol intake during the treatment is contraindicated since ethanol can lead to the development of stomach spasms, sickness, vomiting, sudden facial flushing, and headache.
- Patients under the age of 18 must not use the drug in combination with amoxicillin.
- In the case of long-term therapy with the drug, periodic laboratory monitoring of peripheral blood should be carried out.
- Vertigo, ataxia (gait abnormality), and other neurological disorders require the withdrawal of the drug.
- Flagyl ER pills can stain the urine red-brown.
- During the treatment of trichomoniasis vaginalis, one should refuse from sexual activity and conduct therapy with a sexual partner.
- During menstruation, the treatment is continued.
- After the etiotropic therapy of giardiasis, the symptoms of the pathological process can persist for several more weeks; therefore, the efficiency of treatment is monitored using laboratory research.
- For the treatment time, you should refuse from the activities that require an increased concentration of attention and rapid psychomotor reactions.