Flamyd 250 mg is an orally administered antimicrobial agent containing Metronidazole, a nitroimidazole derivative. It is widely used for the treatment and prevention of infections caused by anaerobic bacteria and certain protozoa. Flamyd 250 mg is available in tablet, suspension, vaginal gel, suppository, and intravenous forms, providing versatile options for various clinical situations. The drug acts by disrupting microbial DNA synthesis, leading to cell death, making it highly effective in systemic, gastrointestinal, urogenital, and skin infections.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Indications

Flamyd 250 mg is indicated for the treatment and prevention of infections caused by anaerobic bacteria and protozoa, including:

• Prevention of post-operative infections due to anaerobes (e.g., Bacteroides spp. and anaerobic streptococci)

• Systemic infections: septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis, post-operative wound infections

• Urogenital infections: trichomoniasis, bacterial vaginosis

• Protozoal infections: all forms of amoebiasis (intestinal, extra-intestinal, and asymptomatic cyst carriers), giardiasis

• Oral infections: acute ulcerative gingivitis, acute dental infections

• Skin infections: anaerobically infected leg ulcers and pressure sores

• Surgical prophylaxis: prevention of anaerobic infections before and after surgery

• Antibiotic-associated pseudomembranous colitis

Therapeutic Class

• Amoebicides

• Anti-diarrhoeal Antiprotozoal

Pharmacology

Metronidazole is metabolically reduced by anaerobic organisms via its 5-nitro group, producing reactive intermediates that bind to DNA and disrupt nucleic acid synthesis. This results in bactericidal and antiprotozoal effects. The drug selectively targets anaerobic pathogens, sparing aerobic flora to a large extent.

Dosage & Administration

Tablets and Suspension:

• Trichomoniasis: Adults – 200 mg thrice daily (tid) or 400 mg twice daily (bid) for 7 days; Children – age-based dosing from 50–100 mg tid or bid

• Intestinal Amoebiasis: Adults – 800 mg tid for 5 days; Children – 200–400 mg tid/qid depending on age

• Extra-intestinal Amoebiasis: Adults – 400–800 mg tid for 5–10 days; Children – age-based doses

• Giardiasis: Adults – 2 g once daily for 3 days; Children – age-based doses

• Acute ulcerative gingivitis & dental infections: Adults – 200 mg tid for 3–7 days; Children – age-based doses

• Bacterial vaginosis: Adults – 400 mg bid for 7 days or 2 g single dose; Children – age-appropriate doses

• Anaerobic infections: Adults – 800 mg initially, then 400 mg tid for 7 days; Children – 7.5 mg/kg tid

• Surgical prophylaxis: Adults – 400 mg tid starting 24 hours before surgery; Children – 7.5 mg/kg tid

Vaginal Gel: One applicator full (~5 g containing 37.5 mg) once or twice daily for 5 days.

Suppository: Anaerobic infections – Adults: 1 g every 8 hours for 3 days, then 1 g every 12 hours; Children: 5–10 years: 500 mg every 8 hours, then every 12 hours.

IV Infusion: Adults and children over 12 years – 500 mg every 8 hours at 5 ml/min; maximum 4 g/24 h. Children under 12 years – 7.5 mg/kg every 8 hours at 5 ml/min.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Interactions

• Alcohol: May cause disulfiram-like reaction (flushing, vomiting, tachycardia)

• Disulfiram: Psychotic reactions reported

• Warfarin: Increased anticoagulant effect; monitor prothrombin time

• Lithium & Cyclosporin: Monitor levels closely

• Phenytoin & Phenobarbital: May reduce plasma Metronidazole levels

• 5-Fluorouracil & Busulfan: Altered clearance, increasing toxicity risk

Contraindications

• Hypersensitivity to Metronidazole or other nitroimidazole derivatives

Side Effects

• Metallic taste, nausea, vomiting, diarrhea

• Drowsiness, rashes

• Rare: peripheral neuropathy, CNS effects, hypersensitivity

Pregnancy & Lactation

• Pregnancy: FDA category B; use only if clearly needed

• Lactation: Excreted in breast milk; exercise caution

Precautions & Warnings

• Monitor hematological parameters for prolonged therapy

• Caution in hepatic encephalopathy; may require dose reduction

• Patients should be warned about possible darkening of urine

• Avoid alcohol during therapy and for at least one day after

Overdose

Symptoms: vomiting, ataxia, mild disorientation. No specific antidote; treat symptomatically and supportively.

Storage

• Store below 30°C, protected from light

• Keep out of reach of children

• Do not use after expiry date

Mode of Action

Metronidazole is metabolically reduced by anaerobic organisms. Its reactive intermediates bind microbial DNA, disrupting replication and transcription, resulting in bactericidal and antiprotozoal effects.

Pediatric & Special Populations

• Hepatic impairment: Reduce dose to one-third and monitor closely

• Renal impairment: No adjustment necessary; metabolites efficiently removed by dialysis.