10. Cautions with other medicines
Anegyn cream or gel isn't known to cause any problems with other medicines. However, there are some medicines that don't mix well with the tablets, suppositories, liquid or vaginal gel.
Tell your doctor before you start taking Anegyn tablets, suppositories, liquid or vaginal gel if you're taking these medicines:
- a blood thinner called warfarin
- lithium (used to treat some types of mental health problem)
- disulfiram (used to help people stay off alcohol)
- phenytoin or phenobarbitone (used to treat epilepsy)
- ciclosporin (used to dampen the immune system)
- fluorouracil or busulfan (used to treat some types of cancer)
- any medicines that you take as a liquid, in case these contain alcohol
- Mild to moderate renal impairment: Dose adjustment not considered necessary as elimination half-life not significantly altered
- Severe renal impairment or end stage of renal disease: Anegyn and Anegyn metabolites may accumulate significantly because of reduced urinary excretion; monitor in severe renal impairment or end stage of renal disease, not undergoing hemodialysis
- Hemodialysis removes significant amounts of Anegyn and its metabolites from systemic circulation; supplementation may be necessary
- Peritoneal dialysis: Monitor for signs of toxicity due to potential accumulation of Anegyn metabolites
In patients stabilized on relatively high doses of lithium, short-term Anegyn therapy has been associated with elevation of serum lithium and, in a few cases, signs of lithium toxicity. Serum lithium and serum creatinine levels should be obtained several days after beginning Anegyn to detect any increase that may precede clinical symptoms of lithium intoxication.
Case 1. Elevations in serum aminotransferase levels during intravenous Anegyn therapy.
A 58 year old man underwent prostate biopsy and cystoscopy and 32 hours later developed fever and was admitted for treatment of suspected urosepsis. After a combination of cephalosporin and tobramycin failed to affect his course, intravenous Anegyn (500 mg every 6 hours) was added. He had rapid clinical improvement, but then complained of abdominal pain, nausea, headache, and a metallic taste. Anegyn was stopped after 5 days, and he was switched on oral cefaclor. At the same time, serum ALT and alkaline phosphatase levels were found to be elevated. Physical exam showed slight hepatomegaly without jaundice. Hepatitis B serology was negative. Over the following week, the patient recovered symptomatically and was discharged home. All laboratory tests were normal 4 weeks after stopping Anegyn.
6. Vaginal gel
For treating bacterial vaginosis, you'll use an applicator to put the Anegyn gel into your vagina. The usual dose is 1 applicator full, every night for 5 nights. It's recommended that you do not use the gel while having your period.
Before taking Anegyn
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking Anegyn it is important that your doctor or dentist knows:
- If you are pregnant or breast-feeding.
- If you feel you will be unable to stop drinking alcohol for the duration of your treatment.
- If you have any problems with the way your liver works.
- If you have a rare inherited blood disorder called porphyria.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
- Hypersensitivity to Anegyn or other nitroimidazoles (although cautious desensitization has been applied)
- Pregnancy, 1st trimester (controversial)
- Use of disulfiram within past 2 weeks; use of alcohol during therapy or within 3 days of discontinuing therapy
Effects of Drug Abuse
- No information available
- See "What Are Side Effects Associated with Using Anegyn?"
- Encephalopathcy, seizures, aseptic meningitis, and neuropathies reported with increase in dose and chronic therapy
- Superinfection may occur with prolonged use
- See "What Are Side Effects Associated with Using Anegyn?"
- Encephalopathy, seizures, aseptic meningitis, and neuropathies reported with increase in dose and chronic therapy
- Superinfection may occur with prolonged use
- Severe hepatic impairment; administer lower doses with caution
- Use with caution; potential accumulation in end stagerenal disease; supplemental doses may be needed in patients receiving hemodialysis
- Use with caution in history of blood dyscrasias, heart failure, hepatic failure, H. pylori infection, renal impairment
- Avoid alcohol while taking medication and for at least 1 day after discontinuation
- Antiandrogen: May cause gynecomastia
- Known or previously unrecognized candidiasis may present more prominent symptoms during therapy with Anegyn Injection and requires treatment with a candicidal agent
- Anegyn may be acceptable for use during pregnancy. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. There are published data from case-control studies, cohort studies, and 2 meta-analyses that included more than 5000 pregnant women who used Anegyn systemically during pregnancy
- Many studies included first trimester exposures. One study showed an increased risk of cleft lip, with or without cleft palate, in infants exposed to Anegyn in utero; however, these findings were not confirmed
- In addition, more than 10 randomized, placebo-controlledclinical trials that together enrolled over 5000 pregnant women assessed the possible effect of systemic antibiotic treatment (including with Anegyn) for bacterial vaginosis on the incidence of preterm delivery; most studies did not show an increased risk of congenital anomalies or other adverse fetal outcomes following Anegyn exposure during pregnancy
- Three studies conducted to assess the risk of infantcancer following systemic Anegyn exposure during pregnancy did not show an increased risk; however, the ability of these studies to detect such a signal was limited.
- Anegyn is excreted in human milk; it is not recommended for use while breastfeeding
- Following oral administration, concentrations in human milk are similar to concentrations in plasma
- Potential for tumorigenicity shown in animal studies; a decision should be made whether to discontinue nursing or to discontinue Anegyn; breastfeeding women may choose to pump and discard milk for the duration of therapy and for 24 hours after therapy ends and to feed her infant stored human milk or formula
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Anegyn only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Copyright 1996-2019 Cerner Multum, Inc. Version: 12.02.
Anegyn (met" roe nid' a zole) is a nitroimidazole antibiotic that is activated by reduction of its nitro group by susceptible organisms. The activated form of Anegyn is a highly reactive radical anion which targets and damages large protein molecules and DNA. Mammalian cells do not ordinarily activate Anegyn, which accounts for its lack of toxicity in humans. Anegyn was approved for use in the United States in 1963 and currently several million prescriptions are filled yearly. Anegyn is indicated for treatment and prophylaxis of infections with susceptible anaerobic bacteria and protozoa. The recommended dosage is 500 to 750 mg taken orally three times daily for 5 to 10 days. Anegyn is available alone in tablets of 250, 375, 500 and 750 mg as well as in combination with other medications, in multiple generic formulations and under several brand names including Flagyl, Metryl, Noritate, Pylera and Helida. Other formulations include injectable solutions, extended release tablets, suppositories, and topical creams. The most common side effects include metallic taste, nausea, vomiting, abdominal discomfort and diarrhea.
Metron >About Anegyn
What is Anegyn (Flagyl, Flagyl ER), and how does it work?
Flagyl is an antibiotic effective against anaerobic bacteria and certain parasites. Anaerobic bacteria are single-celled, living organisms that thrive in environments in which there is little oxygen (anaerobic environments). Anaerobic bacteria can cause disease in the abdomen (bacterial peritonitis), liver (liver abscess), and pelvis (abscess of the ovaries and the Fallopian tubes). Giardia lamblia and ameba are intestinal parasites that can cause abdominal pain and diarrhea in infected individuals. Trichomonas is a vaginal parasite that causes inflammation of the vagina (vaginitis). Anegyn selectively blocks some of the functions within the bacterial cells and the parasites resulting in their death.
Anegyn comes as a tablet and an extended-release tablet to take by mouth.
Your dose will depend on your medical condition and your response to treatment.
Follow the instructions on your prescription label carefully when taking this medicine. Don't take more or less Anegyn than is recommended.
Try to take the medicine at the same time each day.
The tablets can be taken with food or a glass of milk to prevent upset stomach.
You should take the extended-release tablet on an empty stomach at least one hour before, or two hours after, a meal.
Don't crush, chew, or break the extended-release tablets. Swallow them whole.
What should I avoid while taking Anegyn?
Do not drink alcohol or consume food or medicines that contain propylene glycol while you are taking Anegyn. You may have unpleasant side effects such as headaches, stomach cramps, nausea, vomiting, and flushing (warmth, redness, or tingly feeling).
Avoid alcohol or propylene glycol for at least 3 days after you stop taking this medicine. Check the labels of any medicines or food products you use to make sure they do not contain alcohol or propylene glycol
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
How it works
Anegyn belongs to a class of drugs called nitroimidazole antimicrobials. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Antimicrobials are drugs used to treat infections. Nitroimidazole antimicrobials treat infections caused by bacteria and other organisms called protozoa. Anegyn tablets work by killing the bacteria or other organism that’s causing the infection. This relieves the infection.
Anegyn oral tablet doesn’t cause drowsiness, but it can cause other side effects.
There are no adequate and well-controlled studies of in pregnant women; there are published data from case-control studies, cohort studies, and 2 meta-analyses that include more than 5000 pregnant women who used Anegyn during pregnancy; many studies included first trimester exposures; one study showed increased risk of cleft lip, with or without cleft palate, in infants exposed to Anegyn in utero; however, these findings were not confirmed
Anegyn crosses placental barrier and its effects on human fetal organogenesis are not known; reproduction studies have been performed in rats, rabbits and mice at doses similar to maximum recommended daily dose based on body surface area comparisons; there was no evidence of harm to fetus due to Anegyn; healthcare provider should carefully consider potential risks and benefits for each specific patient before prescribing therapy
Before using Anegyn, tell your doctor or pharmacist if you are allergic to it; or to other nitroimidazole antibiotics (such as tinidazole); or to other ingredients in this product; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood disorders (blood dyscrasias).
This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.
This drug passes into breast milk. Discuss the risks and benefits with your doctor before breast-feeding.
About metron >
Anegyn is used to treat a wide variety of infections caused by certain types of germ (anaerobic bacteria) and types of micro-organisms called protozoa. These types of organisms often cause infections in areas of the body such as the gums, pelvic cavity and tummy (stomach or intestines) because they do not need oxygen to grow and multiply.