What is the dosage for Metral, and how do I take it?
- Metral may be taken orally with or without food.
- In the hospital, Metral can be administered intravenously to treat serious infections.
- The liver is primarily responsible for eliminating Metral from the body, and doses may need to be reduced in patients with liver disease and abnormal liver function.
Various Metral regimens are used. Some examples are listed below.
- Amebic dysentery: 750 mg orally 3 times daily for 5-10 days
- Amebic liver abscess: 500-750 mg orally three times daily for 5-10 days
- Anaerobic infections: 7.5 mg/kg orally or by injection every 6 hours for 7 to 10 days not to exceed 4 grams daily.
- Bacterial vaginosis: 750 mg (extended release tablets) once daily for 7 days or 500 mg twice daily for 7 days or 2 g single dose or one applicator-full of 0.75% vaginal gel, once or twice daily for 5 days.
- Clostridium difficile infection: 250-500 mg orally 4 times daily or 500-750 orally 3 times daily
- Giardia: 250 mg orally three times daily for 5 days Helicobacter pylori: 800-1500 mg orally daily for several days in combination with other drugs.
- Pelvic inflammatory disease (PID): 500 mg orally twice daily for 14 days in combination with other drugs.
- Trichomoniasis: 2 g single dose or 1 g twice
- Rosacea: apply topical gel 0.75-1% once daily
Drug/Laboratory Test Interactions
Metral may interfere with certain types of determinations of serum chemistry values, such as aspartate aminotransferase (AST, SGOT), alanine aminotransferase (ALT, SGPT), lactate dehydrogenase (LDH), triglycerides, and glucose hexokinase. Values of zero may be observed. All of the assays in which interference has been reported involve enzymatic coupling of the assay to oxidation-reduction of nicotinamide adenine dinucleotide (NAD+ NADH). Interference is due to the similarity in absorbance peaks of NADH (340 nm) and Metral (322 nm) at pH 7.
5. Cream or gel
When Metral cream or gel is prescribed for rosacea, you'll normally use it twice a day for about 2 months. Treatment can sometimes last longer. Follow the instructions from your doctor or pharmacist.
If you're using the cream or gel for a skin infection, or infected ulcers or wounds, it's usual to put it on once or twice a day. Follow your doctor or pharmacist's instructions, and continue treatment until your infection has healed.
What Are Side Effects Associated with Using Metral?
Common Side effects of Metral include:
Side effects of Metral from postmarketing reports include:
- Difficult or painful sexual intercourse
- Rectalpain and inflammation
- Fleeting joint pains that may resemble serum sickness
- Crohn's disease
This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.
What Other Drugs Interact with Metral?
If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.
Severe Interactions of Metral include:
Metral has serious interactions with at least 39 different drugs.
Metral has moderate interactions with at least 117 different drugs.
Metral has mild interactions with at least 84 different drugs.
This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.
How long should I take it for?
It's very important to keep taking Metral for as long as your doctor has prescribed it.
What is metron >
Metral is an antibiotic that fights bacteria.
Metral is used to treat bacterial infections of the vagina, stomach or intestines, liver, skin, joints, brain, heart, and respiratory tract. Metrogel (topical Metral) is also used to treat rosacea, a skin condition. Vaginal Metral gel is also used to treat bacterial infections of the vagina.
Metral will not treat a vaginal yeast infection.
What if I forget to use it?
If you forget to use Metral cream or gel, put it on as soon as you remember, unless it's nearly time for your next dose. Do not use it more than twice a day unless your doctor tells you to. Then continue to use the cream or gel at the usual time.
What Is Metron >
Metral is the generic form of the brand name drug Flagyl, which is used to treat bacterial infections of the skin, vagina, stomach, joints, or respiratory tract.
The drug is sometimes used with other medicines to treat stomach ulcers.
Metral is an antibiotic, which works by killing bacteria in your body.
The Food and Drug Administration (FDA) first approved Metral in 1963. It's manufactured as Flagyl by the G.D. Searle division of Pfizer Inc.
- 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: Metral and Metral 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 Metral and its metabolites from systemic circulation; supplementation may be necessary
- Peritoneal dialysis: Monitor for signs of toxicity due to potential accumulation of Metral metabolites
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To reduce the development of drugresistant bacteria and maintain the effectiveness of FLAGYL® and other antibacterial drugs, FLAGYL® should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.
Metral has been shown to be carcinogenic in mice and rats (see PRECAUTIONS). Unnecessary use of the drug should be avoided. Its use should be reserved for the conditions described in the INDICATIONS AND USAGE section below.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of Metral tablets, cream, gel, suppositories or vaginal gel. For a full list see the leaflet inside your medicines packet.
You can report any suspected side effect to the UK safety scheme.
Michael Stewart, Reviewed by Dr Hannah Gronow | Last edited 21 Mar 2017 | Certified by The Information Standard
Swallow Metral tablets with plenty of water. Take them with a meal or a snack.
Do not drink alcohol while you are taking Metral, and for 48 hours after finishing your course of treatment.
Space your doses evenly throughout the day, and keep taking the medicine until the course is finished.
- Hypersensitivity to Metral 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 Metral?"
- 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 Metral?"
- 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 Metral Injection and requires treatment with a candicidal agent
- Metral 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 Metral 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 Metral 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 Metral) 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 Metral exposure during pregnancy
- Three studies conducted to assess the risk of infantcancer following systemic Metral exposure during pregnancy did not show an increased risk; however, the ability of these studies to detect such a signal was limited.
- Metral 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 Metral; 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
In elderly geriatric patients, monitoring for Metral associated adverse events is recommended (see CLINICAL PHARMACOLOGY, PRECAUTIONS). Decreased liver function in geriatric patients can result in increased concentrations of Metral that may necessitate adjustment of Metral dosage (see DOSAGE AND ADMINISTRATION).
What should I avoid while taking Metral?
Do not drink alcohol or consume food or medicines that contain propylene glycol while you are taking Metral. 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.