Before taking Metrosept
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 Metrosept 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.
Symptoms of a Metrosept overdose may include:
- Loss of coordination or balance
- Numbness or tingling
If you suspect an overdose, contact a poison control center or emergency room immediately.
You can get in touch with a poison control center at 800-222-1222.
Other uses for this medicine
Metrosept tablets are used to treat bacterial vaginosis in women.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Case 1. Elevations in serum aminotransferase levels during intravenous Metrosept 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 Metrosept (500 mg every 6 hours) was added. He had rapid clinical improvement, but then complained of abdominal pain, nausea, headache, and a metallic taste. Metrosept 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 Metrosept.
Drug interaction overview
- Metrosept reported to potentiate anticoagulant effect of warfarin and other oral coumarin anticoagulants, resulting in a prolongation of prothrombin time and increased risk of hemorrhages; prothrombin time and international normalized ratio (INR) should be carefully monitored and anticoagulant dose adjusted accordingly; monitor patients for signs and symptoms of bleeding
- Metrosept reported to increase plasma concentrations of busulfan, which can result in an increased risk for serious busulfan toxicity such as sinusoidal obstruction syndrome, gastrointestinal mucositis, and hepatic veno-occlusive disease; Metrosept should not be administered concomitantly with busulfan unless benefit outweighs risk
- Simultaneous administration of drugs that decrease microsomal liver enzyme activity, such as cimetidine, may decrease metabolism and reduce plasma clearance of Metrosept which may result in Metrosept toxicity
- Simultaneous administration of drugs that induce microsomal liver enzyme activity, such as phenytoin or phenobarbital, may accelerate elimination of Metrosept and therefore decrease its efficacy
- Concomitant use of Metrosept and CYP3A4 substrates (e.g., amiodarone, tacrolimus, cyclosporine, carbamazepine, phenytoin, and quinidine) may increase respective CYP3A4-substrate plasma levels; monitoring of plasma concentrations of CYP3A4 substrates may be necessary
- Metrosept decreases clearance of 5-fluorouracil and may therefore cause 5-fluorouracil toxicity
- Metrosept may potentiate effects of vecuronium
Mixing Metrosept with herbal remedies and supplements
There are no known problems with taking herbal remedies and supplements alongside Metrosept. However, some remedies and supplements that come as liquids that you drink may also contain alcohol. Check the list of ingredients or ask the supplier or manufacturer.
There are published data from case-control studies, cohort studies, and 2 meta-analyses that included more than 5000 pregnant women who used Metrosept 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 Metrosept in utero; however, these findings were not confirmed
In addition, more than 10 randomized, placebo-controlled clinical trials that together enrolled over 5000 pregnant women assessed the possible effect of systemic antibiotic treatment (including with Metrosept) 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 Metrosept exposure during pregnancy
Three studies conducted to assess the risk of infant cancer following systemic Metrosept exposure during pregnancy did not show an increased risk; however, the ability of these studies to detect such a signal was limited
How should this medicine be used?
Metrosept comes as a tablet, an extended-release tablet, and as a capsule to take by mouth. Metrosept capsules and tablets are usually taken as a one-time dose (or divided into two doses on 1 day) or two to four times daily for up to 10 days or longer. Metrosept extended-release tablets are usually taken once daily at least 1 hour before or 2 hours after a meal for 7 days. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Metrosept exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the extended-release tablets whole; do not split, chew, or crush them.
Continue to take this medication even if you feel well. Do not stop taking it without talking to your doctor. If you stop taking this medication too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.
Why is Metrosept prescribed to patients?
- Flagyl is used to treat parasitic infections including Giardia infections of the small intestine, amebic liver abscess, and amebic dysentery (infection of the colon causing bloody diarrhea), bacterial vaginosis, trichomonas vaginal infections, and carriers of trichomonas (both sexual partners) who do not have symptoms of infection.
- Flagyl is also used alone or in combination with other antibiotics in treating abscesses in the liver, pelvis, abdomen, and brain caused by susceptible anaerobic bacteria.
- Flagyl is also used in treating infection of the colon caused by a bacterium called C. difficile. Many commonly-used antibiotics can alter the type of bacteria that inhabit the colon. C. difficile is an anaerobic bacterium that can infect the colon when the normal types of bacteria in the colon are inhibited by common antibiotics. This leads to inflammation of the colon (pseudomembranous colitis) with severe diarrhea and abdominal pain.)
- Flagyl also is used in combination with other drugs to treat Helicobacter pylori (H. pylori) that causes stomach or intestinal ulcers.
- Flagyl topical gel is used for treating acne rosacea.
- Flagyl vaginal gel is used for treating bacterial vaginosis.
How to use Metrosept 0.75 % Topical Gel
Use this medication on the skin only. Wash and dry your hands before and after applying this medication. Wash and dry the area to be treated. Wait 15 minutes, then apply a thin layer of medication usually once or twice daily, or as directed by your doctor. Wait 5 minutes before applying cosmetics.
Avoid using this medication around the eye area, unless directed by your doctor. Watery eyes or tearing of the eyes may occur if this medication is applied too close to the eyes. Avoid getting this medication in your eyes. If this occurs, rinse your eyes with large amounts of cool water.
Use this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day.
It may take about three weeks before any improvement is seen, and up to nine weeks for full benefit. If no improvement is seen after three weeks, consult your doctor.
Why is this medication prescribed?
Metrosept capsules and tablets are used to treat infections of the reproductive system, gastrointestinal (GI) tract, skin, heart, bone, joint, lung, blood, nervous system, and other areas of the body. Metrosept capsules and tablets are also used to treat sexually transmitted diseases (STDs). Metrosept extended-release (long-acting) tablets are used to treat bacterial vaginosis (an infection caused by too much of certain types of harmful bacteria in the vagina) in women. Metrosept is in a class of medications called nitroimidazole antimicrobials. It works by stopping the growth of bacteria.
Antibiotics will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.
What if I forget to use it?
If you forget to use Metrosept 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.
5. Cream or gel
When Metrosept 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 brand names are available for Metrosept?
- Flagyl and Flagyl ER are the available brand names for Metrosept in the US.
- Metro IV, Metromidol, Protostat, and Satric are brands names for Metrosept that have been discontinued in the US.