Metrobac IV 

Presentation: Metrobac IV is a sterile solution for intravenous infusion containing Metronidazole BP.

Indications:Metrobac (Metronidazole) administered intravenously is indicated for the treatment of serious infections caused by susceptible anaerobic bacteria and protozoa, including:  

• Septicaemia, bacteraemia  
• Peritonitis, intra-abdominal abscess  
• Brain abscess  
• Pelvic infections (endometritis, tubo-ovarian abscess, post-operative gynaecological infections)  
• Post-operative wound infections  
• Pneumonia, empyema, lung abscess
• Bone and joint infections  
• Skin and soft tissue infections  
• Dental infections (severe cases)  
• Prevention of post-operative infections in contaminated or potentially contaminated surgery (especially colorectal, gynaecological, and oral surgery)
• Treatment of antibiotic-associated pseudomembranous colitis caused by Clostridium difficile

Dosage and Administration: Metrobac IV is administered by slow intravenous infusion, usually over a period of 20-30 minutes for the 100 ml bag, or longer for larger volumes. The dosage and duration of treatment depend on the type and severity of the infection, as well as the patient's age, weight, andrenal function.Administration should be carried out by a healthcare professional.

Typical adult dosage regimens may include:

• Treatment of anaerobic infections: A loading dose of 15 mg/kg infused over one hour, followed by 7.5 mg/kg every 6 hours, not exceeding 4 g per 24 hours.
• Surgical prophylaxis: A single dose of 15 mg/kg infused over 30-60 minutes, completed one hour prior to surgery.
• Pseudomembranous colitis:500 mg every 8 hours.  

Dosage adjustments may be necessary in patients with severe renal impairment (reduce dose or increase dosing interval) and severe hepatic impairment (reduce daily dose). The duration of treatment usually ranges from 7 to 10 days, but may be longer depending on the infection.

Side Effects: Side effects associated with Metrobac (Metronidazole) intravenous infusion may include:

• Nausea, vomiting  
• Abdominal pain
• Diarrhoea  
• Metallic taste  
• Headache  
• Dizziness  
• Phlebitis or thrombophlebitis at the infusion site Less common side effects can include:
• Seizures  
• Peripheral neuropathy (numbness or tingling in the extremities)
• Encephalopathy (brain disorder)
• Optic neuropathy
• Allergic reactions (rash, itching, urticaria)  
• Reversible neutropenia (low white blood cell count)
• Elevated liver enzymes

Alcohol should be avoided during treatment with Metrobac IV and for at least 24 hours after the last dose due to the possibility of a disulfiram-like reaction (flushing, headache, nausea, vomiting, abdominal cramps).

Precautions:Metrobac (Metronidazole) is contraindicated in patients with known hypersensitivity to metronidazole or other nitroimidazole derivatives.Caution should be exercised in patients with:

• Active or a history of central nervous system disorders (e.g., epilepsy).
• Severe hepatic impairment.
• Blood dyscrasias.
• Cockayne syndrome (risk of severe irreversible hepatotoxicity/acute liver failure).  

Metronidazole can interact with several other medications, including warfarin (increased risk of bleeding), lithium (increased lithium toxicity), phenytoin and phenobarbital (decreased metronidazole levels), and cimetidine (increased metronidazole levels).Inform your doctor about all other medications you are receiving. Prolonged use should be undertaken with caution and with appropriate monitoring for potential neurological side effects.

Use in Pregnancy and Lactation: Metronidazole should be used during pregnancy only if clearly needed and the potential benefits outweigh the possible risks to the foetus. Metronidazole is excreted in human milk in concentrations similar to those found in maternal plasma. Breastfeeding is not recommended during treatment with Metrobac IV and for a period after the last dose, as advised by your doctor.

Storage:Store Metrobac IV infusion according to the manufacturer's instructions, usually at room temperature (not exceeding 30°C) and protected from light.Do not freeze. Once the infusion bag or bottle is opened, it should be used promptly, and any remaining solution should be discarded. Keep out of reach of children.

Important Note: This information is for general knowledge and informational purposes only, and does not substitute professional medical advice. Always consult your doctor or pharmacist for specific instructions and guidance regarding your medication. They can assess your individual medical condition and provide the most appropriate advice.