Nidazyl 

Presentation: Nidazyl is available in tablet form, typically containing 200 mg or 400 mg of Metronidazole BP. Nidazyl is a product of Orion Pharma Ltd. in Bangladesh. It is also available as a suspension, with each 5 ml usually containing Benzoyl Metronidazole equivalent to Metronidazole BP 200 mg, in a 60 ml bottle.

Indications: Nidazyl (Metronidazole) is indicated for the treatment of various infections caused by anaerobic bacteria and protozoa, including:

• Prevention of post-operative infections due to anaerobic bacteria.
• Septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis, and post-operative wound infections caused by anaerobes. 
• Urogenital trichomoniasis.
• Bacterial vaginosis (non-specific vaginitis).
• All forms of amoebiasis (intestinal and extra-intestinal, including liver abscess and asymptomatic cyst carriers).
• Giardiasis. 
• Acute ulcerative gingivitis. 
• Anaerobically infected leg ulcers and pressure sores. 
• Acute dental infections due to anaerobic organisms. 
• Antibiotic-associated pseudomembranous colitis. 
• In combination therapy for the eradication of Helicobacter pylori in peptic ulcer disease.

Dosage and Administration: The dosage and duration of treatment with Nidazyl depend on the type and severity of the infection, as well as the patient's age and weight. It should be administered orally, usually with or after food to minimize gastrointestinal upset.

• Adults: The usual dose ranges from 200 mg to 800 mg two to three times daily for 5 to 10 days, depending on the infection. For specific conditions like trichomoniasis, a single dose of 2 g or a course of lower doses over several days may be prescribed.
• Children: Dosage is usually calculated based on body weight (e.g., 7.5 mg/kg three times daily). Specific dosages for different infections and age groups should be determined by a physician.

For the suspension, the dose should be measured using a suitable measuring device. Follow the physician's instructions carefully.

Side Effects: Common side effects of Nidazyl (Metronidazole) may include:

• Nausea, vomiting
• Diarrhoea
• Abdominal discomfort
• Metallic taste
• Furry tongue
• Headache
• Dizziness

Less common side effects may include:

• Drowsiness
• Insomnia
• Skin rash, itching
• Darkening of urine
• Rarely, reversible neutropenia or thrombocytopenia, and neurological symptoms like paraesthesia or seizures.

Consumption of alcohol should be avoided during and for at least 48 hours after treatment with Metronidazole due to the possibility of a disulfiram-like reaction (flushing, headache, nausea, vomiting).

Precautions: Nidazyl (Metronidazole) is contraindicated in patients with known hypersensitivity to Metronidazole or other nitroimidazole derivatives.

Caution should be exercised in patients with:

• Active central nervous system disorders (e.g., epilepsy).
• Severe hepatic impairment (dosage adjustment may be needed).
• Renal impairment (accumulation of metabolites may occur).
• History of blood dyscrasias.

Metronidazole may interact with certain medications, including warfarin (increased anticoagulant effect), lithium (increased lithium levels), phenytoin and phenobarbital (decreased Metronidazole levels), and disulfiram (psychotic reactions). Inform your doctor about all other medications you are taking.

Use in Pregnancy and Lactation: Metronidazole is classified as Pregnancy Category B by the US FDA. While animal studies have not shown teratogenic effects, adequate and well-controlled studies in pregnant women are lacking. It should be used during pregnancy only if clearly needed. Metronidazole is excreted in breast milk, and breastfeeding is not recommended during treatment and for 48 hours after the last dose.

Storage: Store Nidazyl tablets and suspension below 30°C, protected from light and moisture. Keep out of reach of children. Do not use after the expiry date. For the suspension, follow any specific storage instructions mentioned on the label, such as shaking well before use.

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.