Hello. How correctly and how much should you take Metronidazole tablets to treat male and female trichomoniasis?
Answer from Valentina Aleksandrovna Levchenko (doctor)
Hello! Metronidazole successfully fights both trichomoniasis and trichomonas carriage, so it is usually prescribed to both sexual partners at the same time. Since the diagnosis of trichomoniasis is made solely on the basis of laboratory tests, the doctor prescribing Metronidazole has all the data to select the optimal treatment regimen.
It was not for nothing that I used the phrase “optimal scheme”, since there are several of them:
- For two weeks, take 2 tablets daily.
- The first two days, two tablets twice a day, then three tablets a day, the last 4 days - two tablets a day.
- For 5 days, take two tablets every 6 hours.
- The first day - three tablets every 6 hours, the second day - 2 tablets every six hours.
The indicated regimens are written for tablets with 250 mg of the active substance, but 500 mg are also available for sale, this must be taken into account. As for men and women, the dosage regimen is no different, but other factors are more related to age, concomitant diseases, general condition of the body, etc. play an important role when choosing a treatment option.
Unfortunately, I do not know your medical history and do not see the clinical picture of the disease in order to note which method would be most appropriate, so I recommend that you strictly follow the doctor’s instructions. If your sexual partner refuses to visit a doctor, but agrees to be treated (otherwise your treatment makes no sense), I would risk recommending to him the same regimen that will be prescribed to you.
Most sexually transmitted infections enter the body as a result of unprotected sexual intercourse. Among the most common is trichomoniasis. The correct choice of medication for trichomoniasis not only determines the success of treatment, but also reduces the risk of complications.
In the article we will tell you which drugs for treating trichomonas infection are most effective and what treatment regimen should be followed in order to cure the disease completely.
Ways to eliminate infection
Trichomoniasis is an infectious disease that occurs when the mucous membrane of the genital organs is damaged by the protozoan microorganism Trichomonas and is sexually transmitted. In the vast majority of cases, infection occurs due to direct contact with the pathogen during unprotected sexual intercourse.
The development of the disease occurs against the background of decreased immunity of the body and other infectious diseases of the genitourinary area.
As a result of infection, destruction of epithelial tissue occurs, multiple erosions, ulcers and inflammatory processes occur in the genitourinary organs.
Therefore, treatment of trichomoniasis in both men and women involves taking medications according to an individual regimen, taking into account the specifics of complications. The main objectives of treatment measures remain unchanged:
- The use of anti-trichomonas drugs for the complete elimination of infectious agents.
- Restoration of natural vaginal microflora.
- Normalization of the functions of the genitourinary organs.
- Prescribing medications to strengthen the immune system.
- Elimination of signs of the disease.
- Treatment of complications.
You should not self-medicate. Trichomonas are able to adapt to certain medications and provoke the development of a latent form of the disease, in which symptoms do not appear. It is better to let an experienced doctor determine how to treat trichomoniasis in each specific case.
The success of treatment depends not only on complex therapy; measures aimed at preventing reinvasion are considered an important component of treatment measures. The best way to prevent reinfection or spread of infection is to ensure that all sexual partners of the infected person are treated.
This condition must be met even if symptoms of the disease do not appear. Trichomonas carriage is often observed in men and does not exclude the possibility of infection of other people.
be careful
Among women: pain and inflammation of the ovaries. Fibroma, myoma, fibrocystic mastopathy, inflammation of the adrenal glands, bladder and kidneys develop.
Want to know what to do? To begin with, we recommend
Features of therapy
To determine how to treat a person infected with trichomoniasis, the doctor must take into account all the factors in the development of the disease - symptoms, duration of the pathology, the presence of additional infections in the body, complications that have arisen.
The choice of medications to eliminate Trichomonas in women involves preliminary pregnancy testing, since the infection can be transmitted to the child or lead to miscarriage. In addition, it matters whether the woman has been treated for infectious inflammation of the genitourinary system previously.
Do not self-medicate! At the first symptoms of the disease, immediately consult a doctor for medical help!
The consequences of Trichomonas infection are eliminated not only with medications; the optimal course of treatment involves various methods of influencing the infection:
- Droppers, injections, tablets.
- The use of local therapy - ointments, gels, suppositories.
- Rinsing the genitourinary organs with special solutions to cleanse them.
- Irrigation of the urethra.
- The use of membrane stabilizers for the regeneration of damaged epithelial cells.
- Physiotherapy.
- Taking drugs that increase vascular permeability.
- Prescribing vitamins and other medications to make therapy more effective.
The development of a comprehensive treatment regimen for trichomoniasis is provided by the attending physician. During the entire period of treatment and preventive measures, sexual contact and alcohol consumption are prohibited.
Tablets and injections to fight infection in women and men
The first and main stage of treating an infection is etiotropic therapy - the process of eliminating the cause of the development of pathology. Drugs are prescribed for the causative agents of trichomoniasis.
When choosing a medicine for oral administration, doctors prefer imidazole-based tablets. Metronidazole is considered an effective drug in this group.
The pharmacological action of Metronidazole is to influence pathogens of protozoal infections. The active substance of the drug penetrates the pathogenic cell and stops the division process.
Eliminating trichomoniasis in both men and women, including pregnant women, the drug has the ability to accumulate in the blood in a volume that is detrimental to trichomonas.
The use of the drug for trichomoniasis is especially effective in treating a fresh form of infection, but can be prescribed to eliminate acute and chronic forms.
Due to the physiological characteristics of the body, the treatment regimen for trichomoniasis in women involves the use of other types of drugs than in men.
Metronidazole vaginal suppositories are additionally used to treat trichomoniasis in women. Combination treatment regimens involve the simultaneous use of Metronidazole with other types of antibiotics.
Metronidazole is taken according to the following regimens:
- Day 1 – 2 tablets of 250 mg every 12 hours. Day 2 – one tablet every 8 hours. Over the next 4 days, the daily dose is 500 mg, which corresponds to taking one tablet every 12 hours.
- A single dose of 8 tablets (2 g) of the drug.
- 4 tablets every 12 hours for a week.
Which regimen is preferable is determined by the attending physician - in each specific case, methods and means of treatment may differ depending on the individual characteristics of the patient and the course of the disease.
Drugs for the treatment of trichomoniasis in men and women differ from each other!
Tiberal is characterized by increased absorption and is able to reduce the symptoms of the disease within three hours after administration.
Tiberal is indicated both for the treatment of trichomoniasis and for its prevention. During etiotropic therapy, Tiberal is taken twice a day, one tablet. To effectively treat trichomoniasis in women, Tiberal is combined with local treatment - vaginal suppositories.
Tinidazole is an antibacterial tablet for trichomoniasis in women and men. They provide an antiprotozoal effect by destroying the DNA structure of Trichomonas and inhibiting its synthesis.
Tinidazole tablets are taken only as prescribed by a doctor in accordance with one of the following regimens:
- Single dose: 4 tablets of 0.5 g each.
- Drink one 0.5 g tablet every 15 minutes for an hour.
- 0.15 g every 12 hours for a week.
Tinidazole is given to children at a dose of 50 mg per kg of child weight.
Along with this, trichomoniasis is treated with injections - their use significantly increases the effectiveness of therapy.
Ceftriaxone is the most commonly used broad-spectrum antibiotic for intramuscular administration.
Ceftriaxone belongs to the cephalosporin series of drugs and has an antimicrobial effect against anaerobic, aerobic, gram-positive and gram-negative microorganisms. For trichomoniasis, Ceftriaxone can be administered both intramuscularly and intravenously - by stream or drip.
Ceftriaxone is an effective remedy for trichomoniasis for men, as it quickly eliminates inflammatory processes in the prostate gland, providing tangible relief almost instantly. The dose for one injection is calculated by the attending physician, depending on the specifics of the pathology.
In case of a particularly complex course of the disease, Solcotrichovac is prescribed. The daily dose of intramuscular injection of the drug is 0.5 ml.
Specifics of local therapy
The use of local therapy provides an additional treatment effect, relieving the symptoms of pathology and preventing tissue destruction.
The list of effective medications for trichomoniasis infection in women includes:
- Vaginal suppositories Ornidazole. The regimen of use is a single daily administration for a week.
- Vaginal cream Clindamycin. Used to relieve inflammation in the vagina for 4 days.
- Intravaginal tablets Ginalgin.
- Vaginal tablets Klion-D.
Additional remedies for trichomoniasis for women are sitz baths with herbs, douching, and tampons soaked in a combination of urogyronine and chloramphenicol.
Given that male physiology differs from female physiology, some local therapy methods that are relevant for women are not available to men. Therefore, relevant manifestations of pathology in men are eliminated by introducing medicinal agents with an antibacterial effect into the urethra.
You can also use traditional medicine methods, but only as an additional treatment along with the main one!
In addition, in the treatment of inflammation of the male genitourinary system, the use of creams, ointments and gels is indicated - Clotrimazole, Hexicon, Metrogyl-gel.
Traditional medicine and homeopathy are not able to provide a lasting effect in eliminating the infection, but they can achieve temporary improvement during the acute development of the disease.
Trichomoniasis is an infectious disease transmitted primarily through sexual contact. It is caused by protozoa of the genus Trichomonas.
Metronidazole or Trichopolum is an antibacterial and antiprotozoal drug used in the treatment of trichomoniasis.
With trichomoniasis, immunity is not formed. Consequently, you can get sick with it more than once, although Trichomonas carriage also exists. The incubation period ranges from three to thirty days after questionable sexual intercourse.
Clinic of fresh trichomoniasis:
- foul-smelling yellowish discharge;
- painful process of urination;
- urine is cloudy, there may be flakes, foam;
- sometimes the frequency of urination increases, and blood is mixed in the urine;
- severe itching in the genitals, groin, thighs;
- redness of the external genitalia, thighs and groin area;
- Scratching and sometimes ulcers are also observed there.
At the same time, the torpid form occurs, that is, the symptoms are scanty or simply absent.
- triggers for exacerbation of chronic trichomoniasis:
- alcohol;
- sexual arousal and coitus;
- changes in vaginal pH;
- immunodeficiencies, including HIV;
- endocrine dysfunction of the gonads.
Complications of trichomoniasis:
- urethral stricture;
- acute prostatitis;
- neoplasms of the cervix;
- acute vesiculitis.
Diagnosis of trichomoniasis
Thus, it is easy to recognize infection with urogenital trichomonas even before laboratory tests. However, a venereologist usually prescribes the following laboratory tests:
- microscopy of native (live) urine samples, vaginal swabs, ejaculate, prostate secretions, smears from the urethra and cervix;
- microscopy of smears with Gram, Romanovsky-Giemsa or methylene blue staining.
Preparing for the study:
- discontinuation of antibiotics at least a week before sampling;
- Do not douche or wash in front of the fence;
- do not urinate three to four hours before the smear;
To analyze native preparations, slides should be immediately transferred to the laboratory within a maximum of two hours. Under microscopy, Trichomonas is a large cell in the shape of a pear or oval, with movable flagella. When stained, it is purple.
- PCR - polymerase chain reaction of the same biological preparations where Trichomonas DNA is detected;
- cultural method - germination of protozoan cultures, in particular Trichomonas, on nutrient media;
- serological tests, including RIF40 (rapid test), which detects antibodies to Trichomonas.
None of the diagnostic methods provides a 100% guarantee of accuracy. In men, Trichomonas is less detectable, since it is inactive in the urethra.
Sensitivity of Trichomonas to metronidazole
The cultural method is of particular importance when selecting treatment when culture is performed to determine the sensitivity of the pathogen to metronidazole or other drugs. The first experiments of this kind were carried out back in 1962, when the minimum effective concentration of metronidazole was 0.25-1 μg/ml. In the 90s, strains were discovered that required concentrations of 50 to 250 μg/ml.
And from 5% to 20% of Trichomonas were basically insensitive to Trichopolum. This phenomenon is based on the phenomenon of resistance or drug resistance. They say that it occurs when the pathogen is resistant to an inhibitory concentration of 15 mcg/ml.
To select an effective drug and its concentration, biological material is inoculated on Petri dishes. Covering part of the space with papers soaked in a solution of trichopolum in different concentrations, and then assessing the growth of colonies under them. Similar cultures are also carried out for sensitivity to other antiprotozoal drugs, namely:
- imorazole,
- chloroquine;
- nifuratel;
- tinidazole;
- McMiror;
- secnidazole;
- delagil.
The cultural method allows you to determine sensitivity to antiprotozoal drugs in vitro, that is, outside the patient’s body. It is very accurate, but has a significant drawback: it takes too long to complete. To monitor the effectiveness of treatment, the doctor must evaluate the dynamics of effectiveness more than once. Moreover, in the human body, that is, in vivo.
They focus on the standard time frame for the destruction of protozoa, prescribing smears several times on the first, third, fifth and seventh days of therapy. If trichomonas is not released from the second to the fifth day, then the pathogen is sensitive to the pharmaceutical drug.
Monitoring the effectiveness of treatment for trichomoniasis
Smears for microscopy of native and stained preparations and PCR, inoculation by cultural method are prescribed according to the following scheme:
- 10-14 days after the course of treatment (men, women);
- every month three times at the end of the cycle or after menstruation (women);
What is metronidazole
Metronidazole– Metronidazolum is a drug with antiprotozoal and antimicrobial activity. Capable of destroying protozoa, including Giardia, Gardnerella and Trichomonas.
Available in 250 mg tablets and may have the following trade names:
- metronidazole (from 14 rubles);
- trichopolum (from 83 rubles)
- trichosept (from 110 rubles)
- metronidazole nycomed (from 72 rubles)
- flagyl (from 109 rubles)
- Klion (from 62 rubles)
Metronidazole may additionally have the following dosage forms:
- solution for intravenous administration (100 ml bottle, with 5 mg of active substance);
- vaginal suppositories (500 mg, 250 mg, 125 mg);
- vaginal gel with applicator (tube contains 30.0 gel, 1.0 active ingredient);
- ointment and cream, 10 mg of active ingredient.
Metronidazole is a derivative of 5-nitroimidazole, which reduces the nitro group of the same name, which inhibits DNA synthesis in protozoa. This contributes to their destruction. Amoxicillin or aminocaproic acid eliminates immunity to metronidazole. Therefore, they are prescribed to adults simultaneously. Metronidazole also increases sensitivity to radiation of tumors, stimulates healing, and is even used in the treatment of alcoholism. Penetrating through the placental and blood-brain barriers, the drug is well absorbed and penetrates almost all organs and tissues.
If taking Trichopolum lasts more than a week, a clinical blood test is necessary. A decrease in the number of leukocytes serves as a sign to discontinue Trichopolum. Also, long-term use of metronidazole sometimes contributes to a false-positive diagnosis of syphilis (Nelson serum test).
In addition to trichomoniasis, it is used for the following diseases:
- giardiasis;
- intestinal and extraintestinal amebiosis;
- cutaneous leishmaniasis;
- pneumonia;
- osteomyelitis;
- giardiasis;
- sepsis;
- bacterial endocarditis;
- pseudomembranous colitis;
- empyema and lung abscess;
- liver abscess;
- peritonitis;
- radiation therapy for oncology;
- meningitis;
- purulent salpingo-oophoritis (including with an abscess);
- endometritis;
- gastrointestinal ulcers;
- alcoholism;
- prevention of postoperative complications during operations on the intestines and pelvic organs.
Contraindications to taking metronidazole;
- liver and kidney failure;
- lactation;
- leukopenia;
- epilepsy and severe organic lesions of the nervous system;
- pregnancy (1st trimester);
- allergy to metronidazole.
Trichopolum is prescribed to pregnant women carefully, keeping in mind its ability to penetrate the placental barrier. The reasons for prescribing in the second and third trimesters are carefully weighed. During the period of embryo formation, it is absolutely contraindicated.
How to take metronidazole?
Indications (cream, ointments):
- rosacea, acne;
- bacterial vaginosis;
- trophic ulcers and chronic wounds;
- demodicosis (skin mite);
- wounds and trophic ulcers that do not heal for a long time;
- with demodicosis;
- other indications for taking trichopolum.
Side effects– these are those pathological conditions that were detected while taking the drug in the experiment. The list of them is very long, but in practice this happens rarely, more often in case of overdose:
- diarrhea;
- dry mouth;
- refusal to eat;
- nausea;
- constipation;
- taste of metal and;
- vomit;
- confusion;
- ataxia;
- asthenia;
- dizziness;
- ataxia;
- polyneuropathy;
- insomnia;
- leukopenia;
- cephalgia;
- convulsive syndrome;
- hallucinations;
- flattening of the T wave;
- neutropenia;
- irritability or low mood;
- polyuria and dysuric syndrome.
There may be a temporary change in urine color to red-brown.
Complications of taking metronidazole They are rare, but their list includes:
- stomatitis;
- pancreatitis;
- intestinal colic;
- glossitis;
- cystitis;
- urinary incontinence;
- candidiasis;
Allergic reactions occurred in the form of urticaria, flushing, joint pain, nasal congestion and fever.
In combination with alcohol it causes poisoning: flushing of the face, intoxication, dyspepsia. The table shows the features of the interaction of metronidazole with other pharmaceuticals.
Table No. 1. Interaction of metronidazole with other drugs
|
Pharmaceutical drug |
Action |
Notes |
|
Indirect coagulants: Fenindione, Warfarin, Diphenindione, Anisindione, Warfarex, Sinkumar |
Potentiates the effect of anticoagulants, increasing prothrombin time |
Tendency to bleed |
|
Ethanol, ethyl alcohol |
Intolerance: Cramps (abdomen), cephalalgia, lightheadedness, vomiting, flushing, nausea |
Used in the treatment of alcoholism |
|
Disulfiram |
Neurological complications |
Pause for at least half a month |
|
Cimetidine |
Suppresses the elimination of metronidazole by increasing the accumulated dose |
Risk of side effects and complications |
|
Phenobarbital, Phenytoin |
Accelerates the metabolism of metronidazole |
|
|
Lithium preparations: Lithium oxybutyrate, Nicotinate, Oxybate Carbonate, Succinate, |
Increases the concentration of lithium drugs |
Reduction of lithium dosage required |
|
Vecuronium bromide and non-polarizing muscle relaxants |
antagonism |
Do not take together |
|
Sulfonamides: Biseptol, Sulfadimethoxine, Etazol, Sulfadimizine, Sulfurea, Sulfamethizole |
Potentiate the effect of trichopolum as an antibiotic |
|
|
Amoxicillin |
Suppresses resistance to metronidazole |
Do not administer to people under 18 years of age |
Terms of sale and storage.
Metronidazole is sold by prescription. Tablets should be kept in a dry, dark place, at a temperature of no more than 25 degrees, shelf life is 2 years. Keep away from children and elderly people
Treatment of urogenital trichomoniasis
The drug of choice for the treatment of trichomoniasis is metronidazole. To confirm the effectiveness of the prescription, a cultural method is used, that is, culture for sensitivity to metronidazole. Trichomonas is sensitive to nitroimidazole drugs.
The main treatment regimen with metronidazole for urogenital trichomoniasis:
- Orally, 250 mg (1 tablet) twice a day for 5 days.
- Orally, 500 mg (2 tablets once) per day for 5 days
- Orally, 500 mg (2 tablets) 2 times a day for 2 days
Metronidazole for trichomoniasis in women is prescribed not only in tablets, but also topically, in suppositories.
After 3-4 weeks, control tests are performed, and if treatment is insufficiently effective, therapy can be repeated.
Features of metronidazole dosage:
- “Loading dose” - 1.0 (4 tablets) once, for both partners.
- children from 2 to 5 years: 250 mg (1 tablet per day), 100 mg twice a day. 3 days;
- children from 5 to 10 years: 375 mg/day (1.4 tablets), 125 mg twice or thrice a day, week;
- children over 10 years old – 500 mg per day (2 tablets), 7 days;
- Pregnant women (starting from 13 weeks) once, with a loading dose, only if there are absolute indications.
If kidney function decreases, the daily dose should be halved.
Alternative treatment regimens for urogenital trichomoniasis
Tinidazole:
- 1.0 orally, once
- 500 mg twice a day, 2 days
- 250 mg twice a day, 3 days
- 1.0 g 1 time per day for 2 days (severe course)
Ornidazole:
- 500 mg 2 times a day, course - 5 days (severe course)
- 250 mg, twice a day, 2 days
Ornidazole is the only drug against Trichomonas that is compatible with ethyl alcohol.
Secnidazole 1.0 once, efficiency 99.9%.
Nimorazole according to the scheme: 1 day - 1.0; Days 2 and 3 - 250 mg; Day 4 - 500 mg.
In case of recurrent course of chronic trichomoniasis
Solko-trikhovak(therapeutic vaccine) 0.5 ml intramuscularly, three times, every 2 weeks, and once a year after the end of treatment.
Comparative characteristics of the effectiveness of antiprotozoal drugs for trichomoniasis
Compared to alternative drugs, metronidazole benefits due to its broad spectrum of action and cost-effectiveness. Secnidazole is considered the most effective, and Ornidazole, while somewhat less effective, does not require giving up alcohol. In published studies, metronidazole (40.4%) has the lowest effectiveness, and ornidazole (93.3%) and secnidazole (99.9%) have the highest. Side effects occurred when taking Metronidazole in 23% of cases, nimorazole in 12%, and ornidazole in 9%. Trichomonas are especially sensitive to metronidazole (45%), atrican (84%) and ornidazole (73%).
The maximum clinical result is achieved with sequential administration of ornidazole and tenonitrozole.
When treating urogenital trichomoniasis, the following rules should be observed:
- simultaneous treatment of partners;
- refusal of sex during treatment;
- abstinence from alcohol during treatment;
- completing the course of treatment even in the absence of symptoms;
- control tests 10 days after the end of therapy and after 2 menstrual cycles.
Resistance to drugs for the treatment of trichomoniasis
Resistance to antiprotozoal drugs or drug resistance occurs in the following cases:
- the formation of resistant strains of trichomonas with long-term use of the drug in the population;
- self-medication;
- self-discontinuation of the drug (chronicity of infection);
- disruption of cell transport.
So, according to science, 35-45% of trichomonas are sensitive to metronidazole, and 55% are sensitive to tinidazole. Therefore, alternative regimens of new drugs to which the pathogen has not yet developed resistance are used. Also, to overcome resistance, increased concentrations, that is, higher doses of drugs, are used. Also, to overcome resistance, amoxycycline and aminocaproic acid are prescribed together with metronidazole.
Metronidazole for trichomoniasis: questions for a venereologist
What to do if metronidazole does not help with trichomoniasis?
This happens when the pathogen strain is resistant to metronidazole. In this case, either increase the dose or use alternative treatment regimens. Recovery cannot be achieved if only one person in a couple receives treatment. If sexual relations continue, the patient becomes infected again. If metronidazole is discontinued prematurely, even if there are no more symptoms of the disease, trichomoniasis becomes chronic.
How quickly do symptoms go away with treatment?
Usually, after one or two days, the symptoms of trichomoniasis disappear, but this does not mean a complete cure.
Is it possible to take Trichopolum during pregnancy and HIV?
The presence of HIV infection does not in any way affect the course of treatment for trichomoniasis; medications are prescribed as usual. During pregnancy, metronidazole should not be taken in the first trimester, and even then it is better to abstain from this drug
Where to go for treatment?
Treatment of trichomoniasis is carried out by a venereologist at a dermatovenereal dispensary or a private clinic of the appropriate profile.
For effective treatment of trichomoniasis with metronidazole, contact the author of this article, a venereologist in Moscow with many years of experience.
Instructions
"Metronidazole" is prescribed for the following indications: infections of the abdominal cavity, pelvic organs, vaginal vault, soft tissues and skin, sepsis, gastritis or ulcers caused by Helicobacter pylori, protozoal infections (intestinal amebiasis, balantidiasis, extraintestinal amebiasis, trichomoniasis, trichomonas vaginitis, giardiasis, cutaneous leishmaniasis, trichomonas urethritis), infections of bones, joints, central nervous system, pneumonia, bacterial endocarditis, empyema and lung abscess, pseudomembranous colitis associated with antibiotics.
The drug tablets should be taken after meals. To treat trichomoniasis, take 2 tablets twice a day for 10 days. At the same time, 2 suppositories are used intravaginally in the morning and evening. It is recommended to start using suppositories at the beginning of the menstrual cycle. Douching should be avoided during this period. If necessary, the course of treatment for trichomoniasis is repeated after 1 month. It is necessary to treat both partners simultaneously.
Children are prescribed the following daily doses: at the age of 2-5 years - 250 mg, from 5 to 10 years - 250-375 mg, from 10 years - 500 mg. The specified amount is divided into two doses. The course of therapy is 10 days. To treat giardiasis, adults need to take 500 mg twice a day for 5-7 days. Children under one year of age are given 125 mg per day, from 2 to 4 years old - 250 mg, from 5 to 8 years old - 375 mg, from 8 years old - 500 mg. The frequency of use is 2 times, the course of treatment is 5 days. At the end of therapy, a control study is prescribed after 2-3 months to determine the completeness of the cure.
For amebiasis, the daily amount of the drug is 1-1.5 g in 2-3 doses, the duration of use is 5-10 days. For acute amoebic dysentery, 2.25 g is prescribed in 3 divided doses. The dose for children is 1/4–1/2 the adult dose. To treat diseases caused by Helicobacter pylori, take 500 mg 3 times a day for a week (as part of a combination treatment).
Metronidazole is contraindicated in case of organic lesions of the central nervous system, liver failure, leukopenia, in the 1st trimester of pregnancy, hypersensitivity to components. The drug may cause the following side effects: diarrhea, constipation, nausea, vomiting, dry mouth, pancreatitis, dysuria, cystitis, urinary incontinence, polyuria, candidiasis, impaired coordination of movements, dizziness, depression, irritability, confusion, increased excitability, allergic reactions .
Metronidazole for trichomoniasis allows for effective treatment of a sexually transmitted disease. The drug has a detrimental effect on the causative agent of the disease (Trichomonas), and deprives it of the ability to continue life.
General information and benefits of metronidazole
Metronidazole belongs to the group of antiprotozoal and antimicrobial drugs with a broad spectrum of action. The main active ingredient of the drug (metronidazole) has a destructive effect on the DNA of bacterial cells, inhibits protein synthesis, thereby leading to the death of pathogens.
The product is available in tablet form, as a solution for injection and vaginal suppositories. May also be prescribed in the form of other medicines:
- Kliona;
- metrogyla;
- nobody
Metronidazole is considered a fairly mild medicine. However, its use should be avoided in patients with epilepsy, brain tumors, and liver failure.
How to take and dosage for trichomoniasis
The treatment regimen with metronidazole is selected individually in each specific case. The tablets should be taken only after meals. Failure to comply with this point significantly increases the likelihood of developing side effects of the drug.
The following are common ways to take metronidazole:
| Duration of admission | Dosage |
| 1 day | 2 g once |
| 3 days | 2 g daily |
| 5 days | 0.5 g four times a day |
| 7 days | 500 mg twice daily |
| 7 days | 1 g morning and evening |
| 10 days | 0.25 g twice throughout the day |
According to the instructions, the drug can be used in another way - 0.25 mg three times a day for 4 days. From days 5 to 8, the same dose is reduced to two doses. Simultaneously with taking the tablets, it is recommended to use hepatoprotectors that protect the liver. Metronidazole in the form of vaginal tablets is used once a day for a 6-day course.
In more than 90% of cases, in patients who completed a full course of metronidazole therapy, after 4 weeks there was a complete disappearance of unpleasant symptoms and traces of the causative agent of trichomonas infection in the blood.
Is it effective for chronic trichomoniasis?
In the chronic form of trichomoniasis, characterized by a protracted course and mild symptoms, the drug is used for intravenous drip administration. In this case, it will take 6 to 10 days to heal.
A single injection will require 500 metronidazole. The procedure should last for 20 minutes. Between sessions it is necessary to maintain a time interval of at least 8 hours.
To avoid the development of a fungal infection, the medicine should not be mixed with other medications.
With drip administration of metronidazole, there is a possibility of developing leukopenia, which requires periodic monitoring of the patient’s blood condition. After drips, it is possible to develop such phenomena as deterioration of coordination and weakening of attention, and therefore, immediately after the procedure, it is recommended to refrain from driving vehicles or high-precision mechanisms.
Metronidazole during pregnancy
Trichomoniasis during pregnancy poses a threat to the unborn fetus if the infection in the mother’s body is mixed. In this case, simultaneously with trichomonas, chlamydia, ureaplasma, gonococci, etc. can be detected in the patient’s blood.
Metronidazole is contraindicated in the first trimester of pregnancy and the lactation period. Starting from the 4th month of gestation, it can be used in case of acute disease, but requires constant monitoring by an obstetrician-gynecologist. During this period, it is recommended to use forms of the drug intended for vaginal administration. If all instructions are followed, no toxic effects on the fetus are observed, embryonic development is not disrupted, and the child is born completely healthy.
The last trimester of pregnancy is considered the safest period for treatment with metronidazole. In the remaining weeks of gestation, the medicine can be prescribed in any form, since the risk of complications becomes minimal.
Despite the relative harmlessness of metronidazole in the second and third trimesters, many experts prescribe this drug only in extreme cases.
At any stage of gestation, one-day therapy with this drug is completely contraindicated, since a high concentration of the active substance in the blood plasma can penetrate into the fetus’s body.
Dosage for pregnant women
Most often, pregnant women are prescribed metronidazole tablets, which allow them to quickly achieve the desired therapeutic effect. The dosage in this case will be as follows:
- Chronic form of trichomoniasis - 250 mg (1 tablet) twice a day for a 10-day course.
- Acute course of the disease - the dose remains the same, but treatment is shortened to 8 days and supplemented with the introduction of vaginal suppositories.
If during therapy a woman experiences discomfort in the digestive tract, it is recommended to switch from using the tablet form to using suppositories.
Drug price
Metronidazole is one of the available drugs. Various dosage forms of the product have the following costs:
- 20 tablets of 250 mg – $41;
- 20 tablets of 500 mg – $16;
- 10 vaginal suppositories 500 mg – $72;
- solution for intravenous administration 100 ml – $4.
In most pharmacies, this medicine can be purchased without a doctor's prescription.
