Clinical medicine profile
Metronidazole / Diloxanide
Nitroimidazole antimicrobial / antiprotozoal
- Route
- ORAL / IV / TOPICAL / VAGINAL
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Hypersensitivity to nitroimidazoles.
- First trimester use traditionally avoided unless essential (practice evolving — follow current obstetric guidance).
- Disulfiram within 2 weeks.
Precautions
- Avoid alcohol during and for 24–72 h after (disulfiram-like reaction).
- Neurologic toxicity with prolonged/high dose (neuropathy, seizures).
- Metallic taste common.
- Dark urine possible.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
tabs TID x 5/7 [10/7 in refractory cases]. Children 5-12 years; 12 tab or 10mL TID x 5/7.Children below 5 years: 5mL TIDx5/7.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Metabolites accumulate in renal failure; review dosing in ESRD.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Hepatic metabolism — reduce dose in severe liver disease.
Use, effects & interactions
Indications
- Diloxanide furoate is active against the cystic form of amoeba.
- Hence the combination is effective in all forms of amoebiasis.
- Clinical selection for Metronidazole / Diloxanide should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Nitroimidazole antimicrobial / antiprotozoal.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- GI discomfort, anorexia, metallic taste, dry mouth, headache, skin rash, vertigo, depression, insomnia, drowsiness, urethral dis- comfort, darkened urine, transient fall in BP, temporary leucopenia, bone marrow depression, transient epileptic seizure, furred tongue.
Drug interactions
Open multi-drug checker ↗- Cornerstone for anaerobic coverage and protozoa (giardia, amoeba, trichomonas).
- Combine with other agents for mixed aerobic–anaerobic infections as indicated.
- Warn every patient about alcohol.
Mechanism & disposition
Metronidazole and other imid- azole are selective for anaerobic bacteria due to their ability to intracellularly reduce imidazole which covalently binds to DNA, disrupt its heli- cal structure, inhibiting bacterial nucleic acid synthesis.
Read complete mechanism
Metronidazole and other imid- azole are selective for anaerobic bacteria due to their ability to intracellularly reduce imidazole which covalently binds to DNA, disrupt its heli- cal structure, inhibiting bacterial nucleic acid synthesis. The mode of action of diloxanide is unknown but it may inhibit protein synthesis.
1–2 hours
8–24 hours
ORAL / IV / TOPICAL / VAGINAL
including abscesses and CSF. Hepatic
Pregnancy, lactation & diet
Widely used in later pregnancy for BV/trichomoniasis in many protocols; avoid unnecessary first-trimester exposure — follow current guidance.
Single-dose regimens often compatible with pumping/timing advice; prolonged high dose — review.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.