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Metronidazole

  • Brand Name : Flagyl Injection
  • Drug Class : Nitroimidazoles, Vaginal Preparations, Other, Antibiotics, Other, Cephalosporins, Other, Antibacterials, Topical
  • Medical Author : John P. Cunha, DO, FACOEP
  • Medical Reviewer :
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What Is Metronidazole and How Does It Work?

Metronidazole is used to treat a certain type of vaginal infection (bacterial vaginosis) in women who are not pregnant. Metronidazole is an antibiotic that works by stopping the growth of bacteria.

Metronidazole is available under the following different brand names: Flagyl, Flagyl ER, and Flagyl IV RTU.

What Are the Dosages of Metronidazole?

Dosage of Metronidazole:

Adult and Pediatric Dosage Forms and Strengths

Capsule

  • 375mg

Tablet

  • 250 mg
  • 500 mg

Tablet, extended-release

  • 750 mg

Infusion solution

  • 500 mg/100mL

Dosage Considerations – Should be Given as Follows:

Anaerobic Bacterial Infections

  • Loading dose: 15 mg/kg intravenously (IV); not to exceed 4 g/day
  • Maintenance dose: 7.5 mg/kg oral/intravenous (IV) (over 1 hour) every 6 hours x 7-10 days (or 2-3 weeks if severe)

Sexually Transmitted Disease

Bacterial Vaginosis

  • Non-pregnant women
    • 500 mg orally twice daily x 7 days, OR
    • 2 g orally once/day single dose, OR
    • Extended-release: 750 mg orally once/day x 7 days
  • Pregnant women
    • 500 mg orally twice daily x 7 days, OR
    • 250 mg orally three times/day x 7 days

Colorectal Surgical Infection

  • Prophylaxis; start after mechanical bowel preparation the afternoon and evening before surgery
  • 1 g orally every 6-8 hours for 3 doses
  • 15 mg/kg IV over 30-60 min; complete approximately 1 hour before surgery; may administer 7.5 mg/kg IV over 30-60 min at 6 and 12 hours after initial dose for maintenance; discontinue within 12 hours after surgery

Trichomoniasis

  • Adult: 250 mg orally every 8 hours for 7 days; alternatively, 375 mg orally every 12 hours for 7 days
  • 2 g orally once daily single dose; alternatively, 1g orally every 12 hours for 2 doses
  • Pediatric: less than 45 kg body weight: 15 mg/kg/day IV/oral divided every 8 hours for 7 days; not to exceed 2 g/day

Amebiasis

  • Adult: 500-750 mg orally every 8 hours for 5-10 days
  • Pediatric: 35-50 mg/kg orally divided once every 8 hours for 10 days

Giardiasis (Off-label)

  • Adult: 500 mg orally every 12 hours for 5-7 days
  • Pediatric: 15 mg/kg/day IV/oral divided once every 8 hours for 5 days

Gardnerella Infection

  • Immediate release: 500 mg orally every 12 hours
  • Extended-release: 750 mg orally once daily for 7 days; take on empty stomach

Helicobacter Pylori Infection (Off-label)

  • Adult: 250-500 mg orally four times daily in combination with tetracycline (500 mg) and bismuth subsalicylate (525 mg) x 14 days
  • Pediatric: With amoxicillin and bismuth subsalicylate: 15-20 mg/kg/day oral divided once every 12 hours for 4 weeks

Nongonococcal Urethritis (Off-label)

Pelvic Inflammatory Disease (Off-label)

Pouchitis (Orphan)

Orphan indication sponsor

  • Formac Pharmaceuticals, NV; Gaston Geenslaan 1; Belgium

Crohn’s Disease (Orphan)

  • Topical treatment of active perianal Crohn’s disease
  • Orphan indication sponsor
    • Braintree Laboratories, Inc; 60 Columbian Street West; PO Box 850929; Braintree, MA 02185-0929

Perioral Dermatitis (Orphan)

  • Orphan indication sponsor
    • Galderma Laboratories, Inc; P.O. Box 331329; Fort Worth, TX 76163

Neonatal (younger than 28 Days) Anaerobic Infection

Less than 1.2 kg

  • 7.5 mg/kg IV/oral every 48 hours

Younger than 7 days

  • 1.2-2 kg: 7.5 mg/kg IV/oral once/day
  • greater than 2 kg: 15 mg/kg/day IV/oral divided every 12 hours

Older than 7 days

  • 1.2-2 kg: 15 mg/kg/day IV/oral divided every 12 hours
  • every 12 hours 2 kg: 30 mg/kg/day IV/oral divided every 12 hours

Infants and Children

  • 30 mg/kg/day oral/IV divided every 6 hours; not to exceed 4 g/day

Clostridium Difficile Colitis – Pediatric

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