metronidazole (cont.)
DRUG INTERACTIONS: Alcohol should be avoided because metronidazole and
alcohol together can cause severe nausea, vomiting, cramps, flushing, and
headache.
Metronidazole can increase the blood thinning effects of warfarin (Coumadin)
and increase the risk of bleeding probably by reducing the break down of
warfarin.
Cimetidine (Tagamet) increases blood levels of metronidazole while
cholestyramine reduces blood levels of metronidazole by reducing its absorption.
Metronidazole should not be combined with amprenavir for treating human
immunodeficiency disease (infection with HIV) because amprenavir contains
propylene glycol. Metronidazole blocks the breakdown of propylene glycol in the
liver leading to accumulation of propylene glycol in blood. Accumulation of
propylene glycol could cause seizures, increased heart rate, and lead to kidney
failure.
Metronidazole increases the blood levels of carbamazepine, lithium and
cyclosporine though unknown mechanisms. Serious reactions may occur if these
drugs are taken with metronidazole.
PREGNANCY: Metronidazole is not used in early
pregnancy because of potential
adverse effects on the fetus.
NURSING MOTHERS: Metronidazole is excreted in breast milk. Nursing mothers,
because of potential adverse effects on the newborn, should not use
metronidazole.
SIDE EFFECTS: Metronidazole is a valuable antibiotic and is generally well
tolerated with appropriate use. Minor side effects include nausea, headaches,
loss of appetite, a metallic taste, and rarely a rash. Serious side effects of
metronidazole are rare. Serious side effects include seizures and damage of
nerves resulting in numbness and tingling of extremities (peripheral
neuropathy). Metronidazole should be stopped if these symptoms appear.
Reference: FDA Prescribing Information
Last Editorial Review: 7/11/2007
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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