Headache metronidazole

Convulsive seizures, headache, nausea, and peripheral neuropathy (numbness and tingling of the extremities) have been reported with the use of metronidazole... 

Concomitant intake of alcohol and metronidazole is potentially dangerous, leading to a disulfiram-like type reaction characterised by intense vasodilatation, throbbing headache, tachycardia and sweating which can lead to death. 

Metronidazole is an antiprotozoal agent that, if taken concomitantly with alcohol, may result in a disulfiram-like reaction characterised by intense vasodilation, headache, tachycardia, sweating and vomiting. 

Oral bioavailability is almost 100%. Metronidazole is protein bound for less than 20% and is widely distributed, including the CNS. It is metabolized in the liver with an elimination half-life of 8 hours. Common adverse effects include nausea, headache and taste disturbances. With alcohol a severe disulfiram-like reaction, with flushing, sweating and abdominal cramps will occur. 

Oxidation of acetaldehyde is inhibited by disulfiram, a drug that has been used to deter drinking by alcohol-dependent patients undergoing treatment. When ethanol is consumed in the presence of disulfiram, acetaldehyde accumulates and causes an unpleasant reaction of facial flushing, nausea, vomiting, dizziness, and headache. Several other drugs (eg, metronidazole, cefotetan, trimethoprim) inhibit ALDH and can cause a disulfiram-like reaction if combined with ethanol. 

Emtricitabine NRTT1 200 mg daily3 Oral solution should be refrigerated Headache, diarrhea, nausea, asthenia, skin hyperpigmentation Do not administer concurrent lamivudine. Avoid disulfram and metronidazole with oral solution... 

Fosamprenavir PI2 1400 mg bid or 700 mg bid with ritonavir 100 bid or 1400 mg daily with ritonavir 100-200 mg daily. Adjust dose in hepatic insufficiency Separate dosing from antacids by 2 h. Avoid concurrent high-fat meals Diarrhea, nausea, vomiting, hypertriglyceridemia, rash, headache, perioral paresthesias, t liver enzymes See footnote 4 for contraindicated medications. Do not administer with lopinavir/ritonavir or in severe hepatic insufficiency. Also avoid cimetidine, disulfiram, metronidazole, vitamin E, ritonavir oral solution, and alcohol when using the oral solution... 

Lopinavir/ritonavir PI/PI2 400 mg/100 mg bid or 800 mg/200 mg daily. May need dose adjustment in hepatic insufficiency Take with food. Separate dosing from ddl by 1 h. Store capsules and solution in refrigerator Diarrhea, abdominal pain, nausea, hypertriglyceridemia, headache, t liver enzymes, See footnote 4 for contraindicated medications. Also avoid fosamprenavir. Avoid disulfiram and metronidazole with oral solution... 

Carnidazole is an imidazole derivative, less potent than most other similar compounds (1). In early studies, its adverse effects were mild nausea and vomiting, abdominal discomfort, dry mouth, dizziness, headache, and tiredness were reported (SEDA-6,264). Metronidazole-Uke adverse effects should be anticipated. 

The DU-MACH study assessed the efficacy of two omeprazole-based triple therapies (omeprazole, amoxicillin, clarithromycin versus omeprazole, metronidazole, clarithromycin) given for 1 week to 149 patients for eradicating H. pylori, healing duodenal ulcers, and preventing ulcer relapse over 6 months after treatment (4). Both regimens achieved high eradication rates (about 90%) and were well tolerated. Adverse effects were similar in the two groups, and included diarrhea, taste disturbance, headache, nausea, and dyspepsia. 

Ranitidine 300 mg bd and omeprazole 20 mg bd have been compared as components of triple therapies (combining them with either amoxicillin plus clarithromycin or amoxicillin plus metronidazole) in 320 patients with H. pylori (5). Omeprazole and ranitidine combined with two antibiotics for 1 week were equally effective in eradicating H. pylori. This result questions the role of profound acid suppression in eradication. There was no difference in the reported adverse effects, which included nausea, vomiting, diarrhea, metallic taste, skin rashes, and headache. 

Central nervous system symptoms can occur with standard doses of metronidazole, but they are mainly seen with high doses and especially when such doses are given for a long time. Under the latter conditions, there was a 25% incidence of such sjmptoms as headaches, dizziness, tremor, ataxia, and confusion. 

There has been a report of visual loss and headache after metronidazole (10). 

Metronidazole is a well tolerated drug causing expulsion or lysis of the guinea worms. However, the patient may experience nausea, vomiting, weakness, insomnia, headache, dry mouth and metallic taste. 

Dysuria, cystitis, and a sense of pelvic pressure have been reported. Metronidazole has a disulfiram-hke effect, and some patients will experience abdominal distress, vomiting, flushing, or headache if they drink alcohohc beverages during or within 3 days of therapy. Metronidazole and disulfiram or any disuffiram-like drug should not be taken together because confusional and psychotic states may occur. 

Toxicity Adverse effects include gastrointestinal irritation, headache, and dark coloration of urine. More serious toxicity includes leukopenia, dizziness, and ataxia. Drag interactions with metronidazole include a disulfiram-like reaction with ethanol and potentiation of coumarin anticoagulant effects. Although it is not contraindicated in pregnancy, the drug should be used with caution. 

---