Metronidazole contraindications

Metronidazole is contraindicated in patients with known hypersensitivity. Metronidazole is contraindicated during the first trimester of pregnancy (Category B). Metronidazole is given during the second and third trimesters of pregnancy. Metronidazole is used cautiously in patients with blood dyscrasias, seizure disorders, and severe hepatic impairment. The patient must avoid alcohol while taking metronidazole... 

At present, no satisfactory treatment is available for pregnant women with Trichomonas infections. Metronidazole and tinidazole are contraindicated during the first trimester of pregnancy. 

Because of the potential risk of toxicity from the large amount of the excipient propylene glycol, amprenavir oral solution is contraindicated in infants and children below 4 years of age, pregnant women, patients with hepatic or renal failure, and patients treated with disulfiram or metronidazole (see Contraindications and Warnings). 

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... 

The oral solution, which contains propylene glycol, is contraindicated in young children, pregnant women, patients with renal or hepatic failure, and those using metronidazole or disulfiram. Also, because of its in vitro activity against HBV, patients co-infected with HIV and HBV should be closely monitored if treatment with emtricitabine is interrupted or discontinued, owing to the likelihood of hepatitis flare. 

Paromomycin has been advocated as a treatment for giardiasis in pregnant women, especially during the first trimester, when metronidazole is contraindicated, and as an alternative agent for metronidazole-resistant isolates of G. intestinalis. Although there is limited clinical experience, response rates of 55 to 90% have been reported. Dosing in adults is 500 mg orally three times daily for 10 days, whereas children have been treated with 25 to 30 mg/kg per day in three divided oral doses. Paromomycin formulated as... 

Chloroquine is directly toxic to E. histolytica trophozoites and is highly concentrated within the liver, making it effective for amebic liver abscess. It is used only when metronidazole or another nitroimidazole is either contraindicated or unavailable. Chloroquine is not effective against intestinal amebiasis because it only attains low concentrations in the colon patients receiving chloroquine for amebic liver abscess also should receive paromomycin or iodoquinol to eliminate intestinal colonization. 

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. 

Emetine is contraindicated in pregnancy and in patients with cardiac disease Metronidazole has little activity in the gut lumen Paromomycin is effective in extraintestinal amebiasis... 

Metronidazole given for 10 days is effective as monotherapy in many cases of hepatic abscess and has the dual advantage of being both amebicidal and active against anaerobic bacteria. However, treatment failures can occur and follow-up therapy with chloroquine is highly recommended. Luminal amebicides should also be given to eradicate intestinal infection. Treatment with emetine is contraindicated in patients with a history of cardiac disease. The answer is (D). 

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