Metronidazole cream

In erythrosis 15% to 25% to 30% salicylic acid peeling should be performed at 3-week intervals for a total of three to four peelings (Fig. 17.14a, b). Suggested topical treatment between peeling includes 0,75% metronidazole cream once a day or 1-2% salicylic acid cream once a day and sunblock creams... 

Dahl MV, Jarratt M, Kaplan D, Tuley MR, Baker MD (2001) Once-daily topical metronidazole cream formulations in the treatment of the papules and pustules of rosacea. J Am Acad Dermatol 45 723-730... 

A 40-year-old nurse with a history of contact allergy to metronidazole developed rosacea and used metronidazole cream (Alpharma,... 

Gentofie, Denmark) for a few days. She developed facial edema, swelling, and itching. Tests with metronidazole cream 1% and Rozex gel (0.75% metronidazole) were positive after 3 days. She had handled parenteral metronidazole and oral tablets before without any adverse reactions. 

The rapid onset of the facial dermatitis after topical metronidazole cream in both patients suggested previous sensitization, most probably from occupational exposure. 

Sulfacetamide 10%/sulfur 5% cream or lotion once a day (in certain patients might be less irritating than metronidazole) [5]... 

Breneman DL, Stewart D, Hevia O, Hino PD, Drake LA (1998) A double-blind, multicenter clinical trial comparing efficacy of once-daily metronidazole 1% cream to vehicle in patients with rosacea. Cutis 61 44-47... 

It is not a first-line agent owing to lower efficacy compared with oral metronidazole in non-pregnant populations.38 Avoid clindamycin vaginal cream due to associations with premature labor and neonatal infection.38... 

Clindamycin vaginal cream is the preferred therapy for bacterial vaginosis during lactation because metronidazole is listed as a drug of concern by the American Academy of Pediatrics (AAP)14 (Tables 44—4 and 44—5). Counsel patients that clindamycin cream weakens latex condoms and diaphragms, potentially rendering them ineffective. 

Ferris DG, Litaker MS, Woodward L, Mathis D, Hendrich J Treatment ofbacterial vaginosis A comparison of oral metronidazole, metronidazole vaginal gel and clindamycin vaginal cream. J Fam Pract 1995 41 443-449. 

Echinacea (Echinacea purpurea) Uses immune system stimulant prevention/Rx of colds, flu as supportive th apy for colds chronic infxns of the resp tract lower urinary tract Action Stimulates phagocytosis cytokine production T resp cellular activity topically exerts anesthetic, antimicrobial, anti-inflammatory effects Efficacy Not established may X severity duration of URI Available forms Caps w/ powdered herb equivalent to 300-500 mg, PO, tid pressed juice 6-9 mL, PO, once/d tine 2-4 mL, PO, tid (1 5 dilution) tea 2 tsp (4 g) of powdered herb in 1 cup of boiling water Noles/SE Fever, taste p -version, urticaria, angioedema Contra w/ autoimmune Dz, collagen Dz, progressive systemic Dz (TB, MS, collagen-vascular disorders), HIV, leukemia, may interfere w/ immunosuppressive therapy Interactions t Risk of disulfiram-like reaction W/ disulfiram, metronidazole T risk of exacerbation of HIV or AIDS W/ chinacea amprenavir, other protease inhibitors X effects OF azathioprine, basiliximab, corticosteroids, cyclosporine, daclizumab, econazole vag cream, muromonab-CD3, mycophenolate, prednisone, tacrolimus EMS Possible immunosuppression... 

Adverse local effects of the water-based gel formulation (MetroGel) include dryness, burning, and stinging. Less drying formulations may be better tolerated (MetroCream, MetroLotion, and Noritate cream). Caution should be exercised when applying metronidazole near the eyes to avoid excessive tearing. 

Topical preparations for the treatment of rosacea include metronidazole 0.75% or 1% cream, 0.75% gel, or lotion. None of these preparations is FDA-approved for ophthalmic use, but they have been beneficial fiar some patients. 

Clindamycin also is indicated for the treatment of bacterial vaginosis Its efficacy as a 2% cream is similar to oral metronidazole treatment. Measurable... 

Fischbach, F. Petersen, E. Weissenbacher, E. Martins, J. Hosmann, J. Mayer, H. Efficacy of clindamycin vaginal cream versus oral metronidazole in the treatment of bacterial vaginosis. Obstet. Gynecol. 1993, 82, 405-410. 

Metronidazole Tablet Cores (400 mg) Metronidazole Tablets (200 mg) Metronidazole Tablets (500 mg) Metronidazole Vaginal Gel (1.2%) Miconazole Cream (2%)... 

The topical cream contains metronidazole USP at a concentration of 7.5 mg per gram (0.75%) in an emollient cream consisting of emulsifying wax, sorbitol solution, glycerin, isopropyl palmitate, benzyl alcohol, lactic acid or sodium hydroxide to adjust pH, and purified water. Metronidazole is a member of the imidazole class of antibacterial agents and is classified therapeutically as an antiprotozoal and antibacterial agent. Chemically, metronidazole... 

Physical Parameters. Metronidazole is obtained as cream-coloured crystals having mp 158-160°C. Its solubility at 20°C (g/100 ml) water 1.0 ethanol 0.5 ether < 0.05 and chloroform < 0.05. It is found to be sparingly soluble in dimethyl formamide (DMF) and soluble in diluted acids. The pH of a saturated aqueous solution stands at 5.8. 

Kogak M, Yagli S, Vahapoglu G, Ekjioglu M (2002) Permethrin 5% cream versus metronidazole 0.75% gel for the treatment of papulopustular rosacea. A randomized double-blind placebo-controUed study. Dermatology 205 265-270... 

Signore RJ (1995) A pilot study of 5 percent permethrin cream versus 0.75 percent metronidazole gel in acne rosacea. Cutis 56 177-179... 

If no licensed pharmaceutical preparation is available. This may concern less common disorders. Examples are sodium hypochlorite solution and emulsion for the treatment of ulcers and decubitus, dithranol cream and dithranol ointment in a series of increasing concentrations for psoriasis, levomenthol or Udocaine containing preparations for pruritus, sterile metronidazole gel for foul-smelling wounds and diltiazem hydrochloride creams and gels for the treatment of anal fissures. Many of these are licensed now, although not in every country. 

Simbar. M.. Azarbad. Z.. Mojab, E., Alavi Majd, H. 2008. A comparative study of the therapeutic effects of the Zataria multi ora vaginal cream and metronidazole vaginal gel on bacterial vaginosis. Phvtomedicine 15(12) 1025-1031. 

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