Metronidazole interaction with other drugs

Clinical management of acute metronidazole ingestion is supportive. Administration of activated charcoal can be considered for patients with substantial ingestions that present within an hour of the exposure. There are no specific laboratory tests indicated for this isolated ingestion. With chronic metronidazole toxicity or toxicity resulting from interaction with other drugs, discontinuation of metronidazole is recommended. Supportive care is usually sufficient for the vast majority of patients. 

A single 800-mg dose of metronidazole was given to 12 healthy subjects following 9 days of treatment with diosmin 500 mg daily. The metronidazole AUC and maximum plasma concentrations were raised by 27% and 25%, respectively. This interaction is thought to occur because of an inhibitory effect of diosmin on metronidazole metabolism by hepatic enzymes, and inhibition of P-glycoprotein. The increase in metronidazole levels is similar to that seen with other drugs (e.g. cimetidine (above)) that are not considered to be clinically significant. Therefore no clinically... 

There are drug products whose interaction with PVC bags and infusion sets are so high that they must include labehng precautions for use with PVC containers. These drugs include antineoplastics such as pachtaxel, docetaxel, tacrolimus, and teniposide, and others such as ciprofloxacin, cefoperazone sodium, fluconazole, metronidazole HC1, cimetidine, and propofol [64,65]. 

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