Vomiting metronidazole

Counsel women taking metronidazole regarding potential for nausea, vomiting, and abdominal pain. Counsel patients to avoid alcohol or alcohol-containing substances during therapy with metronidazole owing to the risk of disulfuram-like reactions. 

Various studies demonstrate the successful use of tinida-zole for metronidazole-resistant trichomoniasis.19 Possible side effects include a metallic taste, dizziness, loss of coordination, seizures, severe diarrhea, darkened urine, nausea, vomiting, and a swollen or discolored tongue. 

Metronidazole Nausea/vomiting Metallic taste Refrain from using alcoholic beverages potential for disulfiram-like reaction Substrate for CYP2C9 and inhibitor of CYP2C9, 3A3/4 and 3A5-7 potential interactions may include warfarin (enhanced prothrombin time) and lithium (increased concentrations)... 

GI complaints (e.g., anorexia, nausea, vomiting, diarrhea) are the most common adverse effects, with the single 2-g dose of metronidazole or... 

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. 

Displacement of GABA from its receptors by ciprofloxacin results in increased levels of the neu-roexcitatory transmitter and acute CNS toxicity. The neuroexcitation can range from irritability, confusion, and agitation to seizures and toxic psychosis. Ciprofloxacin has no interaction with alcohol. A disulfiramlike reaction (flushing, nausea, vomiting, and profuse sweating) is associated with alcohol and metronidazole. Avoid alcohol and metronidazole coadministration. 

Adverse effects include nausea, vomiting, diarrhoea, myalgias and because of its serious side effects including cardiac arrhythmia, CHE and hypotension, they have been almost completely replaced by metronidazole. 

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. 

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... 

Adverse Effects. Gastrointestinal disturbances including nausea, vomiting, diarrhea, stomach pain, and an unpleasant taste in the mouth are relatively common with metronidazole. Other adverse effects such as hypersensitivity reactions, peripheral neuropathy, hematologic abnormalities, and genitourinary problems have been reported, but their incidence is relatively low. 

FLUOROURACIL ANTIBIOTICS -METRONIDAZOLE t risk of toxic effects of fluorouracil (>27%), e.g. bone marrow suppression, oral ulceration, nausea and vomiting due to T plasma concentrations of fluorouracil Metronidazole i clearance of fluorouracil Avoid co-administration... 

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. 

Diloxanide often causes flatulence and, occasionally, nausea, vomiting, diarrhea, urticaria, and pruritus. It is an excellent luminal amebicide and is indicated after treatment with the 5-nitroimidazole compounds, which have relatively weak activity on the cyst stage. Experience over 14 years has been summarized by the Centers for Disease Control and Prevention (CDC, Atlanta), confirming the minimal toxicity of diloxanide. Fewer adverse effects were reported in patients aged 20 months to 10 years than in those aged over 10 years. There is no record of interactions between diloxanide and either metronidazole or tinidazole (SEDA-13, 830) (SEDA-17, 333). 

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. 

The efficacy of triple therapy with bismuth plus amoxicillin and metronidazole has been assessed in an open trial in 26 children with duodenal ulcers associated with H. pylori (15). Helicobacter pylori was eradicated in 25 children and the ulcer was healed in 24. During a mean follow-up of nearly 2 years, the annual ulcer relapse rate was 9% (compared with 56% in historical controls, in whom the infection was not eradicated). Adverse events were reported by 13% of the children, and included diarrhea, dizziness, nausea, and vomiting. 

Anorexia, nausea, vomiting, abdominal pain, and diarrhea have all been reported in patients taking metronidazole (14). The use of a large single dose most commonly leads to these complaints. A metallic taste also seems to be quite common (14), as is the occurrence of a black tongue (SEDA-13, 832) (15). 

An 85-year-old woman developed a severe illness (severe diarrhea and vomiting, abdominal tenderness, peritoneal irritation, and systemic toxicity) 8 days after receiving pristinamycin 3g/day for 10 days (34). An assay for Clostridium difficile was positive. She was treated with metronidazole and her symptoms resolved after 72 hours. 

Metronidazole is also used as an antiparasitic in domestic animals. Manifestations of overdose in animals include vomiting, nystagmus, decreased appetite, and ataxia. 

However, this route of administration is eminently logical, in several circumstances. For the acute treatment of migraine, oral drugs are often vomited (sumatriptan). For treating acute asthma, children often cannot use an inhalational device properly (theophyliine). For perioperative antibiotics, patients are often nil by mouth (metronidazole). For inflammatory bowel disease and proctitis, this is simply a topical administration. 

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. 

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