5.1.11 Metronidazole and tinidazole

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5.1 Antibacterial drugs Toggle Pages

5.1.1 Penicillins 5.1.2 Cephalosporins, carbapenems, and other beta-lactams 5.1.3 Tetracyclines 5.1.4 Aminoglycosides 5.1.5 Macrolides 5.1.6 Clindamycin 5.1.7 Some other antibacterials 5.1.8 Sulfonamides and trimethoprim 5.1.10 Antileprotic drugs 5.1.11 Metronidazole and tinidazole 5.1.12 Quinolones 5.1.13 Urinary-tract infections

Chapter 5: Infections Toggle Parent Pages

Principles of antibacterial treatment Upper respiratory tract infections Lower respiratory tract infections Acute exacerbation of bronchiectasis (non-cystic fibrosis) Urinary tract infections (UTI) Gastro-intestinal tract infections Genital tract infections Meningitis Skin and soft tissue infections Lyme disease Eye infections Oral and dental infections COVID-19 treatments for patients who do not require hospitalisation 5.1 Antibacterial drugs 5.2 Antifungal drugs 5.3 Antiviral drugs 5.4 Antiprotozoal drugs 5.5 Anthelmintics

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Page last updated:
19 July 2024

5.1.11 Metronidazole and tinidazole

First Line

Second Line

Specialist

Hospital Only

Alcohol should be avoided during and for 72 hours after tinidazole and at least 48 hours after metronidazole treatment, because of the possibility of a disulfiram-like reaction (flushing, abdominal cramps, vomiting, tachycardia).

Metronidazole

Tablets 200mg, 400mg (£3.56 = 21 x 200mg, £0.97 = 21 x 400mg)
Oral suspension 200mg/5ml (£64.43 = 100ml)
Suppositories 500mg, 1g (£15.18, £23.06 = 10)
Intravenous infusion 500mg/100ml

Indications

Acute necrotising ulcerative gingivitis
Bacterial vaginosis
Cholecystitis - plus doxycycline
Dental abscess
Eradication of H. pylori
Giardiasis
Pericoronitis
Trichomoniasis
Pelvic inflammatory disease
- plus ceftriaxone IM and doxycycline or
- plus doxycycline (second line) (oral regime only)
Bites (Human or Animal) - plus doxycycline (second line)
Clostridioides difficile (C. difficile) (first episode, mild cases only - second line)

Notes

Metronidazole oral suspension is not recommended for C. difficile infection (theoretical risk that efficacy of metronidazole benzoate may be compromised because of reduced exposure to gastric enzymes)

Tinidazole

Tablets 500mg (unlicensed special)