Flagyl, Flagyl ER, Flagyl IV RTU, Flagyl 375, Metizol, Metric 21, Metro I.V., MetroGel, MetroGel Vaginal, MetroLotion, Noritate, Protostat
Classifications: antiinfective; antitrichomonal; amebicide; antibiotic
Pregnancy Category: B
Assessment & Drug Effects
- Discontinue therapy immediately if symptoms of CNS toxicity (see Appendix F) develop. Monitor especially for seizures and peripheral neuropathy (e.g., numbness and paresthesia of extremities).
- Lab tests: Obtain total and differential WBC counts before, during, and after therapy, especially if a second course is necessary.
- Monitor for S&S of sodium retention, especially in patients on corticosteroid therapy or with a history of CHF.
- Monitor patients on lithium for elevated lithium levels.
- Report appearance of candidiasis or its becoming more prominent with therapy to physician promptly.
- Repeat feces examinations, usually up to 3 mo, to ensure that amebae have been eliminated.
Patient & Family Education
- Adhere closely to the established regimen without schedule interruption or changing the dose.
- Refrain from intercourse during therapy for trichomoniasis unless male partner wears a condom to prevent reinfection.
- Have sexual partners receive concurrent treatment. Asymptomatic trichomoniasis in the male is a frequent source of reinfection of the female.
- Do not drink alcohol during therapy; may induce a disulfiram-type reaction (see Appendix F). Avoid alcohol or alcohol-containing medications for at least 48 h after treatment is completed.
- Urine may appear dark or reddish brown (especially with higher than recommended doses). This appears to have no clinical significance.
- Report symptoms of candidal overgrowth: Furry tongue, color changes of tongue, glossitis, stomatitis; vaginitis, curd-like, milky vaginal discharge; proctitis. Treatment with a candidacidal agent may be indicated.
- Do not breast feed while taking this drug.