Comparative Pharmacology
Head-to-head clinical analysis: FLAGYL versus METRONIDAZOLE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: FLAGYL versus METRONIDAZOLE.
FLAGYL vs METRONIDAZOLE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Metronidazole, a nitroimidazole antibiotic, enters bacterial cells and is reduced to cytotoxic intermediates that damage DNA and inhibit nucleic acid synthesis, leading to cell death. It is active against anaerobic bacteria and protozoa.
After entry into the cell, metronidazole is reduced by bacterial nitroreductases to form toxic metabolites that damage DNA and inhibit nucleic acid synthesis, leading to cell death.
Metronidazole 500 mg intravenously every 8 hours or 500 mg orally every 8 hours.
500 mg intravenously every 8 hours or 500 mg orally every 8 hours; for bacterial vaginosis, 500 mg orally twice daily for 7 days; for trichomoniasis, 2 g orally as a single dose.
None Documented
None Documented
Clinical Note
moderateMetronidazole + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Metronidazole."
Clinical Note
moderateMetronidazole + Cyclosporine
"The metabolism of Cyclosporine can be decreased when combined with Metronidazole."
Clinical Note
moderateMetronidazole + Fluconazole
"The metabolism of Fluconazole can be decreased when combined with Metronidazole."
Clinical Note
moderateMetronidazole + Clotrimazole
Terminal elimination half-life: 6-8 hours in adults with normal renal function; prolonged to 7-21 hours in hepatic impairment; no significant change in renal impairment; clinically relevant for dosing interval (usually 8-hourly).
8 hours (range 6-10 hours) in adults; prolonged to 18-20 hours in severe hepatic impairment; requires adjustment in cirrhosis.
Renal: 60-80% of dose excreted unchanged in urine; biliary/fecal: 6-15% as metabolites and unchanged drug; enterohepatic circulation contributes to prolonged elimination.
Renal (60-80% unchanged drug), biliary/fecal (6-15% as metabolites, <20% unchanged).
Category C
Category A/B
Nitroimidazole Antibiotic
Nitroimidazole Antibiotic
"The metabolism of Clotrimazole can be decreased when combined with Metronidazole."