Metronidazole

C. diff Risk

Low

Oral Bioavailability

Excellent

Approximate Cost

Dosing

500 mg PO/IV BID-TID

Give dose after dialysis on dialysis daysNo dose adjustment

General Information

Drug Monitoring

With prolonged therapy (>6wks) or if symptoms develop assess for peripheral/optic neuropathy

Adverse Effects

GI symptoms common- especially nausea/vomiting and metallic taste

Peripheral/optic neuropathy with extended therapy

Disulfiram-like reaction with alcohol (severe vomiting)

Rare neurotoxicity including aseptic meningitis and encephalopathy

Major Interactions

Ethanol- disulfiram-like reaction

Increases levels of cyclosporine, lithium, warfarin, and phenobarbital and phenytoin

Pharmacology

Antimicrobial class: Nitroimidazole

Pregnancy category: B