Usual dose, Oral: 30-50 mg/kg/DAY divided into 3 daily doses; Max 2250 mg/DAYUsual dose, IV: 22.5-40 mg/kg/DAY divided q8h. Max 1500 mg/DAY.
There is a wide variety of dosage recommendations in the literature, see other references as needed.
PNA-days 0 - 7PNA-days 7+ 7.5 mg/kg/DOSE given q24-48h.15 mg/kg/DAY divided q12h.
PNA-days 0 - 7PNA-days 7+ 15 mg/kg/DAY divided q12h30 mg/kg/DAY divided q12h
Severe impairment: Dose adjustment may be required. Consult with a pharmacist if using in a patient with severe hepatic impairment.
Renally cleared, requires dosage adjustment with changes in renal function. Consult with a pharmacist for renal dosing.
Suspected or confirmed anaerobic infections including intra-abdominal, biliary, central nervous system, Clostridium difficile, Giardia and pelvic infections.
Also used in Crohns disease, bacterial vaginosis, and hepatic encephalopathy
CBC with differential at baseline and after prolonged or repeated courses of therapy. With prolonged therapy (>6wks) or if symptoms develop assess for peripheral/optic neuropathy
GI symptoms common- especially nausea/vomiting and metallic taste
Peripheral/optic neuropathy with extended therapy
Disulfiram-like reaction (severe vomiting)
Rare neurotoxicity including aseptic meningitis and encephalopathy
Disulfiram reaction wtih alcohol or alcohol-containing medications/products.
May enhance the QT prolongation of drugs which are known to prolong the QT interval
May increase the serum concentation of vitamin K antagonists (warfarin)
Bacterial, protozoal and ameobic DNA is fragmented by reactive nitroso-imidazole radicals
Antimicrobial class: Nitroimidazole
Average serum half life:
Neonates <7 days: (prolonged with lower GA) 24.8-75.3 hours.
Neonates ≥7 days: ~22.5 hours
Children and adolescents: 6-10 hours.
Adults: 8 hours
Route of Elimination:
urine (unchanged drug and metabolites: 60-80%; ~20% of total as unchanged drug)