Flagyl ER: Effective Extended-Release Treatment for Bacterial Infections
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Flagyl ER (metronidazole extended-release) is a prescription antimicrobial medication designed to provide sustained, targeted therapy for specific anaerobic bacterial and protozoal infections. Its advanced extended-release formulation ensures consistent drug delivery, enhancing patient compliance and therapeutic efficacy while minimizing dosing frequency. This medication is particularly valued in clinical practice for its reliable pharmacokinetic profile and broad-spectrum activity against susceptible pathogens.
Features
- Contains 750 mg metronidazole per extended-release tablet
- Once-daily dosing regimen due to proprietary extended-release technology
- Bioequivalent to immediate-release metronidazole 250 mg administered three times daily
- Film-coated tablet designed for ease of swallowing
- Stable at room temperature with a standard shelf life of 24 months
Benefits
- Provides sustained plasma concentrations for consistent antimicrobial coverage
- Reduces dosing frequency to once daily, improving adherence to treatment regimens
- Minimizes peak-trough fluctuations compared to immediate-release formulations
- Effectively treats a range of anaerobic infections with proven clinical efficacy
- Offers predictable pharmacokinetics with established safety profile
- Simplifies treatment protocols for both outpatient and inpatient settings
Common use
Flagyl ER is primarily indicated for the treatment of bacterial vaginosis in adult women. It is also used off-label for other anaerobic infections when extended-release metronidazole therapy is appropriate, including certain intra-abdominal infections, gynecological infections, and skin and skin structure infections caused by susceptible anaerobic bacteria. The extended-release formulation is particularly useful when prolonged antimicrobial coverage is required or when patient compliance with multiple daily dosing is a concern.
Dosage and direction
The recommended dosage for bacterial vaginosis is one 750 mg extended-release tablet taken orally once daily for seven consecutive days. Tablets should be swallowed whole with a full glass of water and must not be crushed, chewed, or split. Administration with food may help minimize gastrointestinal discomfort. Treatment should be completed in its entirety even if symptoms improve before the full course is finished. Dosage adjustments may be necessary in patients with severe hepatic impairment.
Precautions
Patients should be advised to avoid alcohol consumption during therapy and for at least 72 hours after completion of treatment due to the potential for a disulfiram-like reaction. Use with caution in patients with central nervous system diseases, blood dyscrasias, or hepatic impairment. Regular monitoring of blood counts may be warranted during prolonged therapy. Caution should be exercised when operating machinery or driving as dizziness or other neurological effects may occur. Not recommended for use during pregnancy unless clearly needed.
Contraindications
Flagyl ER is contraindicated in patients with known hypersensitivity to metronidazole, other nitroimidazole derivatives, or any component of the formulation. Contraindicated in patients with trichomoniasis during the first trimester of pregnancy. Should not be used in patients who have taken disulfiram within the past two weeks. Not recommended for patients with Cockayne syndrome due to increased risk of severe hepatotoxicity.
Possible side effect
Common side effects include nausea (approximately 8%), headache (6%), metallic taste (5%), and diarrhea (4%). Less frequently reported effects include dizziness, dry mouth, abdominal discomfort, and constipation. Serious but rare adverse reactions may include peripheral neuropathy, seizures, encephalopathy, aseptic meningitis, and leukopenia. Discontinuation should be considered if neurological symptoms develop. Allergic reactions including urticaria and Stevens-Johnson syndrome have been reported rarely.
Drug interaction
Concomitant use with alcohol may cause disulfiram-like reaction. May potentiate effects of warfarin and other oral anticoagulants, requiring close monitoring of prothrombin time. Concurrent administration with disulfiram may cause acute psychosis and confusion. Cimetidine may prolong metronidazole half-life. Phenobarbital may decrease metronidazole efficacy. May increase lithium levels and risk of toxicity. Caution advised with other neurotoxic drugs.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed administration. Maintaining consistent dosing intervals is important for therapeutic efficacy.
Overdose
Symptoms of overdose may include nausea, vomiting, ataxia, and neurological symptoms including seizures. There is no specific antidote for metronidazole overdose. Treatment should be supportive and symptomatic. Gastric lavage may be considered if presented soon after ingestion. Hemodialysis may accelerate elimination of metronidazole and metabolites. Management should include monitoring of neurological status and supportive care.
Storage
Store at controlled room temperature between 20°C to 25°C (68°F to 77°F) with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep in original container with lid tightly closed. Protect from light and moisture. Keep out of reach of children and pets. Do not use after expiration date printed on packaging. Properly dispose of any unused medication.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Flagyl ER is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual response to therapy may vary. Always follow your healthcare provider’s instructions regarding dosage and administration. Report any adverse reactions to your physician promptly.
Reviews
Clinical studies demonstrate Flagyl ER’s efficacy in treating bacterial vaginosis with complete resolution rates comparable to immediate-release formulations while offering improved convenience. Physicians report high patient satisfaction with the once-daily regimen. Patients appreciate the reduced dosing frequency and generally report good tolerability. The extended-release formulation maintains therapeutic metronidazole levels throughout the dosing interval, providing consistent antimicrobial activity.