Flagyl in Combination with Amoxicillin

Major facts about Flagyl indications and treatment in combination with other substances.

Flagyl is a an anti-protozoal medication with a broad spectrum of action. Flagyl (Metronidazole) is considered to be a drug of choice for many parasitic diseases in humans caused by protozoa. It is used for trichomoniasis, giardiasis, amoebiasis treat, in complex treatment of gastric and duodenal ulcer (eradication of Helicobacter pylori), anaerobic infections (peritonitis, abscess, meningitis, empyema, endocarditis). Off-lables uses of Flagyl (Metronidazole) include treatment of chronic alcoholims. Flayl (metronidazole) belongs to the family of nitro-5-imidazole group and is active mainly against anaerobic microorganisms.

It works by suppressing the development of amoebae, trichomonads, as well as some obligate anaerobes: Trichomonas vaginalis, Giardia intestinalis, Entamoeba histolytica, Lamblia, Peptostreptococcus, Clostridium sp., Bacteroides sp., Prevotella, Fusobacterium, Veilonella. In combination with amoxicillin Mentronidazole is active against Helicobacter pylori. It is believed that amoxicillin inhibits the resistance development of Helicobacter pylori to metronidazole.

After administration metronidazole is rapidly and completely absorbed into the blood circulation. It binds to plasma proteins by 10-20%. Metronidazole rapidly penetrates the tissues (lungs, kidneys, liver, skin, bile, cerebrospinal fluid, saliva, semen, vaginal secretions) including mother's milk and passes through the placental barrier.

It is metabolized in the liver. The half-life period is 8-10 hours, which ensures retention of bactericidal concentration level for at least 8 hours. It is eliminated by kidneys. In patients with liver failure half-life remains unchanged.

Flagyl (Metronidazole) is used to treat:

• Urogenital trichomoniasis vaginitis, Trichomonas urethritis in women, Trichomonas urethritis in men, chronic complications of Multifocal trichomoniasis
• Nonspecific vaginitis
• Giardiasis
• Amebic dysentery, amoebiasis
• Anaerobic infections caused by susceptible to the drug microorganisms
• Combinated therapy with heavy mixed aerobic-anaerobic infections caused by mixed aerobic-anaerobic bacterial flora in combination with other antibacterial drugs, particularly with penicillins, cephalosporins and aminoglycosides
• In combination with amoxicillin: chronic gastritis in acute, gastric ulcer and duodenal ulcer in the acute phase, associated with Helicobacter pylori (eradication of Helicobacter pylori).
• Alcoholism.
• For external and topical use: treatment of acne vulgaris and pink, bacterial vaginosis, treatment of nonhealing wounds and trophic ulcers.