Share on Facebook
Share on Twitter
Share on LinkedIn
Share by Email
Print
Likmez Generic Name & Formulations
Legal Class
General Description
Pharmacological Class
How Supplied
Susp—200mL
Manufacturer
Generic Availability
NO
Mechanism of Action
Metronidazole exerts antibacterial effects in an anaerobic environment against most obligate anaerobes. Once metronidazole enters the organism by passive diffusion and activated in the cytoplasm of susceptible anaerobic bacteria, it is reduced; this process includes intracellular electron transport proteins such as ferredoxin, transfer of an electron to the nitro group of the metronidazole, and formation of a short-lived nitroso free radical. Due to this alteration of the metronidazole molecule, a concentration gradient is created and maintained which promotes the drug’s intracellular transport. The reduced form of metronidazole and free radicals can interact with DNA leading to inhibition of DNA synthesis and DNA degradation leading to death of the bacteria. The precise mechanism of action of metronidazole is unclear.
Likmez Indications
Indications
Susceptible anaerobic infections, including intra-abdominal, skin and skin structures, gynecologic, bacterial septicemia, bone and joint, CNS, lower respiratory tract, endocarditis.
Likmez Dosage and Administration
Adult
Shake bottle well. Use a calibrated oral dosing device. 7.5mg/kg every 6hrs for 7–10 days; max 4g/24hrs. Serious infections: parenteral form usually used first. Bone/joint, lower respiratory tract, endocardium infections: may need to treat longer. Severe hepatic impairment: reduce dose by 50%. Hemodialysis: consider dose supplementation after session.
Children
Not established.
Likmez Contraindications
Contraindications
Within 2 weeks of disulfiram (possible psychotic reactions). Concomitant alcohol or propylene glycol containing-products during or at least 3 days after treatment. Cockayne syndrome.
Likmez Boxed Warnings
Boxed Warning
Potential for carcinogenicity.
Likmez Warnings/Precautions
Warnings/Precautions
Avoid unnecessary use. Discontinue if abnormal neurological symptoms occur. Candidiasis. History of blood dyscrasias. Monitor for leukopenia; do CBCs before, during and after therapy. Hepatic or renal impairment: monitor. Elderly: monitor serum levels. Pregnancy. Nursing mothers: not recommended (pump/discard milk during and for 48hrs after the last dose).
Likmez Pharmacokinetics
Absorption
Following oral administration, the peak plasma concentration occurred between 0.25–6 hours.
Distribution
Distributed in CSF, saliva, and breast milk at concentrations similar to those found in plasma. Plasma protein bound: <20%.
Elimination
Renal (60% to 80%), fecal (6% to 15%). Half-life: 9 hours. Renal clearance: ~10mL/min/1.73m2.
Likmez Interactions
Interactions
See Contraindications. May potentiate oral anticoagulants (eg, warfarin), lithium; monitor. Avoid concomitant busulfan; if needed, adjust busulfan dose and monitor. May be antagonized by phenobarbital, phenytoin, other hepatic enzyme inducers. May impair phenytoin clearance. May be potentiated by cimetidine, other hepatic enzyme inhibitors. Concomitant drugs with the potential for prolonging the QT interval; caution. May interfere with serum chemistry tests.
Likmez Adverse Reactions
Adverse Reactions
Nausea, headache, anorexia, vomiting, diarrhea, abdominal cramping, epigastric distress, constipation; seizures, encephalopathy, optic/peripheral neuropathy, aseptic meningitis.
Likmez Clinical Trials
See Literature
Likmez Note
Not Applicable
Likmez Patient Counseling
See Literature
Likmez Generic Name & Formulations
Legal Class
General Description
Pharmacological Class
How Supplied
Susp—200mL
Manufacturer
Generic Availability
NO
Mechanism of Action
Metronidazole exerts antibacterial effects in an anaerobic environment against most obligate anaerobes. Once metronidazole enters the organism by passive diffusion and activated in the cytoplasm of susceptible anaerobic bacteria, it is reduced; this process includes intracellular electron transport proteins such as ferredoxin, transfer of an electron to the nitro group of the metronidazole, and formation of a short-lived nitroso free radical. Due to this alteration of the metronidazole molecule, a concentration gradient is created and maintained which promotes the drug’s intracellular transport. The reduced form of metronidazole and free radicals can interact with DNA leading to inhibition of DNA synthesis and DNA degradation leading to death of the bacteria. The precise mechanism of action of metronidazole is unclear.
Likmez Indications
Indications
Amebic dysentery. Amebic liver abscess.
Likmez Dosage and Administration
Adult
Shake bottle well. Use a calibrated oral dosing device. Give 3 times daily for 5–10 days. Dysentery: 750mg. Abscess: 500mg or 750mg. Severe hepatic impairment: reduce dose by 50%. Hemodialysis: consider dose supplementation after session.
Children
Shake bottle well. Use a calibrated oral dosing device. 35–50mg/kg/24hrs in 3 divided doses for 10 days; max 2250mg/24hrs. Severe hepatic impairment: reduce dose by 50%. Hemodialysis: consider dose supplementation after session.
Likmez Contraindications
Contraindications
Within 2 weeks of disulfiram (possible psychotic reactions). Concomitant alcohol or propylene glycol containing-products during or at least 3 days after treatment. Cockayne syndrome.
Likmez Boxed Warnings
Boxed Warning
Potential for carcinogenicity.
Likmez Warnings/Precautions
Warnings/Precautions
Avoid unnecessary use. Discontinue if abnormal neurological symptoms occur. Candidiasis. History of blood dyscrasias. Monitor for leukopenia; do CBCs before, during and after therapy. Hepatic or renal impairment: monitor. Elderly: monitor serum levels. Pregnancy. Nursing mothers: not recommended (pump/discard milk during and for 48hrs after the last dose).
Likmez Pharmacokinetics
Absorption
Following oral administration, the peak plasma concentration occurred between 0.25–6 hours.
Distribution
Distributed in CSF, saliva, and breast milk at concentrations similar to those found in plasma. Plasma protein bound: <20%.
Elimination
Renal (60% to 80%), fecal (6% to 15%). Half-life: 9 hours. Renal clearance: ~10mL/min/1.73m2.
Likmez Interactions
Interactions
See Contraindications. May potentiate oral anticoagulants (eg, warfarin), lithium; monitor. Avoid concomitant busulfan; if needed, adjust busulfan dose and monitor. May be antagonized by phenobarbital, phenytoin, other hepatic enzyme inducers. May impair phenytoin clearance. May be potentiated by cimetidine, other hepatic enzyme inhibitors. Concomitant drugs with the potential for prolonging the QT interval; caution. May interfere with serum chemistry tests.
Likmez Adverse Reactions
Adverse Reactions
Nausea, headache, anorexia, vomiting, diarrhea, abdominal cramping, epigastric distress, constipation; seizures, encephalopathy, optic/peripheral neuropathy, aseptic meningitis.
Likmez Clinical Trials
See Literature
Likmez Note
Not Applicable
Likmez Patient Counseling
See Literature
Likmez Generic Name & Formulations
Legal Class
General Description
Pharmacological Class
How Supplied
Susp—200mL
Manufacturer
Generic Availability
NO
Mechanism of Action
Metronidazole exerts antibacterial effects in an anaerobic environment against most obligate anaerobes. Once metronidazole enters the organism by passive diffusion and activated in the cytoplasm of susceptible anaerobic bacteria, it is reduced; this process includes intracellular electron transport proteins such as ferredoxin, transfer of an electron to the nitro group of the metronidazole, and formation of a short-lived nitroso free radical. Due to this alteration of the metronidazole molecule, a concentration gradient is created and maintained which promotes the drug’s intracellular transport. The reduced form of metronidazole and free radicals can interact with DNA leading to inhibition of DNA synthesis and DNA degradation leading to death of the bacteria. The precise mechanism of action of metronidazole is unclear.
Likmez Indications
Indications
Trichomoniasis.
Likmez Dosage and Administration
Adult
Shake bottle well. Use a calibrated oral dosing device. Individualize. 1-day regimen (may improve compliance): 2g as a single oral dose or in 2 divided doses of 1g each, given on the same day. 7-day regimen (may minimize reinfection): 250mg 3 times daily for 7 days. Before repeating course, reconfirm diagnosis and allow 4–6 wks between courses. Treat consorts also. Severe hepatic impairment: reduce dose by 50%. Hemodialysis: consider dose supplementation after session.
Children
Not established.
Likmez Contraindications
Contraindications
Within 2 weeks of disulfiram (possible psychotic reactions). Concomitant alcohol or propylene glycol containing-products during or at least 3 days after treatment. Cockayne syndrome.
Likmez Boxed Warnings
Boxed Warning
Potential for carcinogenicity.
Likmez Warnings/Precautions
Warnings/Precautions
Avoid unnecessary use. Discontinue if abnormal neurological symptoms occur. Candidiasis. History of blood dyscrasias. Monitor for leukopenia; do CBCs before, during and after therapy. Hepatic or renal impairment: monitor. Elderly: monitor serum levels. Pregnancy. Nursing mothers: not recommended (pump/discard milk during and for 48hrs after the last dose).
Likmez Pharmacokinetics
Absorption
Following oral administration, the peak plasma concentration occurred between 0.25–6 hours.
Distribution
Distributed in CSF, saliva, and breast milk at concentrations similar to those found in plasma. Plasma protein bound: <20%.
Elimination
Renal (60% to 80%), fecal (6% to 15%). Half-life: 9 hours. Renal clearance: ~10mL/min/1.73m2.
Likmez Interactions
Interactions
See Contraindications. May potentiate oral anticoagulants (eg, warfarin), lithium; monitor. Avoid concomitant busulfan; if needed, adjust busulfan dose and monitor. May be antagonized by phenobarbital, phenytoin, other hepatic enzyme inducers. May impair phenytoin clearance. May be potentiated by cimetidine, other hepatic enzyme inhibitors. Concomitant drugs with the potential for prolonging the QT interval; caution. May interfere with serum chemistry tests.
Likmez Adverse Reactions
Adverse Reactions
Nausea, headache, anorexia, vomiting, diarrhea, abdominal cramping, epigastric distress, constipation; seizures, encephalopathy, optic/peripheral neuropathy, aseptic meningitis.
Likmez Clinical Trials
See Literature
Likmez Note
Not Applicable
Likmez Patient Counseling
See Literature
