metro i.v. in plastic container
Metro I.V. in Plastic Container (Metronidazole) is a nitroimidazole antimicrobial used to treat Abscess, Amebiasis, Bacteroides Infections, Bacterial Endocarditis.
Metronidazole · by B Braun
Available as a generic: Metronidazole
⚠ FDA reports a current shortage of the injection form — availability differs between suppliers — see drug shortages →Key facts
- Active ingredient
- Metronidazole
- Drug class
- Nitroimidazole Antimicrobial
- Form
- Solution
- Strength
- Metronidazole 500MG/100ML
- Type
- Prescription (Rx)
- Brand or generic
- Brand-name
- May treat
- abscess, amebiasis, bacteroides infections
- Manufacturer
- B Braun
- Half-life
- about 8 hours (how long it stays in your system)
- What the pharmacy pays
- ~$0.10 per gm — not your price
- FDA application
- NDA018900
- Availability
- Discontinued (per FDA)
- FDA boxed warning
- Yes — see the boxed warning
What is Metro I.V. in Plastic Container?
From the FDA label:Metronidazole Injection USP is a sterile, parenteral dosage form of metronidazole in water. Each 100 mL of Metronidazole Injection USP contains a sterile, nonpyrogenic, isotonic, buffered solution of Metronidazole USP 500 mg, Sodium Chloride USP 740 mg, Dibasic Sodium Phosphate•7H 2 O USP 112 mg, and Citric Acid Anhydrous USP 40 mg in Water for Injection USP. Metronidazole Injection USP has a calculated osmolarity of 297 mOsmol/liter and a pH of 5.8 (4.5-7.0). Sodium content: 13.5 mEq/container. Metronidazole is classified as a nitroimidazole antimicrobial and is administered by the intravenous route. Metronidazole USP is chemically designated 2-methyl-5-nitroimidazole-1-ethanol (C 6 H 9 N 3 O 3 ): Not made with natural rubber latex, PVC, or DEHP. The plastic container is a copolymer of ethylene and propylene formulated and developed for parenteral drugs. The copolymer contains no plasticizers. The safety of the plastic container has been confirmed by biological evaluation procedures. The material passes Class VI testing as specified in the U.S. Pharmacopeia for Biological Tests – Plastic Containers. The container/solution unit is a closed system and is not dependent upon entry of external air during administration. No vapor barrier is necessary. Chemical Structure
How to use
The recommended dosage schedule for adults for the treatment of anaerobic infections is presented in Table 1: Table 1: Recommended Dosage Schedule for the Treatment of Anaerobic Bacterial Infections in Adults Loading Dose 15 mg/kg infused over one hour (approximately 1 g for a 70-kg adult). Maintenance Dose 7.5 mg/kg infused over one hour every six hours (approximately 500 mg for a 70-kg adult). The first maintenance dose should be instituted six hours following the initiation of the loading dose. Parenteral therapy may be changed to oral metronidazole therapy when conditions warrant, based upon the severity of the disease and the response of the patient to treatment with Metronidazole Injection. The usual adult oral dosage is 7.5 mg/kg every six hours. A maximum of 4 grams should not be exceeded during a 24-hour period. The usual duration of therapy is 7 to 10 days; however, infections of the bone and joint, lower respiratory tract, and endocardium may require longer treatment. Recommended Dosage for the Treatment of Intra-Abdominal Infections in Pediatric Patients Less than 4 Months of Age: The recommended dosage schedule for pediatric patients less than 4 months of age for the treatment of intra-abdominal infections is described in Table 2 below. These dosage schedules achieve drug exposures in pediatric patients similar to adults treated with Metronidazole Injection for…
Side effects
The following are the most serious adverse reactions reported in patients treated with metronidazole and are also described elsewhere in the labeling: convulsive seizures, encephalopathy, aseptic meningitis, optic and peripheral neuropathy (characterized mainly by numbness or paresthesia of an extremity) (see WARNINGS ). The following adverse reactions associated with the use of metronidazole products were identified in clinical studies or postmarketing reports or published literature. Because some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. GASTROINTESTINAL: Nausea, anorexia, vomiting, abdominal discomfort, diarrhea, an unpleasant metallic taste, epigastric distress, abdominal cramping, constipation and pancreatitis. MOUTH: A sharp metallic taste. Furry tongue, glossitis, and stomatitis have occurred; these may be associated with a sudden overgrowth of Candida which may occur during therapy with metronidazole. HEMATOPOIETIC: Reversible neutropenia (leukopenia); thrombocytopenia, eosinophilia. HEPATOBILIARY DISORDERS: Hepatotoxicity and liver failure especially in patients with Cockayne syndrome (see CONTRAINDICATIONS ), jaundice. CARDIOVASCULAR: QT prolongation has been reported, particularly when metronidazole was…
FDA Boxed Warning (the FDA’s most serious warning)
Boxed (black-box) warning — from the FDA label
Metronidazole has been shown to be carcinogenic in mice and rats (see PRECAUTIONS ). Its use, therefore, should be reserved for the conditions described in the INDICATIONS AND USAGE section below.
Warnings
Important safety information
SEVERE CUTANEOUS ADVERSE REACTIONS: Severe cutaneous adverse reactions (SCARs) including toxic epidermal necrolysis (TEN), Stevens-Johnson syndrome (SJS), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP) have been reported with the use of metronidazole. Symptoms can be serious and potentially life threatening. If symptoms or signs of SCARs develop, discontinue Metronidazole injection immediately and institute appropriate therapy. CENTRAL AND PERIPHERAL NERVOUS SYSTEM EFFECTS: Convulsive seizures, encephalopathy, aseptic meningitis, optic and peripheral neuropathy, the latter characterized mainly by numbness or paresthesia of an extremity, have been reported in patients treated with metronidazole products. Since persistent peripheral neuropathy has been reported in some patients receiving prolonged oral administration of metronidazole, patients should be observed carefully. The appearance of abnormal neurologic signs demands the prompt evaluation of the benefit/risk ratio of the continuation of therapy.
Who should not take Metro I.V. in Plastic Container
Hypersensitivity Metronidazole Injection is contraindicated in patients with a prior history of hypersensitivity to metronidazole or other nitroimidazole derivatives. Psychotic Reaction with Disulfiram Use of oral metronidazole is associated with psychotic reactions in alcoholic patients who were using disulfiram concurrently. Do not administer metronidazole to patients who have taken disulfiram within the last two weeks (see PRECAUTIONS -Drug Interactions ). Interaction with Alcohol Use of oral metronidazole is associated with a disulfiram-like reaction to alcohol, including abdominal cramps, nausea, vomiting, headaches, and flushing. Discontinue consumption of alcohol or products containing propylene glycol during and for at least three days after therapy with metronidazole (see PRECAUTIONS -Drug Interactions ). Cockayne Syndrome Metronidazole Injection is contraindicated in patients with Cockayne syndrome. Severe irreversible hepatotoxicity/acute liver failure with fatal outcomes have been reported after initiation of metronidazole in patients with Cockayne syndrome (see ADVERSE REACTIONS ).
Overdose — what happens if you take too much
The use of dosages of metronidazole higher than those recommended has been reported. These include the use of 27 mg/kg three times a day for 20 days, and the use of 75 mg/kg as a single loading dose followed by 7.5 mg/kg maintenance doses. No adverse reactions were reported in either of the two cases. Single oral doses of metronidazole, up to 15 g, have been reported in suicide attempts and accidental overdoses. Symptoms reported include nausea, vomiting, and ataxia. Oral metronidazole has been studied as a radiation sensitizer in the treatment of malignant tumors. Neurotoxic effects, including seizures and peripheral neuropathy, have been reported after 5 to 7 days of doses of 6 to 10.4 g every other day. TREATMENT: There is no specific antidote for overdose; therefore, management of the patient should consist of symptomatic and supportive therapy.
U.S. Poison Control: call or text 1-800-222-1222 (free, 24/7). In an emergency call 911. From the FDA label; not medical advice.
Interactions
Metronidazole has been reported to potentiate the anticoagulant effect of warfarin and other oral coumarin anticoagulants, resulting in a prolongation of prothrombin time. This possible drug interaction should be considered when Metronidazole Injection USP is prescribed for patients on this type of anticoagulant therapy. The simultaneous administration of drugs that induce microsomal liver enzymes, such as phenytoin or phenobarbital, may accelerate the elimination of metronidazole, resulting in reduced plasma levels; impaired clearance of phenytoin has also been reported. The simultaneous administration of drugs that decrease microsomal liver enzyme activity, such as cimetidine, may prolong the half-life and decrease plasma clearance of metronidazole. Alcoholic beverages should not be consumed during metronidazole therapy because abdominal cramps, nausea, vomiting, headaches, and flushing may occur. Psychotic reactions have been reported in alcoholic patients who are using metronidazole and disulfiram concurrently. Metronidazole should not be given to patients who have taken disulfiram within the last two weeks. QT prolongation has been reported, particularly when metronidazole was administered with drugs with the potential for prolonging the QT interval.
Foods & drinks to be careful with
Well-established interactions for this medicine’s drug class, summarized from public health authorities. General information, not medical advice — always confirm with your pharmacist or the label.
Alcohol
Watch out for: beer, wine, spirits, and other products containing alcohol.
Combining alcohol with this antibiotic can cause a disulfiram-like reaction — flushing, nausea, vomiting, headache, and a fast heartbeat.
What to do: Avoid alcohol while taking it and for a few days after your last dose, as your prescriber or the label directs. Alcohol can hide in some liquid medicines and mouthwashes.
Source: Metronidazole — MedlinePlus (U.S. National Library of Medicine)
How long does Metronidazole stay in your body?
The elimination half-life of metronidazole is about 8 hours — the time it takes the body to clear about half of it. As a rule of thumb, a medicine is mostly gone after roughly 4 to 5 half-lives, though this varies from person to person with age and kidney or liver function. This is the average for healthy adults with normal kidney and liver function; the half-life is much longer in newborns (roughly 22 to 109 hours, longer the more premature the baby). Metronidazole has an active metabolite (hydroxy-metronidazole) whose levels build up in older adults (40-80% higher) and in severe kidney disease, though the label does not give a separate half-life for it.
This is general information, not medical advice. It doesn’t tell you when a drug test would read negative (tests detect substances for different, often longer, windows) or when it’s safe to take another dose — ask your pharmacist or prescriber. Source: FLAGYL (metronidazole) label, DailyMed.
Drug class
How this class works, per Metronidazole - StatPearls - NCBI Bookshelf.
May treat (source: NIH RxClass)
- abscess
- amebiasis
- bacteroides infections
- bacterial endocarditis
- pseudomembranous enterocolitis
- giardiasis
See how Metro I.V. in Plastic Container ranks — best-rated nitroimidazole antimicrobial for:
Dosage forms
Solution
The forms currently marketed in the U.S., per the FDA National Drug Code Directory.
Ways to save
Ask for the generic
Same active ingredient, far cheaper. Is there a generic? →
Request a 90-day supply
Bulk fills usually lower the per-dose price vs monthly refills.
Use copay cards
Manufacturer copay cards & patient-assistance programs — especially for brand drugs.
Compare alternatives
A same-class option may cost less. See alternatives →
Frequently asked questions
- What does Metro I.V. in Plastic Container treat?
- Metro I.V. in Plastic Container (Metronidazole) may be used to treat abscess, amebiasis, bacteroides infections, bacterial endocarditis, pseudomembranous enterocolitis, giardiasis, based on NIH RxClass drug-classification data (conditions a drug may treat — not a verbatim copy of the FDA-approved label). This is general reference, not medical advice.
- How does Metro I.V. in Plastic Container work?
- Metro I.V. in Plastic Container is a nitroimidazole antimicrobial. Nitroimidazole antibiotics (such as metronidazole) are activated inside oxygen-free bacteria and parasites, where they turn into reactive forms that break and destabilize the microbe's DNA. This kills the germ while largely sparing the body's own cells.
- How much does Metro I.V. in Plastic Container cost?
- Nobody can tell you what you will pay — your price is set by your insurer's formulary, your deductible and the pharmacy's markup, and none of those are published. What IS published is what the pharmacy paid to acquire it: about $0.10 per gm, per the CMS NADAC survey. Treat that as the floor, not the quote — ask the pharmacist for the cash price as well as your copay, because for cheap generics the cash price often wins.
- Is there a coupon or discount for Metro I.V. in Plastic Container?
- pharmaranks is an independent ratings site, not a pharmacy — we don't issue coupons or sell Metro I.V. in Plastic Container. To pay less, ask your prescriber or pharmacist whether a generic equivalent exists, check the manufacturer's copay/savings card and patient-assistance program, and compare a pharmacy discount card against your insurance copay. Prices vary by pharmacy, insurance, and location, so always confirm at the counter. This is general reference, not medical or financial advice.
- Who makes Metro I.V. in Plastic Container?
- Metro I.V. in Plastic Container is marketed by B Braun. You can see B Braun's full profile, rating, and other products on pharmaranks.
- Is Metro I.V. in Plastic Container a brand-name or generic drug?
- Metro I.V. in Plastic Container is a brand-name product with the active ingredient Metronidazole. Lower-cost generic equivalents containing Metronidazole are available — ask your pharmacist.
- Is Metro I.V. in Plastic Container available over the counter?
- No. Metro I.V. in Plastic Container is a prescription (Rx) medication in the US — you need a prescription from a licensed clinician (in person or via telehealth); it isn't sold over the counter. For some conditions there are OTC alternatives — ask your pharmacist.
- What forms does Metro I.V. in Plastic Container come in?
- Metro I.V. in Plastic Container is currently marketed as solution, per the FDA's National Drug Code Directory.
- What class of drug is Metro I.V. in Plastic Container?
- Metro I.V. in Plastic Container is classified as nitroimidazole antimicrobial, per the FDA's Established Pharmacologic Class.
- Is Metro I.V. in Plastic Container FDA-registered?
- Metro I.V. in Plastic Container is on record with the U.S. FDA under application number NDA018900. You can verify this on its official FDA label.
- Is Metro I.V. in Plastic Container safe?
- There's no single safe-or-not verdict, and we don't yet have a composite recall-safety score for Metro I.V. in Plastic Container. Review its FDA-label side effects and warnings below, and always consult a licensed professional.
- What are the side effects of Metro I.V. in Plastic Container?
- Metro I.V. in Plastic Container's side effects are taken directly from its FDA label. From the label: The following are the most serious adverse reactions reported in patients treated with metronidazole and are also described elsewhere in the labeling: convulsive seizures, encephalopathy, aseptic meningitis,… Both common and serious reactions are documented in full on this page. This is general reference from the FDA, not medical advice — always consult a professional.
Clinical content sourced from the FDA label via openFDA (U.S. FDA). View the FDA label on DailyMed → Provided for general reference only — not medical advice. Always consult a licensed professional and the current prescribing information.
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