Detect Drug Interactions with Metronidazole
Ibrahim Dighriri *
Jazan University, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia.
Ahmed Mobarki
Medical Microbiology, Jazan University, Manchester University, Jazan, Saudi Arabia.
Naif Althomali
Taif University, Taif, Saudi Arabia.
Khalid Alqurashi
Taif University, Taif, Saudi Arabia.
Othman Daghriri
Jazan University, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
Bashaer Bin Howimel
Pharm D, Shaqra University, Dawadmi, Saudi Arabia.
Izdihar Alahmad
Burayadah Private Collage, King Fahad Hospital, Buraidah, Saudi Arabia.
Rawan Alsaadi
Alrayan Collage, Almadinah Almunawara, Saudi Arabia.
Manar Alsufyani
Taif University, Dr. Sulaiman AL-Habib Medical Group, Riyadh, Saudi Arabia.
Manar Balobade
Faculty of Medicine, Najran University, Najran, Saudi Arabia.
Reem Altemani
University of Tabuk, Tabuk, Saudi Arabia.
Bayader Alatawi
University of Tabuk, Tabuk, Saudi Arabia.
Wejdan Sharoufna
Faculty of Medicine, Warsaw University, Qatif, Saudi Arabia.
Taif Almuntashiri
King Khalid University, Abha, Saudi Arabia.
Sultan Almushawwah
Qassim University, Qassim, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Metronidazole has been prescribed to treat infections for over a century and continues to be helpful in the therapy of amoebiasis, trichomoniasis, and giardiasis. Metronidazole is a cost-effective medication because of its low price, few adverse effects, and favorable pharmacokinetic and pharmacodynamic properties; nevertheless, it interacts with a wide variety of other medications. Some interactions with other medicines diminish its effectiveness, while others increase it.
Aims: The study aims to detect and evaluate metronidazole interactions with other medicines at King Abdulaziz Specialist Hospital.
Methodology: This retrospective study encompasses the review of 360 computerized prescriptions inside the outpatient clinic at King Abdulaziz Specialist Hospital in Saudi Arabia between March and September 2020 to detect and evaluate interactions among metronidazole and different medications.
Results: Metronidazole interactions are mostly major or moderate. Metronidazole had the most common interactions with domperidone (15.83 %), famotidine (13.89 %), and ciprofloxacin (11.67 %). Metronidazole contains a nitroimidazole ring, which suppresses the metabolism in the liver of numerous medications, including those that may be metabolized by the CYP3A4 and/or CYP450 2C9 isoenzymes. The combination of metronidazole with phenytoin or phenobarbital can cause metronidazole elimination to be accelerated and phenytoin clearance to be reduced. Metronidazole may improve warfarin's anticoagulant effects, leading to a longer prothrombin time and a higher risk of bleeding. Concurrent use of metronidazole with alfuzosin, escitalopram, and ondansetron may raise the risks of QT-interval prolongation and arrhythmias.
Conclusion: Most metronidazole drug interactions can be avoided by following excellent clinical care and clinical pharmacology concepts, such as avoiding complex treatment regimens, educating patients. and identifying patient risk factors. Furthermore, before prescribing and dispensing medicines, physicians and pharmacists should utilize drug-drug interactions checkers such as Micromedex and Lexicomp or a book such as Stockley's Drug Interactions.
Keywords: Metronidazole, drug interaction, antibiotic, domperidone