Metronidazole/Nifuratel 841 African trypanosomiasis. Although there is no established al- Monensin (BAN, USAN, rINN) Nicarbazin (BAN) ternative treatment for Trypanosoma brucei rhodesiense infec- Lilly-67314; Monensina; Monensinum. 4-{2-[2-Ethyl-3′-methyl- Nicarbazina. An equimolecular complex of 1,3-bis(4-nitro- tions that are resistant to melarsoprol (see p.827), metronidazole 5′-(tetrahydro-6-hydroxy-6-hydroxymethyl-3,5-dimethylpyran- phenyl)urea (C13H10N4O5) and 4,6-dimethylpyrimidin-2-ol 1 and suramin were effective in 1 patient. 2-yl)perhydro-2,2′-bifuran-5-yl]-9-hydroxy-2,8-dimethyl-1,6-di- (C6H8N2O). 1. Foulkes JR. Metronidazole and suramin combination in the treat- oxaspiro[4.5]dec-7-yl}3-methoxy-2-methylpentanoic acid. Никарбазин ment of arsenical refractory rhodesian sleeping sickness—a case Монензин C H N O = 426.4. study. Trans R Soc Trop Med Hyg 1996; 90: 422. 19 18 6 6 C36H62O11 = 670.9. CAS — 330-95-0. Preparations CAS — 17090-79-8. ATC Vet — QP51AE03. ATC Vet — QP51AH03. BP 2008: Metronidazole Gel; Metronidazole Intravenous Infusion; Metron- idazole Oral Suspension; Metronidazole Suppositories; Metronidazole Tab- lets; NHO CH3 USP 31: Metronidazole Gel; Metronidazole Injection; Metronidazole Tab- CH3 CH H lets. 3 N Proprietary Preparations (details are given in Part 3) O O- O- Arg.: Bexon; Colpofilin; Dazotron; Epaq†; Etronil; Flagyl; Format; Ginkan; H H CH3 OO + CH3 + Gynotran; Metral; Metrocev; Metrolocal; Nalox; Noritate†; Padet; Repligen; HO H3C N N Rozex; Taremis; Tolbin; Tricofin; Trimstat†; Austral.: Flagyl; Metrogyl; Met- O H O O O ronide; Rozex; Austria: Acsacea; Anaerobex; Elyzol; Rozex; Trichex; Belg.: H O Anaeromet†; Flagyl; Pharmaflex†; Rosaced; Rozex; Braz.: Ambrosil†; Ame- H3C N N bil†; Astergyl†; Canderm; Dalzolston; Flagyl; Flanizol; Helmizol; Metrizol†; CH3 HO H H O CH3 Metrodax†; Metrogyl†; Metronib†; Metronide; Metroniflex; Metronil; Met- O HO ronin; Metronix; Metrotix†; Metroval; Metrozol; Minegyl†; Neo Metrodazol; H3C Profile Odonid; Rozex; Canad.: Flagyl; Florazole; Metrocream; Metrogel; Metrol- H3C OH Nicarbazin is an antiprotozoal used in veterinary practice for the otion; NidaGel; Noritate; Novo-Nidazol†; Trikacide; Chile: Deprocid; prevention of coccidiosis in poultry. Flagyl; Geloderm; Kabizol; Medazol; Metrocream; Metrogel; Metropast; Noritate†; Cz.: Deflamon†; Efloran; Entizol; Klion†; Medazol†; Rosalox; Ro- Pharmacopoeias. In US for veterinary use only. zex; Denm.: Elyzol; Flagyl; Metrogel†; Rozex; Zidoval; Fin.: Elyzol; Flagyl; USP 31 (Monensin). A mixture of antibiotic substances pro- Rosazol; Rozex; Trikozol; Zidoval; Fr.: Elyzol; Flagyl; Rosiced; Rozacreme; duced by Streptomyces cinnamonensis. Nifuratel (BAN, USAN, rINN) Rozagel; Rozex; Ger.: Arilin; Clont; Elyzol; Flagyl; Fossyol†; Infectoclont; Methylmercadone; Nifurateeli; Nifuratelum. 5-Methylthiomethyl- Metrocreme; Metrogel; Metronid-Puren†; Metronimerck; Metronour; Met- Monensin Sodium (BANM, rINNM) ront†; Rosiced; Vagimid; Gr.: Colpocin-T; Elyzol Dental; Emedal; Flagolin; 3-(5-nitrofurfurylideneamino)-2-oxazolidone. Monensin Sodique; Monensina sódica; Natrii Monensinum. Flagyl; Gnostol; Metrazol; Metrogyl; Periotret; Robaz; Rosiced; Trichovagil; Нифурател Tricodazole; Unitrim; Hong Kong: Elyzol; Flagyl; Gynoplix; Marphazole; Me- Натрий Монензин C10H11N3O5S = 285.3. tole; Metrogyl; Noritate; Qualigyl; Rozex; Unigo; Hung.: Klion; Rozex; Sup- C H NaO = 692.9. plin; India: Aristogyl; Flagyl; Giardyl†; Metrogyl; Monizole; Unimezol†; In- 36 61 11 CAS — 4936-47-4. CAS — 22373-78-0. don.: Anmerob; Biatron; Corsagyl; Dumozol; Farnat; Fladex; Flagyl; ATC — G01AX05. Flametia; Fortagyl; Metrofusin; Molazol; Nidazole; Promuba; Supplin; Tisma- Pharmacopoeias. In US for veterinary use only. ATC Vet — QG01AX05. zol; Trichodazol; Trogiar; Trogyl; Vagizol; Irl.: Anabact†; Flagyl; Metronide; USP 31 (Monensin Sodium). An off-white to tan crystalline Metrotop; Rozex; Israel: Elyzol; Flagyl; Metrogyl; Noritate; Rozex; Venogyl; powder. Slightly soluble in water; soluble in chloroform and in Zidoval; Ital.: Deflamon; Elyzol; Flagyl; Rosased†; Rozex; Vagilen; Zidoval; methyl alcohol; practically insoluble in petroleum spirit. Avoid O moisture and excessive heat. Malaysia: Flagyl; Frotin; Protogyl†; Ranigyl†; Rozex; Setrozole†; Mex.: O Ameblin; Antral†; Biomona; Biotazol; Dasmetrol; Dualizol; Elyzol; Epaq; Fag- Profile izol; Fartricon; Flagenase; Flagenol; Flagepat; Flagyl; Flamin†; Flaxtec; Fresen- O Monensin is an antiprotozoal used as the sodium salt in veteri- O2N N N SCH3 izol; Hemestal; Lagylan; Lamblit; Lozad; Medazol; Medizol; Messeldazol; Me- nary practice for the prevention of coccidiosis in poultry and as a tosan†; Metricom; Metrizol; Metrobendizol; Metrocream; Metrogel; growth promotor for cattle. Metroson; Milezzol; Nidralon-V; Nidrozol; Nitromidager; Ortrizol; Otrozol; Ovazol-V; Planizol; Promibasol; Prozolin; Retofar†; Samonil; Selegil†; Servi- Adverse Effects zol; Solumidazol; Stomffler; Valpar; Vanestrin-V; Vertisal; Neth.: Flagyl; Adverse effects associated with nifuratel include gastrointestinal Metrogel; Rosiced; Rozex; Norw.: Elyzol; Flagyl; Rozex; Zidoval; NZ: Flagyl; Narasin (BAN, USAN, rINN) disturbances, peripheral neuropathy, and thrombocytopenic pur- Rozex; Trichozole; Philipp.: Ameryl; Anerobia; Flagyl; Metrinox; Metrodal; pura. Allergic reactions, hepatotoxicity, blood dyscrasias, and Norstene; Patryl; Robaz; Rodazid; Servizol; Tricomycin; Triconex; Tridel; Compound 79891; Lilly-79891; Narasina; Narasine; Narasinum. 2-(6-{5-[2-(5-Ethyltetrahydro-5-hydroxy-6-methylpyran-2-yl)- pulmonary reactions similar to those seen with the structurally Vamogyl; Zol; Pol.: Metrosept; Rozex; Port.: Dumozol; Flagyl; Metro- related drug nitrofurantoin have been reported rarely. Haemolyt- 15-hydroxy-2,10,12-trimethyl-1,6,8-trioxadispiro[4.1.5.3]penta- derme; Norstene; Rodermil; Roseless; Rosiced; Rus.: Efloran (Эфлоран); ic anaemia may occur in patients with G6PD deficiency given Flagyl (Флагил); Klion (Клион); Metrogyl (Метрогил); Metroseptol dec-13-en-9-yl]-2-hydroxy-1,3-dimethyl-4-oxoheptyl}tetrahy- nifuratel. (Метросептол); Rosamet (Розамет); Trichopol (Трихопол); S.Afr.: Bem- dro-3,5-dimethylpyran-2-yl)butyric acid. etrazole; Flagyl; Medamet; Metagyl†; Metazol; Metrazole; Metrostat; Naro- Наразин Hypersensitivity. There have been several reports of contact bic; Rozex; Trichazole; Zagyl; Zobacide; Singapore: Fladex; Flagyl; Meda- dermatitis associated with nifuratel, including a report after only zole; Metrozole†; MND†; Nizole; Rozex; Spain: Amotein; Flagyl; Rozex; C43H72O11 = 765.0. one application of nifuratel ointment in a man whose wife was Tricowas B; Zidoval; Swed.: Elyzol†; Flagyl; Rozex; Zidoval; Switz.: Arilin; CAS — 55134-13-9. undergoing treatment with nifuratel vaginal pessaries.1 Elyzol; Flagyl; Metrolag; Perilox; Rivozol†; Rosalox; Rozex; Thai.: Asiazole; ATC Vet — QP51AH04. 1. Bedello PG, et al. Contact dermatitis from nifuratel. Contact Biogyl; Elyzol†; Flagyl; Med-Tricocide†; Medazyl†; Mefiron; Menisole; Dermatitis 1983; 9: 166. Mepagyl†; Mesolex†; Metrazole; Metrocide; Metrogyl; Metrolex; Metrovid; Milanidazole; Robaz; Tricomed; Unigo; Vagil†; Vagyl; Turk.: Flagyl; Metrajil; Precautions H3C Nifuratel should not be given to patients with renal impairment, Metrazol; Metrosel; Nidazol; Roza; UAE: Negazole; UK: Acea; Anabact; H C neuropathies, or G6PD deficiency. Elyzol; Flagyl; Metrogel; Metrolyl; Metrosa; Metrotop; Metrozol; Noritate; 3 Norzol; Rozex; Vaginyl; Zidoval; Zyomet; USA: Flagyl; Metrocream; Metro- CH3 Interactions gel; Metrogel Vaginal; Noritate; Protostat; Vandazole; Venez.: Bactrizol; Fle- O O A disulfiram-like reaction may occur in patients taking alcohol gyl; Menizol; Metren; Metris; Metrogyl; Metrovax; Rozek. while on nifuratel therapy. OH CH3 Multi-ingredient: Arg.: Bexon; Ciprocort; Estilomicin; Farm-X Duo; Pharmacokinetics Farm-X Ginecologico; Flagystatin; Ginal Cent; Ginkan; Linfol; Linfol Cicatri- HO O H C When taken orally nifuratel is absorbed from the gastrointestinal zante; Mailen; Monizol Cort; Naxo TV; Neocolpoben†; Ovumix; Pelvicillin H C 3 CH 3 O 3 tract. A metabolite, with activity against bacteria but not against NF; Pentol; Septigyn; Tratomax; Vagicural Plus; Austral.: Somac-MA; Aus- H C trichomonads, is excreted in the urine. tria: Helicocin; Braz.: Bio-Vagin; Colpatrin; Colpist; Colpistar; Colpistatin; HO 3 Donnagel; Flagyl Nistatina; Fungimax; Ginestatin; Minegyl C/Nistatina†; Ni- O OO Uses and Administration H C Nifuratel is a nitrofuran derivative with a broad antimicrobial stazol†; Periodontil; Profargil†; Tricolpex; Tricomax; Vagi Biotic; Vagimax; 3 HO CH3 Canad.: Flagystatin; Losec 1-2-3 M; Rosasol; Cz.: Klion-D; Rodogyl†; Fin.: spectrum. It is active against the protozoan Trichomonas vagina- Flagyl Comp; Helipak A; Helipak T; Losec Helira†; Fr.: Birodogyl; Missilor; lis and has an antibacterial spectrum similar to that of nitrofuran- Rodogyl; Tergynan; Hung.: Klion-D; India: Aristogyl Plus; Aristogyl-F; Baci- H3C toin and some antifungal activity against Candida albicans. Al- gyl-N†; Dyrade-M; Dysfur-M†; Entamizole; Flagyl-F†; Kaltin MF; Metrogyl-F†; though other drugs are preferred, nifuratel has been used to treat Neocip M; NM Powder; Okaflox M; Powergyl; Qugyl; Indon.: Fladystin; susceptible infections of the genito-urinary tract in oral doses of Pharmacopoeias. In US for veterinary use only. 200 to 400 mg three times daily. It has also been given vaginally. Flagystatin; Trichostatic; Vagistin; Ital.: Meclon; Malaysia: Neo-Penotran; USP 31 (Narasin Granular). It