Apetryl200 mg/5 ml

Apetryl 200 mg/5 ml is indicated in the treatment of following diseases: The prevention of post-operative infections due to anaerobic bacteria (particularly species of bacteroides and anaerobic streptococci). The treatment of septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis and post-operative wound infections caused by anaerobes. ... Read moreApetryl 200 mg/5 ml is indicated in the treatment of following diseases: The prevention of post-operative infections due to anaerobic bacteria (particularly species of bacteroides and anaerobic streptococci). The treatment of septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis and post-operative wound infections caused by anaerobes. In the treatment of urogenital trichomoniasis. Bacterial vaginosis (also known as non-specific vaginitis). All forms of amoebiasis (intestinal, extra-intestinal disease and that of symptomless cyst passers). Giardiasis. Acute ulcerative gingivitis. Anaerobically infected leg ulcers and pressure sores. Acute dental infections due to anaerobic organisms. Antibiotic associated pseudomembranus colitis.

Amoebicides, Anti-diarrhoeal Antiprotozoal

Apetryl 200 mg/5 ml is a member of the imidazole class of antibacterial drug and is classified therapeutically as an antiprotozoal agent. The 5-nitro group of Apetryl 200 mg/5 ml is reduced by anaerobes metabolically. Studies have demonstrated that the reduced form of this drug interacts with DNA and gives bactericidal action of Apetryl 200 mg/5 ml.

Tablet and Suspension: Trichomoniasis (Adults & Children over 10 yrs)- 200 mg tid or 400 mg bid for 7 days 800 mg in the morning and 1-2 gm at night for 2 days 2 gm as a single dose for 1 days Trichomoniasis (Children)- Children 7-10 yrs: 100 mg tid Children 3-7 yrs: 100 mg bid Children 1-3 yrs: 50 mg tid Intestinal amoebiasis (Adults & Children over 10 yrs)-  800 mg tid for 5 days Intestinal amoebiasis (Children)- Children 7-10 yrs: 400 mg tid Children 3-7 yrs: 200 mg qid Children 1-3 yrs: 200 mg tid Extra-intestinal & Asymptomatic amoebiasis (Adults & Children over 10 yrs)- 400-800 mg tid for 5-10 days Extra-intestinal & Asymptomatic amoebiasis (Children)- Children 7-10 yrs: 200-400 mg tid Children 3-7 yrs: 100-200 mg qid Children 1-3 yrs: 100-200 mg tid Giardiasis (Adults & Children over 10 yrs)- 2 gm once daily for 3 days Giardiasis (Children)- Children 7-10 yrs: 1 gm once daily Children 3-7 yrs: 600-800 mg once daily Children 1-3 yrs: 500 mg once daily Acute ulcerative  gingivitis (Adults & Children over 10 yrs)- 200 mg tid for 3 days Acute ulcerative  gingivitis (Children)- Children 7-10 yrs: 100 mg tid Children 3-7 yrs: 100 mg bid Children 1-3 yrs: 50 mg tid Acute dental infections (Adults & Children over 10 yrs)- 200 mg tid for 3-7 days Bacterial Vaginosis (Adults & Children over 10 yrs)- 400 mg bid for 7 days 2 gm as a single dose for 1 days Leg ulcers and pressure sores (Adults & Children over 10 yrs)- 400 mg tid for 7 days Anaerobic infections (Adults & Children over 10 yrs)- 800 mg initially and then 400 mg tid for 7 days Anaerobic infections (Children)- Children 1-10 yrs: 7.5 mg/kg tid Surgical prophylaxis (Adults & Children over 10 yrs)- 400 mg tid started 24  hours before  surgery for 1 days Surgical prophylaxis (Children)- Children 1-10 yrs: 7.5 mg/kg tid Vaginal Gel: The recommended dose is one applicator full of Apetryl 200 mg/5 ml gel (approximately 5 grams containing approximately 37.5 mg of Apetryl 200 mg/5 ml) intravaginally once or twice a day for 5 days. For once a day dosing, Apetryl 200 mg/5 ml gel should be administered at bedtime. Suppository: Anaerobic Infections- Adults: 1 g every 8 hours for 3 days, then 1 g every 12 hours. Children: 5-10 years: 500 mg every 8 hours for 3 days, then every 12 hours, Over 10 years adult dose. Surgical Prophylaxis- Adults: 1 g 2 hours before surgery; up to 3 further doses of 1 g may be given every 8 hours for high risk procedures. Children: 5-10 years: 500 mg 2 hours before surgery; up to 3 further doses of 500 mg may be given every 8 hours for high risk procedures. IV Infusion: Apetryl 200 mg/5 ml intravenous infusion requires no dilution and should not be mixed with any other drugs prior to administration. Adults and children over 12 years: Infuse 500 mg 8 hourly at a rate of 5 ml/minute and a maximum of 4 g should not be exceeded during a 24-hour period. Treatment for 7 days is sufficient for most patients, but treatment can be extended, especially for cases where reinfection is likely. For surgical prophylaxis, administration shortly before surgery should be followed by 8-hourly doses for the next 24 hours. Children under 12 years: 7.5 mg/kg body weight/day every 8 hours at a rate of 5 ml/minute.

Tablet and Suspension: Trichomoniasis (Adults & Children over 10 yrs)- 200 mg tid or 400 mg bid for 7 days 800 mg in the morning and 1-2 gm at night for 2 days 2 gm as a single dose for 1 days Trichomoniasis (Children)- Children 7-10 yrs: 100 mg tid Children 3-7 yrs: 100 mg bid Children 1-3 yrs: 50 mg tid Intestinal amoebiasis (Adults & Children over 10 yrs)-  800 mg tid for 5 days Intestinal amoebiasis (Children)- Children 7-10 yrs: 400 mg tid Children 3-7 yrs: 200 mg qid Children 1-3 yrs: 200 mg tid Extra-intestinal & Asymptomatic amoebiasis (Adults & Children over 10 yrs)- 400-800 mg tid for 5-10 days Extra-intestinal & Asymptomatic amoebiasis (Children)- Children 7-10 yrs: 200-400 mg tid Children 3-7 yrs: 100-200 mg qid Children 1-3 yrs: 100-200 mg tid Giardiasis (Adults & Children over 10 yrs)- 2 gm once daily for 3 days Giardiasis (Children)- Children 7-10 yrs: 1 gm once daily Children 3-7 yrs: 600-800 mg once daily Children 1-3 yrs: 500 mg once daily Acute ulcerative  gingivitis (Adults & Children over 10 yrs)- 200 mg tid for 3 days Acute ulcerative  gingivitis (Children)- Children 7-10 yrs: 100 mg tid Children 3-7 yrs: 100 mg bid Children 1-3 yrs: 50 mg tid Acute dental infections (Adults & Children over 10 yrs)- 200 mg tid for 3-7 days Bacterial Vaginosis (Adults & Children over 10 yrs)- 400 mg bid for 7 days 2 gm as a single dose for 1 days Leg ulcers and pressure sores (Adults & Children over 10 yrs)- 400 mg tid for 7 days Anaerobic infections (Adults & Children over 10 yrs)- 800 mg initially and then 400 mg tid for 7 days Anaerobic infections (Children)- Children 1-10 yrs: 7.5 mg/kg tid Surgical prophylaxis (Adults & Children over 10 yrs)- 400 mg tid started 24  hours before  surgery for 1 days Surgical prophylaxis (Children)- Children 1-10 yrs: 7.5 mg/kg tid Vaginal Gel: The recommended dose is one applicator full of Apetryl 200 mg/5 ml gel (approximately 5 grams containing approximately 37.5 mg of Apetryl 200 mg/5 ml) intravaginally once or twice a day for 5 days. For once a day dosing, Apetryl 200 mg/5 ml gel should be administered at bedtime. Suppository: Anaerobic Infections- Adults: 1 g every 8 hours for 3 days, then 1 g every 12 hours. Children: 5-10 years: 500 mg every 8 hours for 3 days, then every 12 hours, Over 10 years adult dose. Surgical Prophylaxis- Adults: 1 g 2 hours before surgery; up to 3 further doses of 1 g may be given every 8 hours for high risk procedures. Children: 5-10 years: 500 mg 2 hours before surgery; up to 3 further doses of 500 mg may be given every 8 hours for high risk procedures. IV Infusion: Apetryl 200 mg/5 ml intravenous infusion requires no dilution and should not be mixed with any other drugs prior to administration. Adults and children over 12 years: Infuse 500 mg 8 hourly at a rate of 5 ml/minute and a maximum of 4 g should not be exceeded during a 24-hour period. Treatment for 7 days is sufficient for most patients, but treatment can be extended, especially for cases where reinfection is likely. For surgical prophylaxis, administration shortly before surgery should be followed by 8-hourly doses for the next 24 hours. Children under 12 years: 7.5 mg/kg body weight/day every 8 hours at a rate of 5 ml/minute.

Disulfiram: Psychotic reactions have been reported in patients who were using Apetryl 200 mg/5 ml and disulfiram concurrently. Alcohol: Alcoholic beverages and drugs containing alcohol should not be consumed during therapy and for at least one day afterwards because of the possibility of a disulfiram-like (antabuse effect) reaction (flushing, vomiting, tachycardia). Oral anticoagulant therapy (warfarin type): Potentiation of the anticoagulant effect and increased hemorrhagic risk caused by decreased hepatic catabolism. In case of co-administration, prothrombin time should be more frequently monitored and anticoagulant therapy adjusted during treatment with Apetryl 200 mg/5 ml. Lithium: Plasma levels of lithium may be increased by Apetryl 200 mg/5 ml. Cyclosporin: Serum cyclosporin and serum creatinine should be closely monitored when co-administration is necessary. Phenytoin or phenobarbital: increased elimination of Apetryl 200 mg/5 ml resulting in reduced plasma levels. 5-Fluorouracil: Reduced clearance of 5-fluorouracil resulting in increased toxicity of 5-fluorouracil. Busulfan: Plasma levels of busulfan may be increased by Apetryl 200 mg/5 ml, which may lead to severe busulfan toxicity.

Apetryl 200 mg/5 ml is contraindicated in patients with a history of hypersensitivity to Apetryl 200 mg/5 ml or other Nitroimidazole derivatives.

Metallic taste, nausea, vomiting, diarrhoea, drowsiness, rashes may be observed during treatment.

US FDA Pregnancy Category of Apetryl 200 mg/5 ml is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Apetryl 200 mg/5 ml have been shown to be excreted in human milk. So, caution should be exercised when Apetryl 200 mg/5 ml is administered to a nursing woman.

If for compelling reasons, Apetryl 200 mg/5 ml must be administered longer than the usually recommended duration, it is recommended that hematological tests, especially leucocyte count should be carried out regularly and that patients should be monitored for adverse reactions such as peripheral or central neuropathy (such as paresthesia, ataxia, dizziness, convulsive seizures). Apetryl 200 mg/5 ml should be administered with caution to patients with hepatic encephalopathy. Patients should be warned that Apetryl 200 mg/5 ml may darken urine.

Single oral doses of Apetryl 200 mg/5 ml, up to 12 g have been reported in suicide attempts and accidental overdoses. Symptoms were limited to vomiting, ataxia and slight disorientation. There is no specific antidote for Apetryl 200 mg/5 ml overdosages. In case of suspected massive overdosages, a symptomatic and supportive treatment should be instituted.

Store below 30°C. Keep protected from light. Keep medicines out of the reach of children. Do not use later than the date of expiry.

Amoebicides, Anti-diarrhoeal Antiprotozoal

Apetryl 200 mg/5 ml is a member of the imidazole class of antibacterial drug and is classified therapeutically as an antiprotozoal agent. The 5-nitro group of Apetryl 200 mg/5 ml is reduced by anaerobes metabolically. Studies have demonstrated that the reduced form of this drug interacts with DNA and gives bactericidal action of Apetryl 200 mg/5 ml.

US FDA Pregnancy Category of Apetryl 200 mg/5 ml is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Apetryl 200 mg/5 ml have been shown to be excreted in human milk. So, caution should be exercised when Apetryl 200 mg/5 ml is administered to a nursing woman.

Hepatic impairment: Apetryl 200 mg/5 ml is mainly metabolised by hepatic oxidation. Substantial impairment of Apetryl 200 mg/5 ml clearance may occur in the presence of advanced hepatic insufficiency. Significant cumulation may occur in patients with hepatic encephalopathy and the resulting high plasma concentrations of Apetryl 200 mg/5 ml may contribute to the symptoms of the encephalopathy. Apetryl 200 mg/5 ml should therefore, be administered with caution to patients with hepatic encephalopathy. The daily dosage should be reduced to one third and may be administered once daily. Patients should be warned that Apetryl 200 mg/5 ml may darken urine.Renal impairment: The elimination half-life of Apetryl 200 mg/5 ml remains unchanged in the presence of renal failure. The dosage of Apetryl 200 mg/5 ml therefore needs no reduction. Such patients however retain the metabolites of Apetryl 200 mg/5 ml. The clinical significance of this is not known at present. In patients undergoing haemodialysis Apetryl 200 mg/5 ml and metabolites are efficiently removed during an eight hour period of dialysis. Apetryl 200 mg/5 ml should therefore be re-administered immediately after haemodialysis. No routine adjustment in the dosage of Apetryl 200 mg/5 ml need be made in patients with renal failure undergoing intermittent peritoneal dialysis (IDP) or continuous ambulatory peritoneal dialysis (CAPD).