Usage
Ornidazole + Povidone Iodine is a topical combination medication primarily used for the prevention and treatment of various skin and wound infections. It is indicated for minor skin wounds, burns, ulcers, bacterial skin infections (like paronychia and impetigo), fungal skin infections (like tinea or cutaneous candidiasis), mixed bacterial and fungal skin infections, and skin infections after minor surgical procedures. It is also used for infection control during insertion and care of urinary catheters, circumcision, suture removal, and dressing changes.
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Pharmacological Classification: Antibiotic (Ornidazole) and Antiseptic (Povidone Iodine).
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Mechanism of Action: Ornidazole, a nitroimidazole antibiotic, disrupts bacterial DNA synthesis and function, thereby inhibiting bacterial and protozoal growth. Povidone Iodine releases iodine, a broad-spectrum antiseptic that oxidizes cellular components of microorganisms (bacteria, fungi, and some viruses) leading to their destruction.
Alternate Names
- PROVIDINE AM+
- Puradine Oz Ointment
- Omidine-OZ Ointment
- POVONE-OZ
- Wounsol Ointment
- Mercidine
How It Works
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Pharmacodynamics: Ornidazole exerts its antibacterial effect by disrupting microbial DNA synthesis. Povidone iodine exerts a broad-spectrum antiseptic action through the release of free iodine, which oxidizes microbial cellular components.
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Pharmacokinetics: Ornidazole applied topically exhibits minimal systemic absorption. With topical Povidone Iodine, systemic absorption of iodine can occur, particularly with repeated application to large areas of damaged skin or mucous membranes. Iodine is metabolized in the thyroid and excreted primarily in the urine.
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Mode of Action: Ornidazole creates cytotoxic metabolites that damage DNA and other critical biomolecules within microorganisms. Iodine disrupts microbial protein synthesis and alters cell membranes.
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Elimination Pathways: Topically applied Ornidazole has minimal systemic absorption. Absorbed iodine is primarily excreted in the urine.
Dosage
Standard Dosage
Adults: Apply a thin layer to the affected area 1-2 times daily, or as directed by a physician.
Children: Use in children under 12 years of age should be guided by a physician’s recommendation. Some sources suggest use for children over 2 years of age is acceptable if prescribed.
Special Cases:
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Elderly Patients: Use with caution, especially in patients over 70 years old, as per physician guidance.
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Patients with Renal Impairment: Use with caution. Monitor kidney function. Dosage adjustments may be necessary.
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Patients with Hepatic Dysfunction: Use with caution. Dosage adjustments may be necessary, especially in severe hepatic impairment.
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Patients with Comorbid Conditions: Use with caution in patients with thyroid disorders. Pre-existing thyroid conditions should be evaluated by a doctor before use due to iodine content.
Clinical Use Cases
This medication is primarily intended for topical application on minor skin conditions and is generally not suitable for use in the listed clinical settings:
- Intubation
- Surgical Procedures (except for pre- and post-operative skin disinfection)
- Mechanical Ventilation
- Intensive Care Unit (ICU) Use
- Emergency Situations
For such cases, systemic antibiotics or other appropriate treatments should be considered.
Dosage Adjustments
Dose modification should be based on individual patient factors like renal/hepatic function, thyroid status, and age.
Side Effects
Common Side Effects:
- Mild burning sensation at the application site
- Itching
- Stinging sensation
- Redness
- Skin rash or dryness
Rare but Serious Side Effects:
- Allergic reactions (e.g., hives, difficulty breathing, swelling of the face, lips, tongue, or throat)
- Severe skin irritation
- Signs of thyroid dysfunction (with prolonged use)
Long-Term Effects:
- Hypothyroidism or hyperthyroidism (with prolonged use and significant iodine absorption)
Adverse Drug Reactions (ADR):
- Angioedema
- Contact dermatitis
Contraindications
- Hypersensitivity to iodine or ornidazole.
- Severe liver or kidney impairment
- Thyroid disorders
- Lithium therapy
- Radioactive iodine treatment
Drug Interactions
- Other antiseptics, topical antibiotics, corticosteroids, lithium, and thyroid medications.
Pregnancy and Breastfeeding
- Use with caution during pregnancy and breastfeeding. Consult a physician.
Drug Profile Summary
- Mechanism of Action: Ornidazole inhibits bacterial DNA synthesis. Povidone Iodine releases iodine, a broad-spectrum antiseptic.
- Side Effects: Local skin reactions (burning, itching, redness), rarely allergic reactions or thyroid dysfunction.
- Contraindications: Hypersensitivity, severe liver/kidney impairment, thyroid disorders, lithium therapy, radioactive iodine treatment.
- Drug Interactions: Limited with topical use; consult a physician if other topical medications are used concurrently.
- Pregnancy & Breastfeeding: Use with caution. Consult physician.
- Dosage: Apply thinly 1-2 times daily.
- Monitoring Parameters: Monitor for local skin reactions and signs of thyroid dysfunction with prolonged use.
Popular Combinations
- Ornidazole + Povidone Iodine is itself a combination and not typically combined with other drugs in the same topical formulation. However, it can be used in conjunction with systemic antibiotics if required.
Precautions
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General Precautions: Pre-screening for allergies, metabolic disorders, and organ dysfunction is recommended.
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Specific Populations: As outlined in the “Special Cases” section under Dosage.
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Lifestyle Considerations: Avoid alcohol consumption while using Ornidazole due to the potential for a disulfiram-like reaction.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Ornidazole + Povidone Iodine?
A: Apply a thin layer to the affected area 1-2 times daily or as directed by a physician.
Q2: Can this medication be used on deep wounds?
A: No, it is intended for minor skin wounds, cuts, and burns, not deep or serious wounds requiring surgical treatment.
Q3: Can it be used during pregnancy?
A: Use with caution during pregnancy and breastfeeding. Consult a physician.
Q4: Are there any drug interactions I should be aware of?
A: Interactions are limited with topical use, but inform your physician about all medications, supplements, and herbs you are taking.
Q5: What are the common side effects?
A: Common side effects include mild burning, itching, stinging, redness, and skin rash or dryness at the application site.
Q6: What should I do if I miss a dose?
A: If you miss a dose, apply it as soon as you remember. Do not double the dose.
Q7: Can I stop using it once my symptoms improve?
A: No, complete the full course of treatment prescribed by your physician even if symptoms improve earlier.
Q8: Can this be used for surgical procedures?
A: While generally not indicated for use during surgical procedures themselves, it can be used for pre- and post-operative skin disinfection.
Q9: How does Ornidazole work differently from Povidone Iodine?
A: Ornidazole acts as a systemic antibiotic by disrupting bacterial DNA synthesis, while povidone-iodine acts as a topical antiseptic by releasing iodine, which has broad antimicrobial properties.
Q10: Can it be used in patients with renal impairment?
A: Use with caution in patients with renal impairment, and monitor their kidney function. Dosage adjustments might be necessary.
