Usage
Ornidazole + Sodium Chloride solution for infusion is prescribed for the treatment of infections caused by anaerobic bacteria and certain protozoa. These infections may include:
- Bacterial Vaginosis: A common vaginal infection.
- Trichomoniasis: A sexually transmitted infection.
- Amoebiasis: An infection caused by the parasite Entamoeba histolytica.
- Giardiasis: An infection caused by the parasite Giardia lamblia.
- Anaerobic Bacterial Infections: Infections caused by bacteria that thrive in the absence of oxygen, including septicemia, meningitis, peritonitis, postoperative wound infections, and pelvic infections.
- Surgical Prophylaxis: Prevention of postoperative anaerobic bacterial infections, particularly in abdominal and gynecological surgeries.
Pharmacological Classification: Antibiotic (nitroimidazole class) and electrolyte replenisher.
Mechanism of Action: Ornidazole inhibits DNA synthesis and disrupts the DNA structure of susceptible anaerobic bacteria and protozoa, leading to their death. Sodium Chloride maintains electrolyte balance and hydration.
Alternate Names
Ornidazole is also known as Tiberal. No alternate names for Sodium Chloride itself, however, the infusion itself may vary such as Ornidazole 0.5% w/v Solution for Infusion, Ornidazole and Sodium Chloride Injection, Orniject Infusion and Ornidazen IV Infusion. Some common brand names for Ornidazole include Dazolic, Ornida, and Tibazole.
How It Works
Pharmacodynamics: Ornidazole enters anaerobic microorganisms and undergoes reductive activation, forming reactive metabolites that damage DNA. This DNA damage prevents bacterial and parasitic replication, ultimately leading to cell death. Sodium Chloride plays a crucial role in maintaining fluid and electrolyte balance, nerve impulse transmission, and muscle function.
Pharmacokinetics:
- Absorption: Ornidazole is readily absorbed after oral administration, with bioavailability exceeding 90%. Intravenous administration achieves rapid and complete systemic availability.
- Metabolism: Ornidazole is primarily metabolized in the liver to less active metabolites.
- Elimination: Ornidazole and its metabolites are mainly excreted in urine, with a small portion eliminated in feces.
Dosage
Standard Dosage
Adults:
- Anaerobic infections: Initial intravenous dose of 0.5 to 1 g, followed by 500 mg every 12 hours for 5 to 10 days. Oral therapy should be substituted as soon as feasible.
- Surgical prophylaxis: 1 g intravenous infusion approximately 30 minutes before surgery.
- Trichomoniasis: Single dose of 3 tablets (1500 mg) or two tablets daily (1000 mg) for five days.
Children:
- Trichomoniasis, Giardiasis, and Amoebiasis: 25 mg/kg/day in a single dose.
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically necessary, but caution is advised in patients with impaired liver function.
- Patients with Renal Impairment: Dosage adjustment is generally not required.
- Patients with Hepatic Dysfunction: Dose adjustments may be necessary in severe hepatic impairment, typically doubling the dosing interval.
- Patients with Comorbid Conditions: Dosage adjustments may be needed depending on the specific comorbid condition.
Clinical Use Cases
The Ornidazole + Sodium Chloride infusion is specifically indicated for:
- Surgical Procedures: Prophylaxis against anaerobic infections.
- Emergency Situations: Treatment of severe anaerobic infections.
Dosage Adjustments
Dosage modifications may be needed based on individual patient factors, especially in the presence of severe hepatic impairment. Consult current guidelines for specific recommendations.
Side Effects
Common Side Effects:
- Nausea
- Headache
- Dizziness
- Metallic taste
- Dry mouth
Rare but Serious Side Effects:
- Seizures
- Peripheral neuropathy
- Leukopenia or thrombocytopenia
- Severe allergic reactions (anaphylaxis)
Long-Term Effects:
Chronic complications are rare with short-term use. Long-term use may result in peripheral neuropathy.
Contraindications
- Hypersensitivity to ornidazole or other nitroimidazoles.
- First trimester of pregnancy.
- Patients with certain CNS diseases (e.g., epilepsy, multiple sclerosis) should use with extreme caution.
Drug Interactions
- Alcohol: Avoid alcohol during and shortly after treatment (disulfiram-like reaction).
- Anticoagulants (e.g., warfarin): Ornidazole may enhance anticoagulant effects.
- Vecuronium and Warfarin: Incompatible for intravenous co-administration.
Pregnancy and Breastfeeding
- Pregnancy: Contraindicated in the first trimester. Use with caution in the second and third trimesters only if clearly needed.
- Breastfeeding: Ornidazole is excreted in breast milk. Breastfeeding is not recommended during treatment and for a period after the last dose based on the prescribing information.
Drug Profile Summary
- Mechanism of Action: Disrupts microbial DNA synthesis and structure.
- Side Effects: Nausea, headache, dizziness, metallic taste, rarely seizures, peripheral neuropathy.
- Contraindications: Hypersensitivity, first-trimester pregnancy, certain CNS diseases (use with caution).
- Drug Interactions: Alcohol, anticoagulants, vecuronium, warfarin.
- Pregnancy & Breastfeeding: Contraindicated in the first trimester; breastfeeding not recommended.
- Dosage: Varies depending on indication and patient factors; see detailed dosage section.
- Monitoring Parameters: Liver function tests, complete blood count (CBC), neurological status.
Popular Combinations
Ornidazole is sometimes combined with ofloxacin or amoxicillin and lansoprazole for specific infections.
Precautions
- Assess for allergies and pre-existing medical conditions before administration.
- Caution in patients with liver disease, alcoholism, epilepsy, or brain damage.
- Exercise care in pregnant or breastfeeding women, as well as in children.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Ornidazole + Sodium Chloride?
A: The dosage varies according to the infection being treated. Please consult the detailed dosage guidelines above.
Q2: What are the common side effects?
A: Common side effects include nausea, headache, dizziness, metallic taste, and dry mouth.
Q3: Can Ornidazole + Sodium Chloride be used during pregnancy?
A: It is contraindicated in the first trimester and should be used with caution in the second and third trimesters only if clearly needed.
Q4: What are the serious side effects of ornidazole?
A: Rare but serious side effects include seizures, peripheral neuropathy, and blood disorders. Allergic reactions can also occur.
Q5: Can patients drink alcohol while taking ornidazole?
A: No, alcohol should be avoided during and after treatment due to a potential disulfiram-like reaction.
Q6: How does Ornidazole + Sodium Chloride work?
A: Ornidazole disrupts microbial DNA, and Sodium Chloride helps maintain electrolyte balance.
Q7: Are there any drug interactions with Ornidazole?
A: Yes, clinically significant interactions exist with alcohol, anticoagulants, vecuronium, and warfarin. Always consult a comprehensive drug interaction database.
Q8: What should I monitor in patients receiving Ornidazole + Sodium Chloride?
A: Liver function tests, complete blood count, and neurological status should be monitored.
Q9: Is there an alternative for breastfeeding mothers?
A: Other treatments exist and should be considered as breastfeeding is not recommended during and after treatment. Specific recommendations should be made on a case-by-case basis.
