Flagyl IV Special Precautions

Used with caution in nursing mothers as metronidazole is excreted in breast milk, during first and second trimesters of pregnancy as metronidazole crosses the placental barrier.
Used with caution in patients with central nervous system diseases. Disturbances of central nervous system have been reported in some cases but disappeared if therapy is discontinued or dose is decreased.
Taking alcohol during metronidazole therapy may cause abdominal cramps, nausea, vomiting, headache, flushing.
In prolonged metronidazole administration, it is recommended to perform hematological tests.
Cases of severe hepatotoxicity/acute hepatic failure, including cases with a fatal outcome with very rapid onset after treatment initiation, in patients with Cockayne syndrome have been reported with products containing metronidazole for systemic use. In this population, metronidazole should therefore be used after careful benefit-risk assessment and only if no alternative treatment is available. Liver functions tests must be performed just prior to the start of therapy, throughout and after end of treatment until liver function is within normal ranges, or until the baseline values are reached. If the liver function tests become markedly elevated during treatment, the drug should be discontinued. Patients with Cockayne syndrome should be advised to immediately report any symptoms of potential liver injury to their physician and stop taking metronidazole.
The use of Flagyl for prolonged treatment duration should be carefully weighed.
Dosage should be reduced and administered with caution in patients with hepatic diseases.
Safety and effectiveness in pediatric patients have not been established, except in the treatment of amoebiasis.
Effects on ability to drive and use machines: Patients should be warned about the potential for drowsiness, dizziness, confusion, hallucinations, convulsions or eye disorders, and advised not to drive or operate machinery if these symptoms occur.