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Metronidazole + Miconazole nitrate (Inserdin) should be used cautiously in patients with alteration of hematopoietic function, with central and peripheral nervous system disorders.
It is recommended to avoid sexual contacts during the treatment. Administration of the vaginal suppositories can reduce the efficacy of local contraception (preservatives, vaginal diaphragms) due to interactions of the suppository base with the latex.
As a prophylaxis for reinfection, simultaneous treatment of sexual partner is recommended and in the case of trichomonal vaginitis administration of systemic medicinal products, for example, metronidazole orally.
Patients should be advised not to take alcohol during the therapy and for 3 days after the end of the treatment, because of the possibility of a disulfiram-like reaction.
During the treatment, there may be a change in the values of transaminases and glycemia.
Renal/Liver failure: In renal failure, the half-life of metronidazole is not changed. Therefore, dose reduction is not necessary, but in serious impaired renal function in which hemodialysis is required, dose adjustment should be done. In serious liver function failures, metronidazole clearance may be impaired. Metronidazole may increase encephalopathy symptoms due to increased plasma levels and therefore should be used carefully in hepatic encephalopathy patients. The daily dose of metronidazole must be reduced to 1/3 in patients with hepatic encephalopathy.
Effects on Ability to Drive and Use Machines: Systemic administration of metronidazole may affect driving and using machines. In comparison with systemic use, topical metronidazole is absorbed in vagina in low concentrations. Metronidazole + Miconazole nitrate (Inserdin) may cause dizziness, ataxia, fatigue and weakness, therefore may affect driving or operating machinery.
Use in Children: Not to be used in children under 18 years of age.
Use in the Elderly: Same dose as for adults is administered in elderly over 65 years.
Or as prescribed by the physician.
