Metromic/Metromic Forte Special Precautions

Patients should be warned not to take alcohol during the therapy and for 3 days after the end of the treatment because of the possibility of disulfiram-like reactions.
High doses and long term systemic use may cause peripheral neuropathy and convulsion. Should not be used in young females who are not sexually active.
The suppositories base may damage rubber or latex condoms or diaphragms, therefore concurrent use is not recommended.
Other vaginal products (e.g. Tampon, douche or spermicide) should not be used during the treatment.
Sexual partners with Trichomonas vaginalis should be treated at the same time.
In renal insufficiency metronidazole dose should be reduced.
In severe hepatic insufficiency 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.
Should not be used in girls who are not sexually mature.
Not to be swallowed or applied by other routes.
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. Patients should be warned about the potential for dizziness, ataxia, fatigue and weakness and advised not to drive or operate machinery if these symptoms occur.
Use in the Elderly: Elderly patients (over 65 years): same recommendations as for the rest of the patients.