Dosing
CrCl > 80: 125- 500 mg po/iv q 6 to 12 (usually q 12).
CrCl 80-50: 125- 500 mg po/iv q 6 to 12 (usually q 12).
CrCl 50-10: 125- 500 mg po/iv q 6 to 12 (usually q 12).
CrCl < 10: 125- 500 mg po/iv q 6 to 12 (usually q 12).
Hemodialysis: 125- 500 mg po/iv q 6 to 12 (usually q 12).
Peritoneal dialysis: 125- 500 mg po/iv q 6 to 12 (usually q 12).
Important side effects
Ataxia, dizziness, headache, peripheral neuropathy, seizures, anorexia, gi discomfort, metallic taste, n/v, disulfiram-like (antabuse) reaction with puke central.
Important drug interactions
Acenocoumarol, amprenavir, anisindione, carbamazepine, cholestyramine, cyclosporine, dicumarol, disulfiram, ergot derivatives, fluorouracil, fosphenytoin, lithium, phenindione, phenobarbital, phenprocoumon, phenytoin, tacrolimus, warfarin.
Rants and Screeds
Pearls
Treatment of choice
Anaerobes, there ain't better. But only strict anaerobes. Treat the microaerophilic organisms with a beta lactam.
Use for
Amebiasis, anaerobic infections, Arthritis, Bacterial vaginosis, Cellulitis, Clostridium difficile-associated colitis, Clostridium infections, crohn's disease, dermatitis - seborrheic, diarrhea, Diverticulosis/itis, Dracunculus medinesis infections, Endocarditis - bacteroides, Endometritis, post-cesarean, E. histolytica, entamoeba polecki, Fasciola hepatica, fistula prophylaxis, Giardia lamblia, gynecological infections, Helicobacter pylori infections, hepatic encephalopathy, inflammatory bowel disease, Intra abdominal infections, Meningitis, ocular rosacea, Osteomyelitis, periodontal disease, pneumatosis coli, Pneumonia, pouchitis, preterm labor - prevention, rheumatoid arthritis, rosacea, Sepsis - anaerobic, surgical prophylaxis, Sweets Syndrome, tonsillitis, Trichomonas vaginalis.
Don't use for
Pregnancy. In pregnancy I mean. Not for pregnancy.
Class
By itself. See. In a class by itself. Humor.