Emgyl Tablet and Suspension; Use and Prescription

Emgyl metronidazole tablets ip 400mg uses and dosage

Category

Emgly belobg to the category of Anti-Microbes

Overview.

Metronidazole is an antibiotic that is used to treat a wide variety of infections. It works by stopping the growth of certain bacteria and parasites. This antibiotic treats only certain bacterial and parasitic infections. It will not work for viral infections (such as common cold, flu).

Description.

About metronidazole. It’s used to treat skin infections, rosacea and mouth infections (including infected gums and dental abscesses). It’s used in the treatment of conditions such as bacterial vaginosis and pelvic inflammatory disease.

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Why Emgyl is used

Emgyl Tablet is a prescription medicine that is used to treat a sexually transmitted infection (called symptomatic trichomoniasis). This medicine works by interacting with DNA that interferes with the DNA synthesis that leads to the end of bacteria.

Emgyl Tablet is also used to treat the following conditions:

  1. a genitourinary infection (called asymptomatic trichomoniasis),
  2. to treat asymptomatic sexual partners,
  3. to treat a parasitic infection of the colon (amebiasis) and a parasitic infection of the small intestine (giardiasis),
  4. treatment of certain anaerobic bacterial infections that include intra-abdominal infections, skin and skin structure infections, female reproductive organ (gynecologic) infections, blood poisoning (bacterial septicemia), lower respiratory tract infection, serious heart infection (endocarditis), central nervous system infections, and bone and joint infections,
  5. to prevent the infections that may occur before, during or after the operation of the intestine (elective colorectal surgery),
  6. to treat acute dental infections e.g. painful infection of the gums (acute ulcerative gingivitis or acute pericoronitis) and pus inside the teeth (acute apical infections),
  7. and to treat anaerobically-infected leg ulcers and pressure sores.

When not to use

Emgyl Tablet will not work against viral infections such as the common cold.

Nitroimidazole Antimicrobial

Emgyl belongs to the Nitroimidazole Antimicrobial class of medicines. Nitroimidazole Antimicrobial.

How to use

Read the medicine guide provided by your pharmacist, your doctor, or the medicine company. If you have any questions related to Emgyl, ask your doctor or pharmacist.

Use Emgyl Tablet as per the instructions provided by your doctor.
Emgyl is used with or after food. Emgyl should be swallowed with water. It should not be chewed.

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Dosage

The typical dose of Emgyl for adults is 750 mg three times daily orally for 5 to 10 days. The usual dose for children is 35 to 50 mg/kg/24 hours or 15.9 to 22.7 mg/lb/kg/24 hours, orally for 10 days divided into three doses.

The maximum dose for adult patients of Emgyl is 2000 mg per day. This medicine is generally used for a period of 7 days for trichomoniasis, 5-10 days for amebiasis, 7-10 days for anaerobic bacterial infections, 5-7 days for bacterial vaginosis, 3-10 days for giardiasis, 3 days for acute ulcerative gingivitis, 3-7 days for acute dental infections, 7 days for leg ulcers and pressure sores, and 7-14 days for eradication of Helicobacter pylori.

caution

This medicine should be used on an as-needed basis. Infections of the bone and joint, endocardium, and lower respiratory tract may require longer treatment. Emgyl should be used as directed by the doctor even if you feel well, or even if you think that there is no need for you to use your medicine.

Discuss with your doctor if your condition does not improve or worsens. Discuss with your doctor if stomach pain, abnormally low weight, nausea, vomiting, fever, feeling of discomfort, fatigue, yellowing of the skin, dark urine, and discolored stools or itching. If you have issues with the health of your liver, For patients with severe liver damage (Child-Pugh C), the dose of Emgyl should be reduced by 50%.
Your doctor may prescribe a lower starting dose of this medicine to understand the impact on the body. Please follow your doctor’s recommendations. Older patients may see an increase in the incidence of side-effects. As a result, a lower dose may be recommended for older patients.

Administering Emgyl to Children

If you are giving Emgyl Tablet to a child, be sure to use a product that is for use in children. Use the child’s weight or age to find the right dose from the product package or medicine label. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.

Decreasing side-effects

To decrease the possibility of side-effects, you might be recommended to use the extended-release form of this medicine by your doctor. The extended-release medicine helps in maintaining a steady level of the medicine in your body for a longer period of time. Do not crush or chew the medicine, unless indicated on the package or by your doctor.

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Best way to administer emgyl

Emgyl is intended for intravenous (into the veins) use only. Emgyl is to be given slowly by intravenous drip infusion only, either as a constant or periodic infusion. Intravenous admixtures comprising Emgyl and other drugs should be avoided. Emgyl Injection, USP is a ready-to-use isotonic solution. There is no requirement of dilution or buffering and do not refrigerate the injection.
Avoid consuming alcohol together with Emgyl.

Your doctor may request that specific lab tests be performed before you start using Emgyl Tablet. Your doctor may ask you to undergo Antibiotic Susceptibility test. This test helps the doctor in selecting an appropriate antibacterial drug for starting the therapy. Your doctor may request liver function test test. Liver function tests must be done just before to the start of treatment, throughout and after the end of treatment until liver function is within average ranges, or till the baseline values are achieved. Emgyl should be discontinued if the liver function tests become markedly raised during treatment.

Medicines may be recommended for uses other than those listed in the medicine guide. You should not use Emgyl Tablet for conditions or symptoms for which it was not prescribed. Do not give Emgyl Tablet to other people, even if they have the same conditions or symptoms that you have. The use of this medicine without the advice of a doctor may cause harm.

Follow storage instructions on the product package if available. Store Emgyl Tablet below 25°C (77°F), away from excess heat and moisture, and protect from light. Store this medicine away from children and pets.
Read more: What are the uses of Emgyl?

How to take Emgyl

Your dose and how often you take Emgyl will depend on the following factors:

  1. age
  2. weight
  3. patient’s health
  4. the health of the patient’s kidneys
  5. response to the medicine
  6. Emgyl Dosage
  7. Dosage for sexually transmitted infection caused by a parasite (trichomoniasis)

Adult

Recommended: 2000 mg as a single dose or 1000 mg in two divided doses on the same day or 250 mg three times a day for seven days.

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Children (Children 1 to 10 years)

Recommended: 40 mg/kg (18.18 mg/lb) in a single dose or 15-30 mg/kg (6.8- 13.6 mg/lb) in a day divided in 2-3 doses

Maximum: 2000 mg per dose

Dosage for parasitic infection of the colon (amebiasis)

Adult

Recommended: 500 mg or 750 mg three times daily for 5 to 10 days

Children

Recommended: 35 to 50 mg/kg/day (15.9-22.7 mg/lb/day) divided into three doses daily for 10 days

Dosage for anaerobic bacterial infections

Adult

Recommended: 7.5 mg/kg (3.3 mg/lb) (approximately 500 mg for a 70 kg/154 lb adults) every six hours for 7 to 10 days

Maximum: 4000 mg in a day for 7 to 10 days

Dosage for bacterial overgrowth in the vagina (bacterial vaginosis)

Adult (adults and children over 10 years)

Recommended: 2000 mg as a single dose on the same day or 400 mg twice a day for 5 to 7 days.

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Dosage for a parasitic infection of the small intestine (giardiasis)

Adult (adults and children over 10 years)

Recommended: 2000 mg once a day for 3 days or 400 mg three times a day for 5 days or 500 mg twice a day for 7-10 days

Children (children 7 to 10 years)

Recommended: 1000 mg once a day for 3 days

Children (children 3 to 7 years)

Recommended: 600-800 mg once daily for 3 days
Children (children 1 to 3 years)

Recommended: 500 mg once daily for 3 days

Dosage for infection of the gums (acute ulcerative gingivitis)

Adult (adults and children over 10 years)

Recommended: 200 mg three times a day for 3 days

Children (children 7 to 10 years)

Recommended: 100 mg three times daily for 3 days

Children (children 3 to 7 years)

Recommended: 100 mg twice daily for 3 days

Children (children 1 to 3 years)

Recommended: 50 mg three times daily for 3 days

Dosage for acute dental infections

Adult

Recommended: 200 mg three times a day for 3 to 7 days

Dosage for leg ulcers and pressure ulcers

Adult

Recommended: 400 mg three times daily for 7 days

Dosage for eradication of Helicobacter pylori bacteria

Children

Recommended: 20 mg/kg/day (9.09 mg/lb/day) for 7-14 days

Maximum: 500 mg for 7-14 days

Minimum Age: infants less than 8 weeks

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Missed Dose

A missed dose should be taken as early as you remember it. However, if the time for the next dose is almost there, then the missed dose should be skipped, and the regular dosing schedule should be continued. Avoid taking a repeated dose to make up for a missed one.

Overdose

What to do if you overdose on Emgyl?

There is no specific antidote for an overdose of Emgyl. In cases of massive overdose, supportive and symptomatic therapy should be started.

Symptoms of an overdose of Emgyl

If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:

  • loss of body movements
  • nausea
  • nerve damage (peripheral neuropathy)
  • seizures
  • suicide attempts
  • vomiting

If you think you have overdosed on Emgyl Tablet, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.

Precautions while using Emgyl

Before you use Emgyl Tablet, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic to nitroimidazole-antimicrobial.

Before you use Emgyl, tell your doctor of your medical history including blood disorder (blood dyscrasia), inflammation of the digestive tract (Crohn’s disease), liver disease, kidney disease, or rare disease causing short stature, premature aging, severe sensitivity to sun, and moderate to severe delay in learning (Cockayne syndrome).

Patients with blood disorders such as dyscrasia are at a risk to develop mild abnormalities like decreased blood cell count. In patients with liver damage, adjustment of dose is required and patients who have Crohn’s disease are at an increased risk to develop stomach and intestinal cancers. Patients with Cockayne syndrome should be advised by the doctor for regular monitoring of liver function both during and after the treatment with Emgyl.

The use of this medicine may change aspartate transaminase, AST. The liver enzyme, AST is found to increase when Emgyl is given to the patient.
The use of Emgyl Tablet may change alanine transaminase, ALT. The liver enzyme, AST is found to increase when Emgyl is given to the patient.

The use of this medicine may change alkaline phosphatase. The liver enzyme, AST is found to increase when Emgyl is given to the patient.
Avoid the consumption of alcohol with Emgyl Tablet. Drinking alcohol may cause a reaction to a medicine (disulfiram-like reaction), cramps in stomach, nausea, vomiting, headache, and flushing.

Consult with your doctor on the use of Emgyl Tablet during pregnancy. Emgyl is known to cross the placenta but its effects on the formation of organs in the human fetus are not known. It should only be given to pregnant women if the doctor finds it essential and not otherwise. Consult with your doctor on the use of Emgyl Tablet during breastfeeding. Emgyl is found to be present in human milk. The decision to use this medicine should depend on the importance of Emgyl to the mother and only if the doctor finds it essential to be given to the mother.

Emgyl Tablet can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Emgyl Tablet can make you feel more sleepy. Emgyl Tablet may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.
Emgyl Tablet may increase side-effects in older patients.

There is a risk of mutations (mutagenicity) in humans if Emgyl is used for longer treatment than it is usually required.

What precautions should be taken during Pregnancy and Nursing, and administering Emgyl to Children or the Older Adults?

Pregnant Women

Only When Necessary

Warning: Emgyl is known to cross the placenta but its effects on the formation of organs in the human fetus are not known. It should only be given to pregnant women if the doctor finds it essential and not otherwise.

Breastfeeding

Only When Necessary

Warning: Emgyl is found to be present in human milk. The decision to use this medicine should depend on the importance of Emgyl to the mother and only if the doctor finds it essential to be given to the mother.

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Younger Adults Population

Possibly safe

Warning: Safety and effectiveness of Emgyl in children have not been established, except for the treatment of an infection caused by parasite amoeba (amebiasis).
Older Adults Population
Possibly safe

Warning: Monitoring of side-effects related to the use of Emgyl is recommended.

Emgyl Side-effects

If any of these side-effects worsen or last for a long time, you should consult with your doctor. The following side-effects may commonly occur when using Emgyl Tablet:

  1. ECG changes in T-wave amplitude
  2. a decrease in sexual desire (decrease of libido)
  3. change in the color of urine (darkened urine)
  4. constipation
  5. cramps in the stomach
  6. diarrhea
  7. excessive production of urine
  8. headache
  9. inflammation of a vein caused by a blood clot (thrombophlebitis)
  10. nausea
  11. pain in upper part of the stomach
  12. painful and difficult urination
  13. serious eating disorder (anorexia)
  14. tiny bumps on the surface of the tongue (furry tongue)
  15. vomiting

Rarely, the use of Emgyl Tablet may cause the following side-effects:

  1. a sense of pelvic pressure
  2. abnormally low levels of neutrophils (reversible neutropenia)
  3. abnormally low levels of thrombocytes
  4. decreased white blood cell count
  5. dizziness
  6. dryness of the mouth
  7. dryness of vagina or vulva
  8. fainting
  9. flushing
  10. hives
  11. inability to control urine (urinary incontinence)
  12. incoordination
  13. inflammation of the tongue (glossitis)
  14. insomnia
  15. irritability
  16. loss of body movements
  17. nasal congestion
  18. pain in joints (arthralgia)
  19. pain in muscle
  20. painful or difficult sexual intercourse (dyspareunia)
  21. rashes due to diseases, allergic reactions, and infections (erythematous rash)
  22. severe itching
  23. speech disorder
  24. swelling in the lower layer of skin
  25. unpleasant metallic taste
  26. vertigo
  27. weakness

The following severe side-effects may also occur when using Emgyl Tablet:

  • central nervous system including brain diseases (encephalopathy)
    Symptoms: convulsive seizures, inflammation of the membranes of the brain and spinal cord (aseptic meningitis), damage to the optic nerve (optic neuropathy), weakness, numbness, tingling sensation and pain due to nerve damage in the hands and feet (peripheral neuropathy), confusion depression
    The symptoms of nervous system due to the use of Emgyl may resolve if the drug is discontinued.
  • stomach and intestinal (gastrointestinal) disorders
    Symptoms: painful swelling and sores inside the mouth, inflammation of rectum (proctitis), inflammation of the digestive tract (Crohn’s disease) colon cancer
  • allergic reactions
    Symptoms: a serious and life-threatening disorder of the skin (Stevens-johnson syndrome) fleeting joint pain that resembles an allergic reaction
  • liver and pancreatic disorders
    Symptoms: increase in liver enzymes (AST, ALT, alkaline phosphatase), inflammation of the liver (hepatitis), liver damage (hepatocellular liver injury and liver failure), yellow discoloration of the skin (jaundice) inflammation of the pancreas (pancreatitis)
    The symptoms of pancreatitis are reversible if the drug is discontinued.
  • blood disorders
    Symptoms: an abnormal decrease in white blood cells, agranulocytes, deficiency of red blood cells, white blood cells and platelets (pancytopenia)
    kidney disorders
    Symptoms: infection of the urinary system (cystitis)
  • eye disorders
    Symptoms: double vision (diplopia) short-sightedness (myopia)
  • female reproductive organ infections
    Symptoms: fungal infection of the vagina
    Your doctor has prescribed this medicine because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious cases of side-effects. This page does not contain a complete list of all possible side-effects.

If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Emgyl by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

  1. ECG changes in T-wave amplitude
  2. abdominal cramping
  3. anorexia
  4. constipation
  5. darkened urine
  6. decrease of libido
  7. diarrhea
  8. dysuria
  9. epigastric distress
  10. furry tongue
  11. headache
  12. inflammation of a vein caused by a blood clot (thrombophlebitis)
  13. nausea
  14. polyuria
  15. vomiting
  16. Infrequent and Rare Side-effects
  17. Following are the infrequent and rare side-effects of this medicine:
  18. a sense of pelvic pressure
  19. abnormally low levels of neutrophils (reversible neutropenia)
  20. abnormally low levels of thrombocytes
  21. decreased white blood cell count
  22. dizziness
  23. dryness of the mouth
  24. dryness of vagina or vulva
  25. erythematous rash
  26. fainting
  27. flushing
  28. hives
  29. incoordination
  30. inflammation of the tongue (glossitis)
  31. insomnia
  32. irritability
  33. loss of body movements
  34. nasal congestion
  35. pain in joints (arthralgia)
  36. pain in muscles
  37. painful or difficult sexual intercourse (dyspareunia)
  38. severe itching
  39. speech disorder
  40. swelling in the lower layer of skin
  41. unpleasant metallic taste
  42. urinary incontinence
  43. vertigo
  44. weakness

Severe Side-effects

Following are the severe side-effects of this medicine:

  1. an abnormal decrease in white blood cells, agranulocytes (agranulocytosis)
  2. brain diseases (encephalopathy)
  3. breast cancer
  4. colon cancer
  5. confusion
  6. convulsive seizures
  7. deficiency of red blood cells, white blood cells, and platelets (pancytopenia)
  8. depression
  9. double vision (diplopia)
  10. fever
  11. fungal infection of the vagina
  12. hepatocellular liver injury
  13. increase in liver enzymes (AST, ALT, alkaline phosphatase)
  14. infection of the urinary system (cystitis)
  15. inflammation of rectum (proctitis)
  16. inflammation of the digestive tract (Crohn’s disease)
  17. inflammation of the liver (hepatitis)
  18. inflammation of the membranes of the brain and spinal cord (aseptic meningitis)
  19. inflammation of the pancreas (pancreatitis)
  20. joint pain sometimes resembling serum sickness
  21. liver failure
  22. near-sightedness (myopia)
  23. optic neuropathy
  24. painful swelling and sores inside the mouth (stomatitis)
  25. peripheral neuropathy
  26. serious and life-threatening disorder of skin (Stevens-johnson syndrome)
  27. yellow discoloration of the skin (jaundice)
  28. Mild Allergic Reactions
  29. Following are the symptoms of mild allergic reactions to this medicine:
  30. flushing
  31. hives
  32. nasal congestion
  33. rashes due to diseases, allergic reactions, and infections (erythematous rash)

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:
a serious and life-threatening disorder of skin (Stevens-johnson syndrome)
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Emgyl Warnings

  • Discoloration of urine
    Patients who on treatment with Emgyl are at an increased risk to develop darken urine.
  • Use of Emgyl for longer treatment
    Patients on longer treatment than usual with Emgyl are at an increased risk. Such patients may develop changes in the amount or structure of the genetic material of cells (mutagenicity).
  • Convulsive seizures
    Patients who on treatment with Emgyl are at an increased risk to develop seizures.
  • Loss of liver function
    As the breakdown of Emgyl is done by liver enzymes, hence in the patients with damaged liver functions, the removal of Emgyl has interfered. Accumulation of Emgyl may occur in patients in whom the functions of the brain are lost when a damaged liver does not remove harmful substances from the blood (liver encephalopathy), and the high levels of Emgyl in the blood may contribute to the symptoms of the encephalopathy. Such patients should take Emgyl with caution, and the daily dose should be reduced to one third and should be given once a day.
  • Patients undergoing the procedure of blood purification (hemodialysis)
    In patients who are undergoing hemodialysis treatment, Emgyl and its metabolites are removed following a period of eight hours of dialysis. Emgyl should be given immediately after performing hemodialysis.
  • Adverse drug reactions which result in fluid-filled blisters (severe bullous skin reactions)
    Patients who are undergoing treatment with Emgyl are at increased risk to develop severe bullous skin reactions such as serious disorder of the skin and mucous membranes (Stevens-Johnson syndrome) and rare skin reaction (acute generalized exanthematous pustulosis). If these symptoms occur, discontinue the use of Emgyl.
  • Severe liver damage
    Patients who are on treatment with Emgyl are at an increased risk of severe liver damage, it may result in a life-threatening outcome. In such patients, Emgyl should be used after careful monitoring and only if there is no other treatment available. Tests for the liver function must be performed before starting the therapy, during and after the therapy until the liver function is within normal values. The drug should be discontinued in case the values of liver function tests become considerably increased during treatment. Patients who have Cockayne syndrome should be advised to report the symptoms of liver injury to their doctor and should be informed to stop taking Emgyl.
  • Inflammation of membranes of the brain and spinal cord (aseptic meningitis)
    Patients undergoing treatment with Emgyl are at an increased risk to develop inflammation of the brain and spinal cord (meningitis).
  • Weakness, numbness, and pain due to nerve damage (peripheral neuropathy)
    Patients who are on treatment with Emgyl are at an increased risk to develop peripheral neuropathy. Such patients are at an increased risk to experience peripheral neuropathy, numbness or tingling sensation of an extremity.
  • Brain disease that alters brain function or structure (encephalopathy)
  • Encephalopathy and peripheral neuropathy (including optic neuropathy) patients are at an increased risk when using Emgyl. Such patients are at an increased risk to experience encephalopathy and weakness, numbness, and pain due to nerve damage in the hands and feet (peripheral neuropathy). Emgyl should be utilized with caution in patients with liver encephalopathy and the dose should lower to one third or may use once a day.

Interactions with Emgyl

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.

Your doctor’s guidelines may need to be followed while taking this medicine along with Busulfan, which is used in the treatment of certain types of cancers. The patients who use Emgyl in combination with busulfan may experience an increase in the levels of busulfan in the blood, which may result in an increased risk of harmful effects of busulfan due to its accumulation. Patients who are on treatment with Emgyl should not be given busulfan if the benefit by busulfan is less than the risk. If there is no other treatment available, the levels of busulfan in the blood should be monitored routinely and its dose should be adjusted properly.

Emgyl Tablet interacts with warfarin and other oral anticoagulants, which are used to prevent blood clots. The patients who use Emgyl in combination with anticoagulants such as warfarin may experience an increased anticoagulant effect of warfarin and other oral anticoagulants, which may further prolong the blood clotting time. In such patients, the time that blood takes to clot (prothrombin time and international normalized ratio) should be carefully monitored.

There may be an interaction of Emgyl with alcoholic beverages, which is an alcoholic drink containing ethanol, known as alcohol. The patients undergoing treatment with Emgyl may experience cramps in stomach, nausea, vomiting, headache, and flushing if they consume alcohol or substances containing propylene glycol during or after treatment. Patients who are on treatment with Emgyl should stop consumption of alcohol or products that contain propylene glycol during and after three days of therapy with Emgyl.

Emgyl Tablet may interact with disulfiram, which is used for the treatment of alcoholism. The patients who use Emgyl in combination with disulfiram may develop mental problems (psychotic reactions). The patients who have taken disulfiram within the last two weeks should not take Emgyl.

Special instructions need to be followed while taking this medicine along with lithium, which is used to treat a major depressive disorder. The patients who are on high dose levels of lithium and who undergo short-term treatment with Emgyl have been associated with increased levels of lithium in the blood. In some cases, lithium poisoning may occur due to high levels of lithium. The levels of lithium and creatinine in the blood should be monitored after certain days of beginning treatment with Emgyl to recognize any increase that may lead to clinical symptoms of damage due to lithium accumulation.

Your doctor’s guidelines may need to be followed while taking this medicine along with 5 fluorouracil, which is used in the treatment of cancer. When Emgyl is given along with 5 fluorouracil, the clearance of 5 fluorouracil is decreased and the accumulation of 5 fluorouracil can result in harmful effects.

Emgyl Tablet interacts with drug or laboratory tests. The patients who use Emgyl may interfere with certain types of tests of blood chemistry values such as aspartate aminotransferase, lactate dehydrogenase, alanine aminotransferase, triglycerides, and glucose hexokinase and the values of zero have been observed.
Special instructions need to be followed while taking this medicine along with ciclosporin, which is used as an immunosuppressant. The patients who use Emgyl in combination with ciclosporin may experience an increase in ciclosporin levels in the blood. Patients who are on treatment with both Emgyl and ciclosporin should closely monitor the levels of ciclosporin and creatinine in the blood.

There may be an interaction of Emgyl with drugs that induce CYP450 enzymes such as phenytoin or phenobarbital, which is used for the prevention of tonic-clonic seizures. The patients who use Emgyl in combination with the drugs that induce microsomal liver enzymes such as phenytoin or phenobarbital may enhance the elimination of Emgyl. It results in reduced levels of Emgyl in the blood and disrupted clearance of phenytoin has also been reported.

Emgyl Tablet may interact with drugs that prevent CYP450 enzymes such as cimetidine, which is used to treat certain types of ulcers. The patients who use Emgyl in combination with the drugs that prevent CYP450 enzymes such as cimetidine may increase the level and decrease the clearance of Emgyl from the blood.

This page does not contain all the possible interactions of Emgyl Tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Interactions of Emgyl by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

  • Disulfiram
  • Alcohol

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

  • Busulfan
  • Anti-coagulant
  • Lithium
  • 5-Fluorouracil
  • Warfarin

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

  • Ciclosporin
  • Cimetidine
  • Phenytoin
  • Phenobarbital

When should Emgyl be not used?

Severe allergic reaction

Emgyl should not be given to patients with a history of severe allergic reaction to Emgyl or other nitroimidazole derivatives. These patients may have the following symptoms if they use this medicine:

  • hives
  • rashes due to diseases, allergic reactions, and infections (erythematous rash)
  • serious skin disorder (Stevens-johnson syndrome)
  • flushing
  • nasal congestion
  • dryness of the mouth
  • fever
  • Use during sexually transmitted infection (trichomoniasis)

Emgyl is not recommended for use in patients with trichomoniasis during the first trimester of pregnancy. In pregnant women, the use of Emgyl as a one-day course of treatment should not be used, as it leads to increased levels of the drug in the blood which can reach into the blood circulation of the unborn baby (fetus).
Psychotic reaction with disulfiram

Emgyl should not be given to patients who have taken disulfiram during the last two weeks. Use of Emgyl is linked to mental problems (psychotic reactions) in patients who drink alcohol.

Alcohol consumption

Alcohol or products that contain propylene glycol should not be used in patients during or for at least three days after the treatment with Emgyl. These patients may have the following symptoms if they use this medicine:

  • cramps in stomach
  • nausea
  • vomiting
  • headache
  • flushing

Traveling With Medication

Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.

While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country’s embassy or website.

Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.

If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Emgyl is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

If there are disposal instructions on the package, please follow the instructions.
If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National

Prescription Drug Take-Back events.

If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.

If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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