Metronidazole

Excreted Unchanged %
20
Half-Life (Normalesrd) Hours
6-14/7-21
Plasma Protein Binding %
20
Volume Of Distribution L/Kg
0.25-0.85
Dose For Normal Renal Function
250-500 mg q8-12h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
100% [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
100% [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose after dialysis
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, [B]
References
Golper TA, Gleason JR, Vincent HH, et al. Drug removal during high efficiency and high flux hemodialysis. Contemp Iss Nephrol. 1993; 27: 175-208. [PMID unavailable] / Golper TA, Marx MA. Drug dosing adjustments during continuous renal replacement therapies. Kidney Int Suppl. 1998; 66: S165-8. [PMID: 9573596] / Guay DR, Meatherall RC, Baxter H, Jacyk WR, Penner B. Pharmacokinetics of metronidazole in patients undergoing continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother. 1984; 25: 306-10. [PMID: 6721462] / Houghton GW, Dennis MJ, Gabriel R. Pharmacokinetics of metronidazole in patients with varying degrees of renal failure. Br J Clin Pharmacol. 1985; 19: 203-9. [PMID: 3986078] / Keane WF, Everett ED, Golper TA, Gokal R, Halstenson C, Kawaguchi Y, et al. Peritoneal dialysis-related peritonitis treatment recommendations. 1993 update. The Ad Hoc Advisory Committee on Peritonitis Management. International Society for Peritoneal Dialysis. Perit Dial Int. 1993; 13: 14-28. [PMID: 8443273] / Lau AH, Chang CW, Sabatini S. Hemodialysis clearance of metronidazole and its metabolites. Antimicrob Agents Chemother. 1986; 29: 235-8. [PMID: 3717930] / St Peter WL, Redic-Kill KA, Halstenson CE. Clinical pharmacokinetics of antibiotics in patients with impaired renal function. Clin Pharmacokinet. 1992; 22: 169-210. [PMID: 1559311]
Toxicity Notes
Metabolites accumulate. Rare drug-induced lupus.