Details
Stereochemistry | ACHIRAL |
Molecular Formula | C6H9N3O3 |
Molecular Weight | 171.154 |
Optical Activity | NONE |
Defined Stereocenters | 0 / 0 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CC1=NC=C(N1CCO)[N+]([O-])=O
InChI
InChIKey=VAOCPAMSLUNLGC-UHFFFAOYSA-N
InChI=1S/C6H9N3O3/c1-5-7-4-6(9(11)12)8(5)2-3-10/h4,10H,2-3H2,1H3
DescriptionCurator's Comment: description was created based on several sources, including
http://www.emedexpert.com/facts/metronidazole-facts.shtml
Curator's Comment: description was created based on several sources, including
http://www.emedexpert.com/facts/metronidazole-facts.shtml
Metronidazole was synthesized by France's Rhone-Poulenc laboratories and introduced in the mid-1950s under the brand name Flagel in the US, while Sanofi-Aventis markets metronidazole globally under the same trade name, Flagyl, and also by various generic manufacturers. Metronidazole is one of the rare examples of a drug developed as ant parasitic, which has since gained broad use as an antibacterial agent. Metronidazole, a nitroimidazole, exerts antibacterial effects in an anaerobic environment against most obligate anaerobes. Metronidazole is indicated for the treatment of the following infections due to susceptible strains of sensitive organisms: Trichomoniasis: symptomatic, asymptomatic, asymptomatic consorts; Amebiasis: acute intestinal amebiasis (amebic dysentery) and amebic liver abscess; Anaerobic bacterial infections; Intra-abdominal infections, including peritonitis, intra-abdominal abscess, and liver abscess; Skin and skin structure infections; Gynecologic infections, including endometritis, endomyometritis, tubo-ovarian abscess, and postsurgical vaginal cuff infection; Bacterial septicemia; Bone and joint infections, as adjunctive therapy; Central Nervous System infections, including meningitis and brain abscess; Lower Respiratory Tract infections, including pneumonia, empyema, and lung abscess; Endocarditis. Metronidazole is NOT effective for infections caused by aerobic bacteria that can survive in the presence of oxygen. Metronidazole is only effective against anaerobic bacterial infections because the presence of oxygen will inhibit the nitrogen-reduction process that is crucial to the drug's mechanism of action. Once metronidazole enters the organism by passive diffusion and activated in the cytoplasm of susceptible anaerobic bacteria, it is reduced; this process includes intracellular electron transport proteins such as ferredoxin, transfer of an electron to the nitro group of the metronidazole, and formation of a short-lived nitroso free radical. Because of this alteration of the metronidazole molecule, a concentration gradient is created and maintained which promotes the drug’s intracellular transport. The reduced form of metronidazole and free radicals can interact with DNA leading to inhibition of DNA synthesis and DNA degradation leading to death of the bacteria. The precise mechanism of action of metronidazole is unknown. Metronidazole has a limited spectrum of activity that encompasses various protozoans and most Gram-negative and Gram-positive anaerobic bacteria. Metronidazole has activity against protozoans like Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis, for which the drug was first approved as an effective treatment.
CNS Activity
Sources: https://www.ncbi.nlm.nih.gov/pubmed/20930076
Curator's Comment: In animal studies, metronidazole readily penetrated the blood-CSF/blood-brain barrier, and data regarding the entry into human CSF and brain abscess confirmed this finding
Approval Year
Targets
Primary Target | Pharmacology | Condition | Potency |
---|---|---|---|
Target ID: CHEMBL2364041 |
Conditions
Condition | Modality | Targets | Highest Phase | Product |
---|---|---|---|---|
Curative | FLAGYL Approved UseINDICATIONS & USAGE Metronidazole vaginal gel USP, 0.75% is indicated in the treatment of bacterial vaginosis (formerly referred to as Haemophilus vaginitis, Gardnerella vaginitis, nonspecific vaginitis, Corynebacterium vaginitis, or anaerobic vaginosis). NOTE: For purposes of this indication, a clinical diagnosis of bacterial vaginosis is usually defined by the presence of a homogeneous vaginal discharge that (a) has a pH of greater than 4.5, (b) emits a “fishy” amine odor when mixed with a 10% KOH solution, and (c) contains clue cells on microscopic examination. Gram’s stain results consistent with a diagnosis of bacterial vaginosis include (a) markedly reduced or absent Lactobacillus morphology, (b) predominance of Gardnerella morphotype, and (c) absent or few white blood cells. Other pathogens commonly associated with vulvovaginitis, e.g., Trichomonas vaginalis, Chlamydia trachomatis, N. gonorrhoeae, Candida albicans, and Herpes simplex virus should be ruled out. Launch Date1963 |
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Curative | FLAGYL Approved UseINDICATIONS & USAGE Metronidazole vaginal gel USP, 0.75% is indicated in the treatment of bacterial vaginosis (formerly referred to as Haemophilus vaginitis, Gardnerella vaginitis, nonspecific vaginitis, Corynebacterium vaginitis, or anaerobic vaginosis). NOTE: For purposes of this indication, a clinical diagnosis of bacterial vaginosis is usually defined by the presence of a homogeneous vaginal discharge that (a) has a pH of greater than 4.5, (b) emits a “fishy” amine odor when mixed with a 10% KOH solution, and (c) contains clue cells on microscopic examination. Gram’s stain results consistent with a diagnosis of bacterial vaginosis include (a) markedly reduced or absent Lactobacillus morphology, (b) predominance of Gardnerella morphotype, and (c) absent or few white blood cells. Other pathogens commonly associated with vulvovaginitis, e.g., Trichomonas vaginalis, Chlamydia trachomatis, N. gonorrhoeae, Candida albicans, and Herpes simplex virus should be ruled out. Launch Date1963 |
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Curative | FLAGYL Approved UseINDICATIONS & USAGE Metronidazole vaginal gel USP, 0.75% is indicated in the treatment of bacterial vaginosis (formerly referred to as Haemophilus vaginitis, Gardnerella vaginitis, nonspecific vaginitis, Corynebacterium vaginitis, or anaerobic vaginosis). NOTE: For purposes of this indication, a clinical diagnosis of bacterial vaginosis is usually defined by the presence of a homogeneous vaginal discharge that (a) has a pH of greater than 4.5, (b) emits a “fishy” amine odor when mixed with a 10% KOH solution, and (c) contains clue cells on microscopic examination. Gram’s stain results consistent with a diagnosis of bacterial vaginosis include (a) markedly reduced or absent Lactobacillus morphology, (b) predominance of Gardnerella morphotype, and (c) absent or few white blood cells. Other pathogens commonly associated with vulvovaginitis, e.g., Trichomonas vaginalis, Chlamydia trachomatis, N. gonorrhoeae, Candida albicans, and Herpes simplex virus should be ruled out. Launch Date1963 |
Cmax
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
16.54 mg/L Clinical Trial https://clinicaltrials.gov/ct2/show/NCT01222585 |
15 mg/kg single, intravenous dose: 15 mg/kg route of administration: intravenous experiment type: single co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: unhealthy age: CHILD sex: UNKNOWN food status: UNKNOWN |
|
6.77 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22918856 |
250 mg single, oral dose: 250 mg route of administration: Oral experiment type: SINGLE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
6 μg/mL |
250 mg single, oral dose: 250 mg route of administration: Oral experiment type: SINGLE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
12 μg/mL |
500 mg single, oral dose: 500 mg route of administration: Oral experiment type: SINGLE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
40 μg/mL |
2000 mg single, oral dose: 2000 mg route of administration: Oral experiment type: SINGLE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
25 μg/mL |
7.5 mg/kg 4 times / day steady-state, intravenous dose: 7.5 mg/kg route of administration: Intravenous experiment type: STEADY-STATE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
AUC
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
75.23 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22918856 |
250 mg single, oral dose: 250 mg route of administration: Oral experiment type: SINGLE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
T1/2
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
7.76 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/22918856 |
250 mg single, oral dose: 250 mg route of administration: Oral experiment type: SINGLE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: HEALTHY age: ADULT sex: FEMALE / MALE food status: FASTED |
|
8 h |
250 mg single, oral dose: 250 mg route of administration: Oral experiment type: SINGLE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
8 h |
500 mg single, oral dose: 500 mg route of administration: Oral experiment type: SINGLE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
8 h |
2000 mg single, oral dose: 2000 mg route of administration: Oral experiment type: SINGLE co-administered: |
METRONIDAZOLE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
8 h |
unknown, oral |
METRONIDAZOLE plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
Funbound
Value | Dose | Co-administered | Analyte | Population |
---|---|---|---|---|
80% |
unknown, oral |
METRONIDAZOLE plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
Doses
Dose | Population | Adverse events |
---|---|---|
12.5 g single, oral Overdose |
unhealthy, 58 years |
Disc. AE: Hepatotoxicity... AEs leading to discontinuation/dose reduction: Hepatotoxicity (9.6%) Sources: |
8.5 g single, oral Overdose |
unhealthy, 62 years |
|
1000 mg/m2 3 times / day steady, oral Highest studied dose Dose: 1000 mg/m2, 3 times / day Route: oral Route: steady Dose: 1000 mg/m2, 3 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
DLT: Nausea and vomiting, Generalised onset motor seizure... Dose limiting toxicities: Nausea and vomiting (13.5%) Sources: Generalised onset motor seizure (12.8%) Neurotoxicity NOS (10.9%) |
5.3 mg/m2 3 times / week multiple, oral Highest studied dose Dose: 5.3 mg/m2, 3 times / week Route: oral Route: multiple Dose: 5.3 mg/m2, 3 times / week Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
DLT: Gastrointestinal toxicity, Central nervous system toxicity... Dose limiting toxicities: Gastrointestinal toxicity (14.5%) Sources: Central nervous system toxicity (13.7%) |
1350 mg 3 times / day steady, oral Overdose Dose: 1350 mg, 3 times / day Route: oral Route: steady Dose: 1350 mg, 3 times / day Sources: |
unhealthy, preterm newborn Health Status: unhealthy Age Group: preterm newborn Sex: F Sources: |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Hepatotoxicity | 9.6% Disc. AE |
12.5 g single, oral Overdose |
unhealthy, 58 years |
Neurotoxicity NOS | 10.9% DLT |
1000 mg/m2 3 times / day steady, oral Highest studied dose Dose: 1000 mg/m2, 3 times / day Route: oral Route: steady Dose: 1000 mg/m2, 3 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
Generalised onset motor seizure | 12.8% DLT |
1000 mg/m2 3 times / day steady, oral Highest studied dose Dose: 1000 mg/m2, 3 times / day Route: oral Route: steady Dose: 1000 mg/m2, 3 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
Nausea and vomiting | 13.5% DLT |
1000 mg/m2 3 times / day steady, oral Highest studied dose Dose: 1000 mg/m2, 3 times / day Route: oral Route: steady Dose: 1000 mg/m2, 3 times / day Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
Central nervous system toxicity | 13.7% DLT |
5.3 mg/m2 3 times / week multiple, oral Highest studied dose Dose: 5.3 mg/m2, 3 times / week Route: oral Route: multiple Dose: 5.3 mg/m2, 3 times / week Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
Gastrointestinal toxicity | 14.5% DLT |
5.3 mg/m2 3 times / week multiple, oral Highest studied dose Dose: 5.3 mg/m2, 3 times / week Route: oral Route: multiple Dose: 5.3 mg/m2, 3 times / week Sources: |
unhealthy, adult Health Status: unhealthy Age Group: adult Sex: unknown Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
---|---|---|---|
OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
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Drug as perpetrator
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PubMed
Title | Date | PubMed |
---|---|---|
Treatment of experimental pneumocystosis: review of 7 years of experience and development of a new system for classifying antimicrobial drugs. | 1992 Sep |
|
Acute encephalopathy associated with metronidazole therapy. | 1997 Mar-Jun |
|
Metronidazole therapy in mice infected with tuberculosis. | 1999 May |
|
Azole-antifungal binding to a novel cytochrome P450 from Mycobacterium tuberculosis: implications for treatment of tuberculosis. | 2001 Jun 15 |
|
Retrospective analysis of drug-induced urticaria and angioedema: a survey of 2287 patients. | 2001 Nov |
|
Reversible metronidazole-induced lesions of the cerebellar dentate nuclei. | 2002 Jan 3 |
|
Effectiveness of metronidazole gel on cyclosporine-induced gingival overgrowth in heart transplant patients. | 2002 Mar |
|
An unexpected and severe neurological disorder with permanent disability acquired during short-course treatment with metronidazole. | 2003 |
|
An open label crossover trial of effects of metronidazol on hyperlipidaemia. | 2003 Aug |
|
Complete remission of Crohn's disease after high-dose cyclophosphamide and autologous stem cell transplantation. | 2003 Aug |
|
Role of bacteria and inducible nitric oxide synthase activity in the systemic inflammatory microvascular response provoked by indomethacin in the rat. | 2003 Feb 7 |
|
[Evaluation on monkeys of reactogenicity and effectiveness of the complex immunoglobulin preparation formulation]. | 2003 May-Jun |
|
A comparison of 15% azelaic acid gel and 0.75% metronidazole gel in the topical treatment of papulopustular rosacea: results of a randomized trial. | 2003 Nov |
|
Modified vaccinia virus ankara recombinants are as potent as vaccinia recombinants in diversified prime and boost vaccine regimens to elicit therapeutic antitumor responses. | 2003 Nov 15 |
|
Cardiac diphtheria in a previously immunized individual. | 2003 Sep |
|
[Efficacy of two Helicobacter pylori eradication treatments in children with recurrent abdominal pain]. | 2004 Apr-Jun |
|
[Two cases of metronidazole-induced encephalopathy]. | 2005 Mar |
|
Abnormal enhancing lesion of dentate nuclei causing neurologic symptoms induced by metronidazole toxicity. | 2005 Mar |
Sample Use Guides
Trichomoniasis:
In the Female: One-day treatment − two grams of FLAGYL, given ither as a single dose or in two divided doses of one gram each, given in the same day.
Anaerobic Bacterial Infections: In the treatment of most serious anaerobic infections, intravenous metronidazole is usually administered initially. The usual adult oral dosage is 7.5 mg/kg every six hours (approx. 500 mg for a 70-kg adult). A maximum of 4 g should not be exceeded during a 24-hour period.
Amebiasis:
Adults: For acute intestinal amebiasis (acute amebic dysentery): 750 mg orally three times daily for 5 to 10 days.
For amebic liver abscess: 500 mg or 750 mg orally three times daily for 5 to 10 days. Pediatric patients: 35 to 50 mg/kg/24 hours, divided into three doses, orally for 10 days.
Route of Administration:
Other
In Vitro Use Guide
Sources: https://www.ncbi.nlm.nih.gov/pubmed/25681616
Cells incubated with lethal drug (Metronidazole (MTZ)) concentration exhibit unchanged DNA profile, only about 50% of cells are positive for γH2A and lose an ability to attach to a surface after few hours of incubation. It is likely that the early reaction of cells to lethal concentration of MTZ is not primarily initiated by the reaction to DNA damage but rather by the immediate interaction of MTZ with biomolecules where activated MTZ is generated.
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Classification Tree | Code System | Code | ||
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WHO-ESSENTIAL MEDICINES LIST |
6.5.1
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WHO-VATC |
QA02BD02
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NDF-RT |
N0000175435
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WHO-ESSENTIAL MEDICINES LIST |
6.2.2
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WHO-ATC |
P01AB01
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WHO-VATC |
QG01AF01
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WHO-ATC |
J01XD01
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WHO-ATC |
A02BD01
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WHO-ATC |
J01RA10
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WHO-ATC |
G01AF01
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WHO-ATC |
A02BD03
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WHO-ATC |
D06BX01
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WHO-ATC |
A02BD11
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WHO-ATC |
J01RA04
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LIVERTOX |
NBK548609
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CFR |
21 CFR 530.41
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FDA ORPHAN DRUG |
17486
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WHO-VATC |
QP51AA01
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WHO-VATC |
QA02BD03
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NCI_THESAURUS |
C279
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EU-Orphan Drug |
EU/3/11/875
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FDA ORPHAN DRUG |
267008
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EPA PESTICIDE CODE |
120401
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WHO-ATC |
P01AB51
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WHO-ATC |
A02BD02
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FDA ORPHAN DRUG |
339111
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WHO-ATC |
J01RA03
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WHO-ATC |
A02BD08
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WHO-VATC |
QD06BX01
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FDA ORPHAN DRUG |
247907
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FDA ORPHAN DRUG |
21687
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WHO-VATC |
QJ01XD01
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FDA ORPHAN DRUG |
514715
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NDF-RT |
N0000007663
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WHO-VATC |
QA01AB17
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FDA ORPHAN DRUG |
61891
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WHO-VATC |
QA02BD08
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NDF-RT |
N0000007663
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WHO-VATC |
QA02BD01
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WHO-ATC |
A01AB17
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100000090285
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207-136-1
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4173
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1032
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443-48-1
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C651
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DTXSID2020892
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admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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69587
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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Metronidazole
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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1442009
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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6909
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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D008795
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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METRONIDAZOLE
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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PRIMARY | Description: A white or pale yellow, crystalline powder; odourless or almost odourless.Solubility: Sparingly soluble in water; slightly soluble in ethanol (~750 g/l) TS and ether R.Category: Antitrichomonal; antiamoebic. Storage: Metronidazole should be kept in a well-closed container, protected from light. Additional information: Metronidazole is stable in air, but darkens on exposure to light. Definition: Metronidazole contains not less than 99.0% and not more than 101.0% of C6H9N3O3, calculated with reference to the dried substance. | ||
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50687
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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1790
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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SUB08922MIG
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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CHEMBL137
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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6922
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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PRIMARY | RxNorm | ||
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50364
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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140QMO216E
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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3129
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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140QMO216E
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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m7506
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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PRIMARY | Merck Index | ||
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METRONIDAZOLE
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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DB00916
Created by
admin on Mon Mar 31 17:49:28 GMT 2025 , Edited by admin on Mon Mar 31 17:49:28 GMT 2025
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ACTIVE MOIETY
METABOLITE (PARENT)
METABOLITE (PARENT)
METABOLITE (PARENT)
PRODRUG (METABOLITE ACTIVE)
SALT/SOLVATE (PARENT)