Details
Stereochemistry | RACEMIC |
Molecular Formula | C12H15N3O9 |
Molecular Weight | 345.2622 |
Optical Activity | ( + / - ) |
Defined Stereocenters | 0 / 1 |
E/Z Centers | 0 |
Charge | 0 |
SHOW SMILES / InChI
SMILES
CC1=NC=C(N1CCOC(=O)CC(O)(CC(O)=O)C(O)=O)[N+]([O-])=O
InChI
InChIKey=BSDGJHSABQWHHI-UHFFFAOYSA-N
InChI=1S/C12H15N3O9/c1-7-13-6-8(15(22)23)14(7)2-3-24-10(18)5-12(21,11(19)20)4-9(16)17/h6,21H,2-5H2,1H3,(H,16,17)(H,19,20)
Molecular Formula | C12H15N3O9 |
Molecular Weight | 345.2622 |
Charge | 0 |
Count |
|
Stereochemistry | RACEMIC |
Additional Stereochemistry | No |
Defined Stereocenters | 0 / 1 |
E/Z Centers | 0 |
Optical Activity | ( + / - ) |
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 |
|||
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 |
---|---|---|---|---|
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 |
|
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 |
|
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 |
|
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 |
|
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 |
|
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: ∞ants sex: food status: |
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 |
---|---|---|---|---|
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 |
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 |
unknown, oral |
METRONIDAZOLE plasma | Homo sapiens population: HEALTHY age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
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 |
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 n = 1 Health Status: unhealthy Condition: chronic depressive illness Age Group: 58 years Sex: F Population Size: 1 Sources: |
Disc. AE: Hepatotoxicity... AEs leading to discontinuation/dose reduction: Hepatotoxicity (9.6%) Sources: |
8.5 g single, oral Overdose |
unhealthy, 62 years n = 1 Health Status: unhealthy Condition: extensive past medical history, including end-stage renal disease Age Group: 62 years Sex: M Population Size: 1 Sources: |
|
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 n = 32 Health Status: unhealthy Condition: advanced carcinoma of the colon or rectum Age Group: adult Sex: unknown Population Size: 32 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 (mean) Highest studied dose Dose: 5.3 mg/m2, 3 times / week Route: oral Route: multiple Dose: 5.3 mg/m2, 3 times / week Co-administed with:: radiotherapy Sources: |
unhealthy, adult n = 28 Health Status: unhealthy Condition: malignant brain tumors Age Group: adult Sex: unknown Population Size: 28 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 n = 1 Health Status: unhealthy Condition: bloody stools and apnoea Age Group: preterm newborn Sex: F Population Size: 1 Sources: |
AEs
AE | Significance | Dose | Population |
---|---|---|---|
Hepatotoxicity | 9.6% Disc. AE |
12.5 g single, oral Overdose |
unhealthy, 58 years n = 1 Health Status: unhealthy Condition: chronic depressive illness Age Group: 58 years Sex: F Population Size: 1 Sources: |
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 n = 32 Health Status: unhealthy Condition: advanced carcinoma of the colon or rectum Age Group: adult Sex: unknown Population Size: 32 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 n = 32 Health Status: unhealthy Condition: advanced carcinoma of the colon or rectum Age Group: adult Sex: unknown Population Size: 32 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 n = 32 Health Status: unhealthy Condition: advanced carcinoma of the colon or rectum Age Group: adult Sex: unknown Population Size: 32 Sources: |
Central nervous system toxicity | 13.7% DLT |
5.3 mg/m2 3 times / week multiple, oral (mean) Highest studied dose Dose: 5.3 mg/m2, 3 times / week Route: oral Route: multiple Dose: 5.3 mg/m2, 3 times / week Co-administed with:: radiotherapy Sources: |
unhealthy, adult n = 28 Health Status: unhealthy Condition: malignant brain tumors Age Group: adult Sex: unknown Population Size: 28 Sources: |
Gastrointestinal toxicity | 14.5% DLT |
5.3 mg/m2 3 times / week multiple, oral (mean) Highest studied dose Dose: 5.3 mg/m2, 3 times / week Route: oral Route: multiple Dose: 5.3 mg/m2, 3 times / week Co-administed with:: radiotherapy Sources: |
unhealthy, adult n = 28 Health Status: unhealthy Condition: malignant brain tumors Age Group: adult Sex: unknown Population Size: 28 Sources: |
Overview
CYP3A4 | CYP2C9 | CYP2D6 | hERG |
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OverviewOther
Other Inhibitor | Other Substrate | Other Inducer |
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PubMed
Title | Date | PubMed |
---|---|---|
Acute encephalopathy associated with metronidazole therapy. | 1997 Mar-Jun |
|
Antituberculosis activity of certain antifungal and antihelmintic drugs. | 1999 |
|
Bactericidal activity of nitrofurans against growing and dormant Mycobacterium bovis BCG. | 2000 Dec |
|
Enhanced activation of rhesus T cells by vectors encoding a triad of costimulatory molecules (B7-1, ICAM-1, LFA-3). | 2001 Dec 12 |
|
Enhanced activation of human T cells via avipox vector-mediated hyperexpression of a triad of costimulatory molecules in human dendritic cells. | 2001 May 1 |
|
Pectin-based microspheres: a preformulatory study. | 2001 Nov |
|
Retrospective analysis of drug-induced urticaria and angioedema: a survey of 2287 patients. | 2001 Nov |
|
Validation of a method for the detection and confirmation of nitroimidazoles and corresponding hydroxy metabolites in turkey and swine muscle by means of gas chromatography-negative ion chemical ionization mass spectrometry. | 2001 Sep 15 |
|
[Fromilid (clarithromycin) in eradication patients in patients with duodenal ulcer associated with Helicobacter pylori (comparison of two treatment variations)]. | 2002 |
|
[Comparative study of combined local treatment (sulfadimidine, metronidazole and nystatin) and the standard monotherapy in uncomplicated bacterial vaginosis]. | 2002 Dec 22 |
|
[Fever and weight loss as leading symptoms of infection with giardia lamblia]. | 2002 Feb |
|
Allergic contact dermatitis from 2-bromo-2-nitropropane-1,3-diol in Metrogel. | 2002 Jan |
|
Metronidazol as a probable cause of severe liver injury. | 2002 Jan-Feb |
|
[Antiamebic effect of metronidazole proved in a study conducted in Cienfuegos province]. | 2002 May-Aug |
|
[Anaerobic bacteria in bronchoalveolar lavage fluid (BAL) after thoracic surgery]. | 2003 |
|
An unexpected and severe neurological disorder with permanent disability acquired during short-course treatment with metronidazole. | 2003 |
|
Antitumor immunity after vaccination with B lymphoma cells overexpressing a triad of costimulatory molecules. | 2003 Apr 2 |
|
[Vulvar amebiasis. Report of a case and review of the literature]. | 2003 Feb |
|
Bone defects of the facial skeleton - replacement with biomaterials. | 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 |
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Bronchospasm and laryngeal stridor as an adverse effect of oxytocin treatment. | 2003 Oct |
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[Use of arilin (Dr.Wolff) in the treatment of bacterial vaginosis and trichomoniasis during the period of 01.10.2003-31.12.2003]. | 2004 |
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TRICOM: enhanced vaccines as anticancer therapy. | 2004 Aug |
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A case of clarithromycin-induced manic episode (antibiomania). | 2004 Mar |
|
Is operative management effective in treatment of perforated typhoid? | 2005 Mar |
|
Can antibiotics prevent preterm birth--the pro and con debate. | 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.
Substance Class |
Chemical
Created
by
admin
on
Edited
Sat Dec 16 18:43:03 GMT 2023
by
admin
on
Sat Dec 16 18:43:03 GMT 2023
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Record UNII |
8Y356BW999
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Record Status |
Validated (UNII)
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Record Version |
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8Y356BW999
Created by
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165412102
Created by
admin on Sat Dec 16 18:43:04 GMT 2023 , Edited by admin on Sat Dec 16 18:43:04 GMT 2023
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METABOLITE ACTIVE -> PRODRUG |
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ACTIVE MOIETY |
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