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Details

Stereochemistry ACHIRAL
Molecular Formula C13H13N3O4
Molecular Weight 275.26
Optical Activity NONE
Defined Stereocenters 0 / 0
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of METRONIDAZOLE BENZOATE

SMILES

CC1=NC=C(N1CCOC(=O)C2=CC=CC=C2)[N+]([O-])=O

InChI

InChIKey=CUUCCLJJOWSASK-UHFFFAOYSA-N
InChI=1S/C13H13N3O4/c1-10-14-9-12(16(18)19)15(10)7-8-20-13(17)11-5-3-2-4-6-11/h2-6,9H,7-8H2,1H3

HIDE SMILES / InChI

Molecular Formula C13H13N3O4
Molecular Weight 275.26
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Description
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

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

Originator

Curator's Comment: was synthesized by France's Rhone-Poulenc laboratories and introduced in the mid-1950s under the brand name Flagyl

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Curative
FLAGYL

Approved Use

INDICATIONS & 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 Date

1963
Curative
FLAGYL

Approved Use

INDICATIONS & 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 Date

1963
Curative
FLAGYL

Approved Use

INDICATIONS & 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 Date

1963
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
16.54 mg/L
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
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

AUC

ValueDoseCo-administeredAnalytePopulation
75.23 μg × h/mL
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

T1/2

ValueDoseCo-administeredAnalytePopulation
7.76 h
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

Funbound

ValueDoseCo-administeredAnalytePopulation
80%
unknown, oral
METRONIDAZOLE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
12.5 g single, oral
Overdose
Dose: 12.5 g
Route: oral
Route: single
Dose: 12.5 g
Sources:
unhealthy, 58 years
Health Status: unhealthy
Age Group: 58 years
Sex: F
Sources:
Disc. AE: Hepatotoxicity...
AEs leading to
discontinuation/dose reduction:
Hepatotoxicity (9.6%)
Sources:
8.5 g single, oral
Overdose
Dose: 8.5 g
Route: oral
Route: single
Dose: 8.5 g
Sources:
unhealthy, 62 years
Health Status: unhealthy
Age Group: 62 years
Sex: M
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
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%)
Generalised onset motor seizure (12.8%)
Neurotoxicity NOS (10.9%)
Sources:
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%)
Central nervous system toxicity (13.7%)
Sources:
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

AEs

AESignificanceDosePopulation
Hepatotoxicity 9.6%
Disc. AE
12.5 g single, oral
Overdose
Dose: 12.5 g
Route: oral
Route: single
Dose: 12.5 g
Sources:
unhealthy, 58 years
Health Status: unhealthy
Age Group: 58 years
Sex: F
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
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:
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
PubMed

PubMed

TitleDatePubMed
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
Bactericidal activity of nitrofurans against growing and dormant Mycobacterium bovis BCG.
2000 Dec
Metronidazole induced acute confusional agitated state.
2000 Feb
Toxic metronidazole-induced MRI changes.
2000 Nov
Enhanced activation of human T cells via avipox vector-mediated hyperexpression of a triad of costimulatory molecules in human dendritic cells.
2001 May 1
Retrospective analysis of drug-induced urticaria and angioedema: a survey of 2287 patients.
2001 Nov
[Fromilid (clarithromycin) in eradication patients in patients with duodenal ulcer associated with Helicobacter pylori (comparison of two treatment variations)].
2002
[Antibiotic prophylaxys in pediatric surgery of genito-urinary abnormalities].
2002 Jun
[Comparative clinical and epidemiological evaluation of beta-lactam antibiotics in the treatment of intraabdominal infections].
2003
An open label crossover trial of effects of metronidazol on hyperlipidaemia.
2003 Aug
[Vulvar amebiasis. Report of a case and review of the literature].
2003 Feb
Crohn's disease--when to operate?
2004
[Efficacy of two Helicobacter pylori eradication treatments in children with recurrent abdominal pain].
2004 Apr-Jun
A case of clarithromycin-induced manic episode (antibiomania).
2004 Mar
Phase I study of sequential vaccinations with fowlpox-CEA(6D)-TRICOM alone and sequentially with vaccinia-CEA(6D)-TRICOM, with and without granulocyte-macrophage colony-stimulating factor, in patients with carcinoembryonic antigen-expressing carcinomas.
2005 Feb 1
Analyses of recombinant vaccinia and fowlpox vaccine vectors expressing transgenes for two human tumor antigens and three human costimulatory molecules.
2005 Feb 15
[Two cases of metronidazole-induced encephalopathy].
2005 Mar
Abnormal enhancing lesion of dentate nuclei causing neurologic symptoms induced by metronidazole toxicity.
2005 Mar
Can antibiotics prevent preterm birth--the pro and con debate.
2005 Mar
Patents

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
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 Mon Mar 31 18:05:06 GMT 2025
Edited
by admin
on Mon Mar 31 18:05:06 GMT 2025
Record UNII
A355C835XC
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
METRONIDAZOLE BENZOATE
EP   MART.   USP   USP-RS   WHO-DD   WHO-IP  
Common Name English
BENZOYL METRONIDAZOLE
Preferred Name English
METRONIDAZOLE BENZOATE [USP MONOGRAPH]
Common Name English
METRONIDAZOLE BENZOATE [MART.]
Common Name English
Metronidazole benzoate [WHO-DD]
Common Name English
2-(2-METHYL-5-NITROIMIDAZOL-1-YL)ETHYL BENZOATE
Systematic Name English
METRONIDAZOLE BENZOATE [WHO-IP]
Common Name English
METRONIDAZOLE BENZOATE [USP-RS]
Common Name English
METRONIDAZOLI BENZOAS [WHO-IP LATIN]
Common Name English
KLION SUSPENSION
Common Name English
METRONIDAZOLE BENZOATE [EP MONOGRAPH]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C279
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
Code System Code Type Description
RXCUI
103866
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY RxNorm
SMS_ID
100000084889
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
FDA UNII
A355C835XC
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
WHO INTERNATIONAL PHARMACOPEIA
METRONIDAZOLE BENZOATE
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY Description: A white or slightly yellowish, crystalline powder. Solubility: Practically insoluble in water; freely soluble in dichloromethane R; soluble in acetone R; slightly soluble in ethanol (~750 g/l) TS; very slightly soluble in ether R. Category: Anti-infective drug. Storage: Metronidazole benzoate should be kept in a well-closed container, protected from light. Requirements: Metronidazole benzoate contains not less than 98.5% and not more than 101.0% of C13H13N3O4, calculated with reference to the dried substance.
RS_ITEM_NUM
1442100
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
EPA CompTox
DTXSID60157221
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
DAILYMED
A355C835XC
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
CAS
13182-89-3
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
ChEMBL
CHEMBL137
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
NCI_THESAURUS
C87387
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
EVMPD
SUB14569MIG
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
PUBCHEM
83213
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
ECHA (EC/EINECS)
236-131-7
Created by admin on Mon Mar 31 18:05:06 GMT 2025 , Edited by admin on Mon Mar 31 18:05:06 GMT 2025
PRIMARY
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