Hepatic Dose Adjustment : Metronidazole

• Following a single intravenous infusion of 500 mg metronidazole, the mean AUC24 of metronidazole was higher by:
• 114% in patients with severe (Child-Pugh C) hepatic impairment
• 54% in patients with moderate (Child-Pugh B)
• 53% in patients with mild (Child-Pugh A)

Adjustment

• For patients with severe hepatic impairment (Child-Pugh C), the dose of FLAGYL should be reduced by 50%
• No dosage adjustment is needed for patients with mild to moderate hepatic impairment. 
• Patients with mild to moderate hepatic impairment should be monitored for metronidazole associated adverse events

 Side Effects

References

1. Drug Leaflet
2. http://www.consultantlive.com/articles/pitfalls-prescribing-metronidazole-dosing-patients-hepatic-dysfunction
3. http://www.globalrph.com/metronidazole_dilution.htm