Metrogyl plus 50g vaginal gel with applicator 10 pcs.

From this article you will learn:

• analysis of the composition of Metrogyl-Dent, analogues,
• application diagram and its features,
• reviews of Metrogyl Denta gel, price 2021.

The article was written by a dentist with more than 19 years of experience.

Metrogyl Denta gel is a drug for topical use in the oral cavity that has an antimicrobial effect against pathogenic bacteria that cause gum inflammation. The antimicrobial effect of the drug is ensured by the active components included in its composition - the antibiotic metronidazole and the antiseptic chlorhexidine. In dentistry, this drug is used mainly only for gingivitis, periodontitis, and less often for aphthous stomatitis.

For Metrogyl Denta gel, the instructions for use allow the use of the drug in adults only from 18 years of age (although in the previous instructions the drug was approved from 6 years of age). This change was adopted in 2021, despite the absence of changes in the composition and concentration of active ingredients. However, a product with the same composition - Asepta Gum Balm, which is no longer registered as a “medicine”, but as a “cosmetic product” - has no age restrictions at all.

Metrogil Denta: photo of the new packaging

It must be said that patient reviews of Metrogyl Denta gel are usually quite mediocre, and in our opinion, this drug is not the optimal choice for most of the “indications for use” that are listed in the official instructions. Nevertheless, this drug really works (for example, for gingivitis or mild periodontitis).

Please note that the author of the article has worked as a periodontist for more than 10 years, treating gum inflammation in patients, and therefore our recommendations really work (state-issued documents on the advanced training of the author of the article in the Periodontology program - you can see in the section editorial office).

Compound

The Metrogyl solution contains the active ingredient metronidazole , as well as: sodium chloride, sodium hydrogen phosphate (anhydrous), citric acid, water.
Metrogyl tablets contain the active ingredient metronidazole , as well as: corn starch, magnesium stearate, colloidal silicon dioxide, hydrogenated castor oil, Opadry II dye, water.

Metrogyl gel includes metronidazole and additional components: propyl parahydroxybenzoate, methyl parahydroxybenzoate, disodium edetate, carbomer 940, sodium hydroxide, propylene glycol, water.

Release form

Currently, Metrogyl solution is produced for intravenous administration, as well as tablets, vaginal gel and gel for external use.

• The solution for intravenous administration can be colorless or pale yellow, transparent, packaged in transparent ampoules of 20 ml (100 mg solution) and in polyethylene bottles of 100 ml (500 mg solution). The containers are placed in cardboard packs.
• Tablets 200 mg - pink, biconvex, film-coated, round, packaged in blisters of 10 pcs., in cardboard packs of 2 blisters.
• Tablets 400 mg - orange, biconvex, film-coated, round, packaged in blisters of 10 pcs., in cardboard packs of 2 blisters.
• Metrogyl vaginal gel is homogeneous, colorless or has a yellow tint, contained in tubes of 30 g.

pharmachologic effect

The broad-spectrum medicine contains metronidazole , a 5-nitroimidazole derivative.

The drug has antimicrobial and antiprotozoal effects. The mechanism of action is based on the reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The 5-nitro group of metronidazole interacts with the DNA of microbial cells, inhibiting the synthesis of their nucleic acids. As a result, the bacteria die.

Metrogyl demonstrates activity against Gardnerella vaginalis, Trichomonas vaginalis, Giardiai ntestinalis, Entamoeba histolytica, Lamblia spp. The drug is also active against obligate anaerobes and a number of gram-positive microorganisms.

If metronidazole is combined with Amoxicillin , activity against Helicobacter pylori is manifested.

Facultative anaerobes and aerobic microorganisms do not show sensitivity to metronidazole, however, in the presence of mixed flora, there is a synergistic effect of metronidazole with antibiotics that are effective against aerobes.

It provokes disulfiram-like reactions, under its influence the sensitivity of tumors to radiation increases, and reparative processes are stimulated.

When applied externally, an anti-acne effect is observed, the mechanism of which is not fully known. Metrogyl ointment appears to demonstrate antioxidant activity. Under the influence of this drug, the production of active oxygen, hydrogen peroxide, and hydroxyl radicals by neutrophils is reduced, that is, potential oxidants that contribute to tissue damage in the place where the inflammatory process develops.

The external form of the drug is active against telangiectasia in rosacea .

Instructions for use METROGYL

Mechanism of action

Nitroimidazoles are synthetic AMPs with high activity against anaerobic bacteria and pathogens of protozoal infections. The first drug of the group, metronidazole, was approved for medical use in 1960. Nitroimidazoles have a selective bactericidal effect against those microorganisms whose enzyme systems are capable of reducing the nitro group. Active reduced forms of drugs disrupt DNA replication and protein synthesis in microbial cells and inhibit tissue respiration. Nitroimidazoles are active against most anaerobes - both gram-negative and gram-positive:

• bacteroides (including B. fragilis), clostridia (including C. difficile), Fusobacterium spp., Eubacterium spp., Peptostreptococcus spp., P. niger, G. vaginalis. P. acnes is resistant. Protozoa (T.vaginalis, E.histolytica, G.lamblia, L.intestinalis, E.coli, Leishmaniaspp.), as well as H.pylori, are sensitive to nitroimidazoles.

The mechanism of action is the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitro group of metronidazole interacts with the DNA of microbial cells, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria.

Active against Trichomonas vaginalis, as well as gram-negative anaerobes Bacteroides spp. (including Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, Bacteroides vulgatus), Fusobacterium spp. and some gram-positive microorganisms (susceptible strains of Eubacterium spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp.). The MIC for these strains is 0.125-6.25 μg/ml.

When applied externally, it has an anti-acne effect, the mechanism of which is precisely unknown (not related to the effect on the Demodex folliculorum mite, found in hair follicles and the secretion of the sebaceous glands, and any effect on the production of this secretion).

Metronidazole for external use may have antioxidant activity. It has been found that it significantly reduces the production of active oxygen, hydroxyl radicals and hydrogen peroxide by neutrophils, which are potential oxidants that can cause tissue damage at the site of inflammation. Metronidazole for external use is ineffective against telangiectasias noted with rosacea.

Aerobic microorganisms and facultative anaerobes are insensitive to metronidazole, but in the presence of mixed flora (aerobes and anaerobes), metronidazole acts synergistically with antibiotics effective against common aerobes.

Pharmacokinetics and pharmacodynamics

After a patient has been administered Metrogyl intravenously, approximately 30-60% of the substance is metabolized through hydroxylation, oxidation and glucuronidation. As a result, a metabolite, 2-oxymetronidazole, is formed, which also produces an antiprotozoal and antimicrobial effect. The half-life is 8 hours (subject to normal liver function), up to 18 hours (if the liver is damaged by alcohol).

Approximately 60-80% of the administered dose is excreted through the kidneys, another 6-15% is excreted through the intestines. Both metronidazole and its metabolites are eliminated from the blood by hemodialysis .

If the antibiotic is taken orally, it is quickly absorbed, and its maximum concentration in the blood is observed after 2 hours. The product has a high ability to penetrate tissues and body fluids. 10-20% bound to plasma proteins. About 60-80% is excreted through the kidneys, while approximately 20% is excreted unchanged. Half-life is 8 hours.

When the product is used externally, a minimal amount is absorbed, so only traces of the active component are detected in the blood. It should be taken into account that the absorbed active substance passes the blood-brain and placental barriers.

Metrogyl plus 50g vaginal gel with applicator 10 pcs.

pharmachologic effect

Antimicrobial and antiprotozoal agent + antifungal agent.

Composition and release form Metrogyl plus 50g vaginal gel with applicator 10 pcs.

Gel – 1 g.:

• Active ingredients: Metronidazole 10.0 mg; Clotrimazole 20.0 mg;
• Excipients: benzyl alcohol 40 mg, disodium edetate 0.50 mg, carbomer-940 10.0 mg, methyl parahydroxybenzoate 1.50 mg, sodium hydroxide 2.0 mg, propyl parahydroxybenzoate 0.50 mg, propylene glycol 50.0 mg, water . required, up to 1.0 g.

30 g in an aluminum tube or a plastic laminated tube, the neck of which is sealed with an aluminum membrane and a screw-on polyethylene cap with a protrusion for perforating the membrane. One lip along with an applicator and instructions for use in a cardboard box.

50 g in an aluminum lip or laminated plastic tube, the neck of which is sealed with aluminum foil laminated with polyethylene and with a polypropylene screw cap with a protrusion (or without a protrusion) for perforating the foil. One tube in a cardboard box along with an applicator and instructions for use.

50 g in an aluminum tube or laminated plastic tube, the neck of which is sealed with aluminum foil laminated with polyethylene and with a polypropylene screw cap with a protrusion (or without a protrusion) for perforating the foil. One tube in a cardboard box along with applicators, in the amount of 10 pieces, instructions for use.

Description of the dosage form

Homogeneous opalescent gel of white or almost white color.

Directions for use and doses

Intravaginally.

The recommended dose is 5 g (one full applicator) 2 times a day (morning and evening).

The course of treatment is 5 days. If necessary, the course of treatment can be repeated after 2 weeks.

Pharmacodynamics

A combined drug for intravaginal use, the effectiveness of which is due to the presence of two active components in its composition: metronidazole and clotrimazole.

The mechanism of action of metronidazole is the biochemical reduction of the 5-nitro group by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitro group of metronidazole interacts with the DNA of microbial cells, inhibiting the synthesis of their nucleic acids, which leads to the death of bacteria. Active against Trichomonas vaginalis, Entamoeba histolytica, Gardnerella vaginalis, Giardia intestinalis, Lamblia spp., as well as obligate anaerobes Bacteroides spp., (including Bacteroides fragilis, Bacteroides thetaitaomicron, Bacteroides vulgatus), Fusobacterium spp., Veillonella spp. ., Prevotella (Prevotella bivia, Prevotella buccae, Prevotella disiens) and some gram-positive microorganisms (Eubacterium spp., Clostridium spp., Peptococcus spp., Peptostreptococcus spp.) The minimum inhibitory concentration (MIC) for these strains is 0.125 - 6.25 μg/ml. Aerobic microorganisms and facultative anaerobes are insensitive to metronidazole, but in the presence of mixed flora (aerobes and anaerobes), metronidazole acts synergistically with antibiotics effective against common aerobes. Clotrimazole is an imidazole derivative. Has a fungicidal effect. Reduces the synthesis of ergosterol, which is an integral part of the cell membrane of the microbial wall, and leads to a change in its structure and properties. In small concentrations it acts fungistatically, and in large concentrations (more than 20 μg/ml) it is fungicidal, and not only on proliferating cells. At fungicidal concentrations, it interacts with mitochondrial and peroxidase enzymes, resulting in an increase in the concentration of hydrogen peroxide to a toxic level, which also contributes to the destruction of fungal cells. It has high activity against pathogenic dermatophytes (Trichophyton mentagrophytes, Microsporum canis, Epidermophyton floccosum), yeast and mold fungi (genus Candida, Torulopsis glabrata, genus Rhodotorula, Pityrosporum orbiculare).

Pharmacokinetics

After intravaginal administration, metronidazole undergoes systemic absorption (about 56%). The relative bioavailability of the vaginal gel is 2 times higher than the bioavailability of a single dose (500 mg) of metronidazole vaginal tablets. Penetrates into breast milk and most tissues, passes through the blood-brain barrier and placenta. After a single intravaginal administration of 5 g of gel (50 mg of metronidazole), the average maximum concentration in the blood serum of healthy women is 237 ng/ml, which is 2% of the average maximum concentration of metronidazole when taken orally at a dose of 500 mg. The time to reach maximum concentration is 6 - 12 hours. Communication with plasma proteins is less than 20%. Metabolized in the liver by hydroxylation, oxidation and glucuronidation. The activity of the main metabolite (2 - oxymetronidazole) is 30% of the activity of the parent compound. Excreted by the kidneys - 60 - 80% of the dose of the systemic drug (20% of this amount unchanged), by the intestines - 6 - 15% of the dose of the systemic drug.

When using clotrimazole intravaginally, no more than 3-10% of the administered dose is absorbed. High concentrations in vaginal secretions and low concentrations in blood persist for 48 to 72 hours. In the liver, clotrimazole is rapidly metabolized to inactive metabolites.

Indications for use Metrogyl plus 50g vaginal gel with applicator 10 pcs.

Bacterial vaginosis of various etiologies, confirmed by clinical and microbiological data; candidiasis vulvitis and vulvovaginitis, urogenital trichomoniasis.

Contraindications

Hypersensitivity to the components of the drug. Leukopenia (including history), organic lesions of the central nervous system (including epilepsy), liver failure, menstrual period. Pregnancy I trimester, lactation period.

Application Metrogyl plus 50g vaginal gel with applicator 10 pcs. during pregnancy and breastfeeding

The use of the drug in the second and third trimester of pregnancy is possible only for health reasons, if the potential benefit to the mother outweighs the risk to the fetus. When prescribing the drug during lactation, breastfeeding must be stopped.

special instructions

Simultaneous treatment of sexual partners is recommended.

During the course of treatment it is necessary to abstain from sexual activity.

For vaginitis caused by Trichomonas vaginalis, it is advisable to simultaneously treat the sexual partner with metronidazole for oral administration. If the drug is used together with metronidazole for oral administration, especially with a repeated course, monitoring of the peripheral blood picture is necessary (danger of leukopenia).

During the treatment period, alcohol intake is contraindicated (a disulfiram-like reaction may develop: cramping abdominal pain, nausea, vomiting, headache, sudden rush of blood to the face).

Metronidazole can immobilize treponemes and lead to a false-positive Nelson test.

Avoid contact with eyes!

Impact on the ability to drive vehicles and operate machinery

The drug does not affect the ability to drive vehicles or engage in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Overdose

There have been no cases of overdose when the drug is prescribed in recommended doses.

Side effects Metrogyl plus 50g vaginal gel with applicator 10 pcs.

Local reactions: Itching, burning and hyperemia of the mucous membrane of the external genitalia; in the sexual partner - a burning sensation or irritation of the penis, frequent urination.

Possible systemic effects: Dizziness, headache, dry mouth, changes in taste, including a “metallic” taste, nausea, vomiting, decreased appetite, abdominal cramps, constipation or diarrhea, dark urine, leukopenia or leukocytosis .

Allergic reactions: Skin rash, urticaria.

If any unwanted side effects occur, you must stop treatment and consult a doctor!

Drug interactions

For intravaginal use only!

Similar to disulfiram, it causes ethanol intolerance.

Enhances the effect of indirect anticoagulants; it is not recommended to combine with non-depolarizing muscle relaxants (vecuronium bromide).

When taken simultaneously with lithium preparations, the concentration of lithium in the blood plasma may increase.

Phenobarbital accelerates the metabolism of metronidazole due to the induction of microsomal liver enzymes, cimetidine reduces it, which can lead to an increase in its concentration in the blood serum and an increased risk of side effects.

Amphotericin B, nystatin, natamycin reduce the effectiveness of clotrimazole when used simultaneously.

Indications for use

The instructions define the following indications for the use of Metrogyl intravenously:

• protozoal infections: ( trichomoniasis , extraintestinal and intestinal amebiasis , balantidiasis , giardiasis , cutaneous leishmaniasis , giardiasis , vaginitis and urethritis );
• infectious diseases caused by Bacteroides spp.: infections of the abdominal cavity, pelvic organs, skin, soft tissues;
• infections caused by Bacteroides spp.: infections of the nervous system, joints, bones, including brain abscess , meningitis , endocarditis , empyema , lung abscess , pneumonia ;
• infectious diseases caused by Bacteroides spp., including Clostridium spp., B. Fragilis: sepsis ;
• pseudomembranous colitis as a result of treatment with antibiotics;
• alcoholism;
• gastritis or ulcer as a result of the action of Helicobacter pylori;
• prevention of complications after surgery.

It is advisable to prescribe tablets in the following cases:

• to prevent the development of postoperative complications (in particular gynecological);
• for protozoal infections ( giardiasis , trichomoniasis , amoebic dysentery , amebiasis etc.);
• anaerobic infections (those that were provoked by Bac.fragilis, as well as clostridia , fusobacteria , anaerobic cocci , eubacteria );
• period after operations;
• infectious diseases of the respiratory tract;
• gas gangrene ;
• septicemia;
• osteomyelitis;
• meningitis , brain abscess ;
• tetanus.

Metrogyl cream is prescribed for the following diseases and conditions:

• acne vulgar;
• rosacea;
• seborrheic dermatitis , oily seborrhea;
• trophic ulcers that appear on the lower extremities as a result of varicose veins , diabetes mellitus ;
• bedsores;
• wounds that heal poorly;
• anal fissures , hemorrhoids .

Metrogyl vaginal gel is indicated for the treatment of vaginitis , which is caused by metronidazole-sensitive microflora, as well as for the treatment of urogenital trichomoniasis .

Pharmacological properties of the drug Metrogyl gel

Metronidazole (1-(β-hydroxyethyl)-2-methyl-5-nitroimidazole) is an effective antibacterial and antiprotozoal agent from the group of nitroimidazole derivatives. Active against Trichomonas vaginalis, Entamoeba histolytica and Giardia intestinalis , as well as against obligate anaerobes - Bacteroides spp . ( B. fragilis, B. distansonis, B. thetaiotaomicron, B. vulgatus), Fusobacterium spp., Clostridium spp., Peptostreptococcus spp., Peptococcus spp. Inactive against aerobic microorganisms. The mechanism of action of Metrogyl is due to the biochemical reduction of the 5-nitro group of metronidazole by intracellular transport proteins of anaerobic microorganisms and protozoa. The reduced 5-nitro group of metronidazole interacts with the DNA of microorganisms, leading to their death. In the presence of mixed flora (aerobic and anaerobic bacteria), metronidazole acts synergistically with antibiotics active against aerobic microorganisms. Improvement usually occurs within 9 days of treatment.

Contraindications

IV Metrogyl is contraindicated for use in the following conditions and diseases:

• organic lesions of the nervous system ( epilepsy , etc.);
• blood diseases;
• liver failure (large doses cannot be taken);
• blood diseases;
• lactation and pregnancy (first trimester);
• nitroimidazole derivatives .

Intravenous injections are given with caution to people suffering from renal failure.

Metrogyl tablets should not be taken in the following cases:

• with organic lesions of the nervous system, in particular epilepsy ;
• for blood diseases;
• for liver failure (large doses of tablets);
• under the age of 12;
• during pregnancy (first trimester);
• high sensitivity to the active substance, to other nitroimidazole .

Prescribed with caution to people with liver and kidney diseases.

Vaginal gel is not prescribed for the following diseases and conditions:

• impaired coordination of movements;
• leukopenia (also in history);
• lesions of the nervous system of an organic nature, including epilepsy ;
• pregnancy (first trimester);
• liver failure;
• high sensitivity, also sensitivity to nitroimidazole derivatives.

Side effects

When using the drug intravenously and orally, the following side effects may develop:

• Gastrointestinal tract: loss of appetite, diarrhea , nausea , intestinal colic, vomiting , constipation , dryness or metallic taste in the mouth, glossitis , pancreatitis , stomatitis ;
• nervous system: impaired coordination, dizziness , impaired consciousness, ataxia , severe excitability, irritability, insomnia , weakness, headache , hallucinations , convulsions ;
• allergies: rash, hyperemia , urticaria , fever , nasal congestion, arthralgia ;
• urinary system : cystitis , dysuria , urinary incontinence , polyuria , candidiasis , change in urine color to red-brown;
• local manifestations: thrombophlebitis , development of pain, swelling, redness at the site of drug administration;
• other manifestations: leukopenia , neutropenia .

When using Metrogyl gel for topical use, a small amount of the active component is absorbed into the blood, so systemic side effects are unlikely. Rarely, the development of allergic manifestations, lacrimation, dryness and burning of the skin is possible.

Metrogyl Denta during pregnancy and lactation -

In the previous version of the instructions for Metrogyl-Dent gel, it was contraindicated for use, but only during the 1st trimester of pregnancy. In the current version of the instructions, it is only “not recommended for use,” but throughout pregnancy (pregnancy is not a complete contraindication for the use of the drug). Thus, Metrogyl denta can still be used during pregnancy, but only in consultation with your doctor.

Regarding breastfeeding, it is best to temporarily stop breastfeeding while using this drug. An interesting point is that if you compare this information with the recommendations of the FDA (U.S. Drug Administration), then according to their recommendations, metronidazole can be taken by pregnant women and is also quite safe when breastfeeding.

Alternatives during pregnancy and breastfeeding - an alternative can be the drug Cholisal, which, in accordance with the manufacturer’s instructions, can be taken throughout pregnancy and the breastfeeding period, but also “with caution.” The term “with caution” means that you should not take the drug unsupervised - it should be prescribed by your dentist, and you should also inform your obstetrician-gynecologist about its prescription.

Contraindications to the use of Metrogyl Denta gel:

• children under 18 years of age,
• allergic reactions to the components of the gel,
• blood diseases,
• diseases of the nervous system.

Instructions for use of Metrogyl (Method and dosage)

Metrogyl solution, instructions for use

A Metrogil dropper is indicated in cases of severe infectious diseases, as well as in cases where the patient is unable to take the medicine orally.

Adolescents over 12 years of age and children receive the drug intravenously (duration of administration is about 40 minutes), the initial dose is 0.5-1 g. Then 500 mg should be administered every 8 hours (rate 5 ml/min.). If a person tolerates the injection normally, then after 2-3 infusions the drug can be administered in a stream. The injections must be taken for 7 days.

If necessary, a longer administration of the medicine is practiced. The permissible dose per day is 4 g. If indicated, maintenance doses can be used - 400 mg three times a day.

A similar regimen of use is practiced for children under 12 years of age, a single dose is 7.5 mg/kg.

To treat purulent-septic diseases, one course of therapy is sufficient.

For prevention, adolescents over 12 years of age and adults are given 0.5-1 g of medication intravenously before surgery, and 1.5 g per day on the day after surgery, that is, 500 mg every 8 hours. After 1-2 days, the patient can be transferred to maintenance oral medication.

If liver and kidney function are impaired, you should not take more than 1 g of medication per day; the dose should be divided into 2 doses.

Metrogyl tablets, instructions for use

You can take the tablets both during and after meals; they do not need to be chewed.

The dose for adults and adolescents over 15 years of age is 200-400 mg two to three times a day. per day

Both the dosage and duration of the course depend on the infection.

For trichomoniasis, you need to drink 200 mg 3 times for 7 days, while women take additional vaginal products with metronidazole. You can increase the dose or repeat the course of therapy if necessary.

For amebiasis , adults receive 400 mg 3 times a day. per day, children - 30-40 mg per 1 kg/day, the dose is divided into three doses. You need to take Metrogyl for up to 10 days.

For amoebic liver abscess, adults receive 400 mg or 800 mg three times a day, the drug is combined with tetracyclines. Children - 30-35 mg per 1 kg/day, the dose is divided into three doses. Therapy lasts up to 10 days.

For anaerobic bacterial infections, adults receive 200-400 mg 2-3 times. per day, children should receive 7 mg per 1 kg of weight every 8 hours. Therapy lasts up to 10 days.

For the purpose of prevention before operations, you need to take 1000 mg once, then 200 mg three times a day.

If Metrogyl is combined with amoxicillin, the dose of metronidazole per day should be 1.5 g, divided into three doses.

Vaginal gel Metrogyl, instructions for use

The ointment is applied intravaginally, once in a dose of 2 g or 500 mg twice a day, 10 days. During this time, sexual activity is not allowed.

Metrogyl gel for thrush is used as prescribed by a doctor.

The gel is applied externally to cleansed skin twice a day, treatment lasts from 3 to 9 weeks, it is possible to use the product for a longer time - up to 4 months. An occlusive dressing can be applied if necessary.

Metrogyl for acne

Often those who use Metrogyl gel on their face give positive reviews for acne. Despite the fact that the official instructions do not provide detailed information about the use of this medicine for the face, Metrogyl gel for acne is still used very often, since metronidazole has a bactericidal and bacteriostatic effect. Accordingly, it helps to get rid of dermatological problems. If the patient has single pimples, it is enough to apply the ointment several times.

In the case of acne, treatment may take longer. However, after the first use, the severity of negative symptoms decreases. Metrogyl is used as the main remedy for the treatment of acne, and in combination with other drugs. Apply the gel twice a day to areas affected by acne.

Metrogyl and Differin

Differin , which is a synthetic retinoid, contains the active component adapalene. This drug has a beneficial effect on the skin; when used with Metrogyl, users note a more pronounced effect.

Metrogyl Denta: instructions for use

Next we will tell you how to properly use Metrogyl Denta as part of complex therapy (together with antiseptic rinses). You probably already realized that this drug will not be very effective as monotherapy, especially when it comes to a form of gum inflammation such as periodontitis.

ANTI-INFLAMMATORY THERAPY SCHEME:

For Metrogyl Denta gel, the instructions for use require that you apply the drug to the gums - 2 times a day (morning and evening - for 7-10 days). Morning treatment is carried out after breakfast and oral hygiene, and it is important in this sequence, and not vice versa. Immediately after brushing your teeth, you should take an antiseptic mouthwash and, without spitting, rinse your mouth with it for 1 minute. For rinsing, 10 ml of solution is enough (this is approximately 1 sip). After rinsing, under no circumstances should you rinse your mouth with water.

If you only have gingivitis, a large list of rinses will suit you (you can read about the main rinses for gum inflammation at this link). But if you have periodontitis, then together with Metrogyl denta gel it is better to use combined products - with 0.2% chlorhexidine or 0.1% hexitedine (which will additionally contain anti-inflammatory components, for example, methyl salicylate). In this case, the best option would be the product – PRESIDENT Antibacterial “Powerful protection against bacteria”, and another good option is “Hexoral” in the form of a solution.

How to apply the gel to the gums - immediately after rinsing, the gel is applied to the gums. It is advisable to pre-dry the gums with a dry gauze pad, because... in this case the gel will stick better. The gel is applied directly only to the gingival margin, which is adjacent to the neck of the teeth (and interdental gingival papillae, respectively). The gel should be applied not only to the gums from the front surface of the teeth, but also from the side of the palate/tongue, although the emphasis should be placed on treating the gums from the front surface of the teeth.

You can apply the gel using your finger or a special thin medical spatula. You need to do this in front of a mirror, with your teeth bared well, so that you can visually see where exactly you are applying the gel. First, the gel is applied to the gums around the lower teeth, and then around the upper teeth. During the application of the gel, as well as after, you may actively salivate. You don’t need to save it or spit it out on purpose, you should swallow it - as you usually do during the day. After applying the gel, we do not recommend drinking for 30 minutes, rinsing your mouth or eating for 2-3 hours.

Important: evening treatment is carried out according to the same scheme (meal → oral hygiene → antiseptic mouth rinse → application of Metrogyl Denta gel to the gums). If you have gingivitis, the duration of therapy is usually 7-8 days, and for periodontitis - 10 days.

Interaction

The dropper with Metrogyl should not contain other medications - it is not recommended to mix the product with other drugs.

Metronidazole activates the effect of indirect anticoagulants, resulting in an increase in the time of prothrombin .

Causes ethanol . When used simultaneously with Disulfiram, a variety of neurological symptoms may develop. It is important to keep the interval between taking these medications at least 2 weeks.

When taking Cimetidine , the metabolism of metronidazole is suppressed, so the concentration of the latter may increase, which leads to the development of side effects.

With the simultaneous use of Phenobarbital , phenytoin , that is, drugs that stimulate microsomal oxidation enzymes in the liver, it is possible to accelerate the elimination of metronidazole. As a result, its plasma concentration decreases.

If metronidazole is taken simultaneously with lithium preparations, the concentration of the latter in plasma may increase. In this case, signs of intoxication of the body may appear.

You should not combine Metrogyl with non-depolarizing muscle relaxants .

The antimicrobial effect of metronidazole is enhanced by sulfonamides .

When the gel is applied topically, there is no significant interaction with other drugs, but it should be used with caution with Warfarin and other indirect anticoagulants, since an increase in prothrombin time is possible.

Gel Metrogyl denta: reviews

It should be noted that Metrogil-denta gum gel was the very first imported gel for gum inflammation, which appeared in Russian pharmacies after the collapse of the USSR. The composition of its active components and their concentrations have not changed since then, and, of course, at the moment it is difficult to consider this gel the optimal choice for the treatment of gum inflammation. Although, as we said above, if you combine it with other means, it is quite possible to get a good result.

The main influence on the effectiveness of using Metrogyl dent will have whether you have previously removed all dental plaque or not. The fact is, they consist of pathogenic bacteria, which are the cause of gum inflammation. Any antiseptic rinses and gels for gums are not capable of disinfecting dental plaque to its entire thickness, i.e. they act only on the most superficial layer of microbial plaque and tartar. And therefore, without removing dental plaque, you will not get a pronounced and lasting effect - even after a full course of using the gel and antiseptic rinses.

Advantages of Metrogyl denta gel –

• good price/tube volume ratio,
• adheres well to the mucous membrane,
• antimicrobial activity is provided immediately due to 2 components - the antibacterial effect of metronidazole and the antiseptic effect of chlorhexidine.

Disadvantages of the drug -

• the concentrations of the active components are slightly lower than the effective therapeutic dosages (this is why the antibiotic gel is over-the-counter - because it is relatively harmless if used uncontrolled),
• the gel does not have a direct anti-inflammatory effect (it reduces inflammation only by suppressing pathogenic bacteria, and not by blocking inflammatory mediators in tissues),
• does not have an analgesic effect,
• and it is also very important that chlorhexidine in Metrogil-dent is not compatible with oral hygiene products that contain sodium lauryl sulfate, because the latter tends to inactivate chlorhexidine (of which there is not too much in the gel anyway).

Important: Scientific research (source) has found that sodium lauryl sulfate (SLS) has the property of inactivating chlorhexidine, which is included in most antiseptic mouthwashes, as well as in many gum gels. This has very important clinical significance, because... mouth rinsing with chlorhexidine solution is prescribed - morning and evening immediately after oral hygiene.

After using toothpaste with SLS, about 2 hours should pass (at least 30 minutes, but this is not enough) for SLS to not affect the effectiveness of chlorhexidine. Considering that the concentration of chlorhexidine in Metrogyl denta gel is already too low, we recommend that you use toothpastes without sodium lauryl sulfate (SLS).

In what cases will Metrogyl Denta not help you?

We have already said above that reviews of Metrogyl Denta gel are often negative, but most often this is due to the fact that many people self-medicate.
There is always only one reason for gum inflammation - insufficient oral hygiene, in which soft microbial plaque accumulates on the teeth, and hard tartar also forms (Fig. 3-4). It is the pathogenic bacteria in the composition of dental plaque/tartar that lead to the development of gum inflammation – gingivitis and periodontitis. Microbial plaque and tartar –

Therefore, before starting treatment, it is correct to carry out ultrasonic cleaning of dental plaque (at the dentist), and only after that carry out a course of treatment at home with antimicrobial and anti-inflammatory agents. Of course, if you start using Metrogil-denta without removing tartar and plaque, you will first certainly notice a temporary improvement (including a decrease in swelling and bleeding of the gums), but this effect will be temporary.

The most important thing here is that such use of the gel leads to the fact that the symptoms of gum inflammation become sluggish and unnoticeable, but the gum inflammation does not disappear anywhere. Sluggish chronic inflammation will gradually lead to the destruction of the attachment of the gingival margin to the necks of the teeth, to the destruction of the bone tissue around the teeth and the inevitable appearance of their mobility. Most patients with problem gums consult a doctor at this stage - when, after prolonged self-medication, they notice that their teeth have become loose. But it is almost impossible to fix such a problem globally at this stage.

Read more about proper gum treatment in the following articles:

• How to properly treat gingivitis
• Effective treatment of periodontitis

special instructions

It is not recommended to combine Metrogyl with amoxicillin in patients under 18 years of age.

Long-term therapy requires constant monitoring of the blood picture.

If the patient develops leukopenia , continuation of therapy depends on whether there is a risk of an infectious process.

Therapy should be discontinued if the patient develops dizziness , ataxia and other symptoms indicating a deterioration in neurological status.

Under the influence of the drug, immobilization of treponema may occur, which leads to a false-positive Nelson test.

During treatment, the urine turns dark.

During the treatment of trichomonas vaginitis and urethritis, you should abstain from sexual intercourse. It is important that both sexual partners undergo therapy at the same time. During menstruation, treatment is not stopped.

Do not allow the gel to get into your eyes. If this happens, you need to rinse your eyes with warm water.

The Metrogyl dropper in gynecology is used only as prescribed by the attending physician.

In cosmetology, Metrogyl gel for the face is used to treat acne and other skin lesions. You can use it on your face only on the recommendation of a specialist.

Special instructions for the use of the drug Metrogyl gel

Avoid getting the gel in your eyes. When applied to large areas of skin or with prolonged use, there is a possibility of resorption of metronidazole and the development of systemic side effects, so the drug should be prescribed with caution to patients with impaired hematopoietic function. If local reactions occur, the drug should be used less frequently or temporarily discontinued. Metronidazole penetrates well into breast milk, so it is not recommended to use Metrogyl during breastfeeding. After applying the gel, you can use cosmetics. During pregnancy, it is prescribed only if absolutely necessary.

Analogs

Level 4 ATC code matches:
Oflokain

Furasol

Chlorophyllipt

Oflomelid

Rozamet

Currently, numerous analogues of Metrogyl gel, tablets and solution are produced. These are the drugs Deflamon , Batsimex , Klion , Metrovagin , Metrolacare , Metron , Orvagil , Trichobrol , Trichopol , Siptrogil , Rosex , etc. Suppositories with the active substance metronidazole .

Gel Metrogyl denta: analogues

Metrogyl Denta gel has analogues, and they are quite widely available in pharmacies. A complete analogue is the Dentamet gel (Russian production), which, like Metrogyl Denta, is registered as a “medicine”. Dentamet gel also contains a combination of metronidazole and chlorhexidine, and in exactly the same concentrations. The cost of the drug for a 25 g tube will be from 150 rubles. The gel is produced.

The second option is Asepta Adhesive Gum Balm, which also contains a combination of metronidazole and chlorhexidine. This drug is registered only as a “cosmetic product”, and in addition, it differs slightly in composition. For example, it has a higher concentration of chlorhexidine - 0.1%, and in addition it also contains menthol, as well as peppermint essential oil. The cost of this product is from 240 rubles. And although this drug will be more effective, you need to take into account that the volume of the gel in the tube will be only 10 g.

Reviews about Metrogil

In most reviews about the drug, users write that all forms of the drug are quite effective. Women who have used Metrogyl vaginal gel leave reviews that the medicine is convenient to use and at the same time it helps to quickly and quite effectively cope with the treatment of infectious diseases. Many women write that vaginal gel helped cure thrush .

There are also often opinions that Metrogyl ointment is an excellent remedy for treating acne . Reading reviews about Metrogyl for acne, we can conclude that this medicine significantly improves the situation after a course of use. Patients consider severe dryness of the skin when using the cream to be a negative point. However, it is often used to combat acne; women also use external remedy Metrogyl under the supervision of a doctor during pregnancy.

Metrogil price, where to buy

The price of Metrogil in tablets is about 80 rubles per pack; suppositories with metronidazole can be bought at a price of 100 rubles.

You can buy Metrogyl facial gel for 160 – 180 rubles.

The price of ampoules depends on the volume; an IV solution in 5 ml ampoules costs 30 rubles. for 1 ampoule. The cost of 100 ml ampoules (for a dropper) is about 80 rubles.

Vaginal gel Metrogyl, price

You can buy vaginal gel for an average of 170 rubles (30 g ointment). The price of the gel in Ukraine (Kharkov, Kyiv, etc.) is 80 – 90 hryvnia. You can find out how much the gel costs at a specific pharmacy.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Metrogyl Plus vaginal gel (tube) 50g + applicator 10 pcs. Unique Pharmaceutical Laboratories
  338 rub. order
• Metrogyl gel vaginal. 10mg/g 30gUnique Pharmaceutical Lab.

  180 rub. order

• Metrogyl gel for external use. approx. 1% 30gUnique Pharmaceutical Lab.

  RUB 242 order

• Metrogyl Denta dental gel for gums 20g 1pcUnique Pharmaceutical Lab.

  RUB 313 order

• Metrogyl Plus vaginal gel tube 50 g + applicator 1 pc. Unique Pharmaceutical Laboratories

  RUB 266 order

Pharmacy Dialogue

• Metrogyl Denta gel for gums 20gUnique Farm Lab

  RUB 329 order

• Metrogyl gel (tube 30g)Unique Farm Lab

  RUB 225 order

• Metrogyl (vial 5mg/ml 100ml)Unique Farm Lab

  26 RUR order

• Metrogyl plus vag.gel (tube 50g + application No. 1)Unique Farm Lab

  RUB 247 order

• Metrogil vag. gel (tube 30g with applique)Unique Farm Lab

  RUB 171 order

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Pharmacy24

• Metrogyl Denta 20 g gel Unik Pharmaceutical Laboratories, India
  55 UAH order
• Metrogyl 30 g gel Unik Pharmaceutical Laboratories, India

  78 UAH order

• Metrogyl 30 g gel Unik Pharmaceutical Laboratories, India

  85 UAH order

• Metrogyl 5 mg/ml 100 ml solution for infusion

  20 UAH order

PaniPharmacy

• Metrogyl denta gel Metrogyl denta gel 20g India, Unique

  61 UAH order

• Metrogyl gel Metrogyl gel 30g India, Unique

  92 UAH order

• Metrogyl gel Metrogyl vag. gel 30g with appl. India, Unique

  103 UAH order

• Metrogyl infusion Metrogyl solution inf. 100ml India, Unique

  24 UAH order

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Metrogyl denta gel – price, composition and analogues

The cost is for 2021. For Metrogyl denta gel the price will be from 280 rubles (per tube of 20 g). The minimum price in social pharmacies is about 250 rubles.

Metrogyl Denta gel: composition

The composition of the gel is written directly on the packaging -

→ Metrogyl Denta gel: instructions for use (official, PDF)

Composition analysis –

Thus, the drug contains 1% metronidazole and 0.05% chlorhexidine, which have an antimicrobial effect. But don't expect too much from this drug. The fact is that the concentrations of the active components are low enough to obtain a pronounced effect in patients with periodontitis (although such concentrations may be quite sufficient for the treatment of gingivitis). And this opinion is based not only on 10 years of clinical experience with the use of Metrogildent gel, obtained by the author of the article in the treatment of gum inflammation in his patients.

Scientific works will also help us with this (source), which shed light on the effectiveness of different types of antiseptics in the treatment of patients with gum inflammation, and allow us to compare them with each other. So, it turns out that the effectiveness of Chlorhexidine very, very much depends on its concentration. Let's see what this means.

Efficiency of antiseptics (from greatest to least) –

• 0.2% chlorhexidine,
• 0.1% hexetidine (hexoral),
• 0.05% chlorhexidine,
• 0.05% cetylpyridine,
• 0.01% miramistin.

In the scientific work, the link to which we provided above, the effectiveness of antiseptics was analyzed specifically in patients with chronic periodontitis. This form of gum inflammation is distinguished not only by its long-term chronic course, but also by the fact that periodontal pockets form around the teeth during periodontitis. So, if for gingivitis - 0.05-0.12% concentration of chlorhexidine may be quite sufficient to achieve clinical effectiveness, then for periodontitis - only 0.2% chlorhexidine is highly desirable.

Important: the fact is that in a large number of patients with periodontitis, not only bacterial but also fungal flora are sown from periodontal pockets. Clinical studies show that the addition of fungal flora makes pathogenic bacteria less sensitive to antimicrobial agents. This requires the use of higher concentrations of antiseptics and antibiotics, and these concentrations must be effective - including against fungal flora, and not just bacterial ones.

0.2% chlorhexidine meets all these requirements (and this applies not only to gels for gums, but also to antiseptic mouth rinses). Now let's see which patients with periodontitis most often develop an “association” of bacterial and fungal flora (24stoma.ru). For example, if you have long-term chronic inflammation of the gums, if you smoke, if you eat a lot of carbohydrates, if you have concomitant chronic tonsillitis, or have gastrointestinal diseases, or in the past there was at least 1 case of candidiasis (thrush) of any localization .

Conclusions : we recommend using Metrogyl denta gel only in the following situations. Firstly, for catarrhal gingivitis. Secondly, with the mildest initial form of periodontitis, i.e. when the depth of periodontal pockets does not exceed 3.5 mm - and only on the condition that nothing from the list above applies to you (i.e. you do not smoke, you do not have chronic tonsillitis, gastrointestinal diseases, and the list goes on). Moreover, if you are going to use Metrogyl denta, then we recommend doing this only as part of combination therapy, which we will discuss below.