Ornidazole

Ornidazole is an antiprotozoal drug that has anti-inflammatory, antibacterial and antiseptic properties. It is often used to treat various infections caused by protozoan parasites and anaerobic bacteria.

The action of the drug is based on its ability to affect the DNA of parasites and bacteria, which leads to their death. It is usually taken orally in the form of tablets or capsules, usually over a period of time, depending on the type of infection and the response to treatment.

As with any medication, ornidazole can have side effects such as nausea, vomiting, headache, diarrhea, and others. Before starting to take the drug, it is important to consult a doctor to make sure that it is safe and appropriate to use in a particular case.

Indications Ornidazole

1. Amoebiasis: Ornidazole is used to treat amoebiasis, an infection caused by protozoan amoebae (Entamoeba histolytica) that usually affects the intestines.
2. Lambliasis: This drug is used to treat Giardiasis, an infection caused by the parasite Giardia lamblia, which most commonly affects the small intestine.
3. Trichomoniasis: The drug is used to treat trichomoniasis, an infection caused by the protozoan Trichomonas vaginalis, which can affect the genitourinary organs, including the vagina and urethra.
4. Infections caused by anaerobic bacteria: Ornidazole may be used to treat a variety of infections such as gastrointestinal infections, soft tissue infections, retroperitoneal infections, and others caused by anaerobic bacteria.

Release form

1. Tablets: Ornidazole is often available in tablet form, which are taken orally and washed down with water. Tablets may have different dosages depending on the specific indication and doctor's recommendations.
2. Capsules: Some manufacturers may make the drug in capsule form. Like tablets, capsules are taken orally with water and can have different dosages.

Pharmacodynamics

1. Mechanism of action: The drug shows its activity by interacting with the DNA of microorganisms. It causes destruction of DNA structure of pathogenic microorganisms, which leads to disruption of their vital processes and death.
2. Antimicrobial action: Ornidazole is effective against a variety of microorganisms, including protozoa, bacteria and fungi. It can be used to treat infections such as amoebiasis, trichomoniasis, gardnerellosis, chlamydia, bacterial skin infections, and others.
3. Broad spectrum of action: The drug has a broad spectrum of action and can be effective against many different pathogens.
4. Anti-inflammatory effects: Some studies suggest that ornidazole may have anti-inflammatory properties, helping to reduce inflammation and tissue damage.
5. Immunomodulatory action: Some studies also indicate that the drug may have an effect on the immune system, strengthening its defense functions and helping the body fight infection.

Ornidazole is active against the following microorganisms:

1. Anaerobes:

   • Clostridium spp. (e.g., Clostridium perfringens, Clostridium difficile).
   • Bacteroides spp.
   • Prevotella spp.
   • Fusobacterium spp.
   • Peptostreptococcus spp.

2. Protozoans:

   • Entamoeba histolytica.
   • Giardia lamblia.
   • Trichomonas vaginalis.

These microorganisms often cause infections in various parts of the body, and ornidazole is used to treat infections caused by them.

Pharmacokinetics

1. Absorption: The drug is usually administered orally in the form of tablets. After ornidazole is taken from the gastrointestinal tract, it is rapidly absorbed into the systemic bloodstream.
2. Distribution: Ornidazole is well distributed in organs and tissues of the body, including the urogenital system, liver and kidneys. It may also pass through the placental barrier and be excreted in breast milk.
3. Metabolism: The drug is metabolized in the liver with formation of active metabolites. The main pathway of metabolism is hydroxylation and conjugation.
4. Excretion: Approximately 60-70% of the dose of ornidazole is excreted from the body through the kidneys, mainly as metabolites, and the remainder through the intestine with bile.
5. Concentration: Maximum blood concentrations of the drug are usually reached within 1-2 hours after oral administration.
6. Pharmacodynamics: Ornidazole is a derivative of nitroimidazole and has antimicrobial action, inhibiting the synthesis of DNA and RNA of aerobic and anaerobic bacteria.
7. Duration of action: The drug's effect on the infection usually lasts for several days after completion of treatment.
8. Interactions with other drugs: Ornidazole may interact with other drugs, especially with drugs that are also metabolized in the liver or excreted through the kidneys.

Dosing and administration

1. Method of Application:

   • Ornidazole is usually taken orally with or after food to reduce the possibility of gastrointestinal side effects.
   • Tablets or capsules are usually washed down with a glass of water.

2. Dosage:

   • The dosage of the drug may vary depending on the specific indication, severity of infection, and other factors.
   • The usual recommended dosage for adults is 500 mg of ornidazole twice daily.
   • Children and adolescents may be prescribed a lower dosage, which is determined by the doctor depending on age and weight.

3. Duration of the course of treatment:

   • The duration of the course of treatment with the drug is also determined by the doctor, depending on the nature of the infection and the severity of the patient's condition.
   • The course of treatment usually lasts from a few days to a few weeks.

4. Individualized recommendations from a physician:

   • The doctor can recommend individual adjustments to the dosage and regimen according to the characteristics of each patient and the nature of the disease.
   • It is important to strictly follow the doctor's instructions and do not change the dosage or regimen without his permission.

Use Ornidazole during pregnancy

Data on its use during pregnancy are limited and its safety in pregnant women has not been fully established.

Therefore, doctors usually try to avoid prescribing ornidazole to pregnant women, especially in the first trimester, when the fetal organs are forming. If treatment with the drug is necessary for a pregnant woman, the doctor will assess the potential risks and benefits of its use and decide the best course of action in each case.

Contraindications

1. Hypersensitivity: Patients with known hypersensitivity to ornidazole or other nitroimidazole drugs should not use it because of the risk of allergic reactions.
2. Pregnancy and breastfeeding: Use of the drug during pregnancy may be contraindicated, especially in the first trimester, due to potential effects on fetal development. Ornidazole is also excreted into breast milk, therefore its use during breastfeeding should be carried out under medical supervision.
3. Liver disorders: In the presence of severe liver function disorders the use of the drug may be contraindicated due to the risk of liver deterioration or the possibility of accumulation of the drug in the body.
4. Renal impairment: In patients with severe renal impairment, ornidazole dose adjustment may also be required due to possible accumulation of the drug in the body.
5. Hematopoietic disorders: The drug may cause toxic effects on bone marrow, which may lead to hematopoietic disorders, including aplastic anemia. Therefore, the use of ornidazole may be contraindicated in patients with hematopoietic disorders.
6. Alcohol: Alcohol consumption should be avoided while taking ornidazole, as it may cause a disulfiram-like reaction with a number of unpleasant symptoms, including nausea, vomiting, dizziness and others.
7. Cardiovascular diseases: The drug may cause changes in the cardiovascular system, therefore its use may be contraindicated in patients with serious cardiovascular diseases.

Side effects Ornidazole

1. Gastrointestinal disorders: This may include nausea, vomiting, diarrhea, abdominal pain, anorexia (loss of appetite), and dyspepsia (digestive disorders).
2. Headache: Some patients may experience headache while taking ornidazole.
3. Allergic reactions: Allergic reactions such as skin rash, itching, urticaria, angioedema (swelling of the face, lips, tongue) and anaphylactic shock (a reaction with acute loss of consciousness and decreased blood pressure) may occur.
4. Systemic reactions: These may include weakness, fatigue, drowsiness, and general malaise.
5. Changes in taste: Some patients may experience changes in taste or a metallic taste in the mouth.
6. Rare side effects: Other side effects such as inhibition of hematopoiesis (e.g., agranulocytosis, leukopenia, thrombocytopenia), increased liver enzyme activity, peripheral neuropathy, changes in blood pressure, dysuropathy (impaired urination), and other rare reactions are possible.

Overdose

Information on overdose with ornidazole is limited and cases of overdose are relatively rare. Ornidazole is usually used for medical purposes under the supervision of a specialist and its use in high doses or in case of overdose is rare.

Since the drug is mainly used to treat infections caused by protozoa or bacteria, overdose may lead to an increase in side effects characteristic of the drug, such as gastrointestinal disorders (nausea, vomiting, diarrhea), headache, drowsiness, allergic reactions, etc.

Interactions with other drugs

1. Metronidazole: Ornidazole and metronidazole are both nitroimidazole derivatives and have a similar mechanism of action. Their combined use may result in a stronger therapeutic effect and an increased risk of undesirable side effects such as nausea, vomiting and diarrhea.
2. Warfarin and other anticoagulants: The drug may increase the effect of anticoagulants, such as warfarin, which may lead to an increased risk of bleeding. Careful monitoring of blood coagulation indices is necessary during concomitant use.
3. Cyclosporine: Ornidazole may increase blood concentrations of cyclosporine by inhibiting its metabolism in the liver. This may increase the toxicity of cyclosporine.
4. Lithium: The drug may increase the concentration of lithium in the blood, which may lead to lithium toxic effects. Careful monitoring of lithium levels in the blood is recommended when coadministered.
5. Phenytoin and carbamazepine: Ornidazole may increase the metabolism of phenytoin and carbamazepine, which may lead to a decrease in their efficacy. Evaluation of clinical response and possible dosage adjustment is necessary.
6. Antifungal drugs: The drug may interact with azoles (e.g., ketoconazole, fluconazole) and other antimycotics, altering their metabolism and blood concentrations.

Storage conditions

1. Temperature: Ornidazole is usually stored at room temperature, which is between 15 and 30 degrees Celsius. Do not allow the drug to overheat.
2. Humidity: Avoid exposure of the preparation to excessive humidity. Store the preparation in a dry place to prevent decomposition or aggregation.
3. Light: Ornidazole should be stored in a light-protected place to prevent exposure to direct sunlight or other light sources that may adversely affect its stability. It is recommended to store the drug in the original package or container.
4. Packaging: It is important to follow the instructions on the drug package regarding storage. The drug is usually supplied in a package designed to protect it from external factors such as light and moisture.
5. Additional recommendations: Some manufacturers may provide additional storage recommendations. It is important to read the information on the package carefully or contact your pharmacist if you have any questions about storage conditions.