Ivermectin/metronidazole/niacinamide topical Disease Interactions

Metronidazole may be systemically absorbed when applied to the skin or mucosal membranes. A disulfiram-like reaction has been reported in patients who consume alcohol during treatment with oral metronidazole. Symptoms include nausea, vomiting, flushing, sweating, headache, abdominal cramps, and hypotension. Therapy with topical metronidazole should be administered cautiously in patients who might be prone to acute alcohol intake. Patients should be instructed to avoid alcohol-containing products during therapy and for at least 48 hours after the last dose.

Metronidazole may be systemically absorbed when applied to the skin or mucosal membranes. The use of metronidazole has rarely been associated with hematologic adverse effects such as mild, transient leukopenia, thrombocytopenia, and bone marrow aplasia. The manufacturers recommend that therapy with metronidazole be administered cautiously in patients with evidence of or a history of blood dyscrasias.

Metronidazole may be systemically absorbed when applied to the skin or mucosal membranes. Once absorbed, metronidazole is extensively metabolized by the liver to both pharmacologically active and inactive compounds. The plasma clearance of metronidazole may be decreased and the half-life prolonged in patients with impaired hepatic function. Therapy with topical metronidazole should be administered cautiously in patients with liver disease.

Metronidazole may be systemically absorbed when applied to the skin or mucosal membranes. The use of oral and intravenous metronidazole has been associated with the development of nervous system toxicity including convulsive seizures and dose-related peripheral neuropathy, the latter characterized primarily by numbness or paresthesia of an extremity. Persistent peripheral neuropathy has been reported in some patients treated for prolonged periods. Other neurologic adverse effects include vertigo, incoordination, ataxia, confusion, agitation, hallucinations, and depression. Therapy with topical metronidazole should be administered cautiously in patients with or predisposed to seizures or other nervous system abnormalities. Metronidazole therapy should be discontinued promptly if neurologic disturbances occur.