INN monograph
Metronidazole / Clotrimazole Pessary
Nitroimidazole antimicrobial / antiprotozoal · POM
Verified · Updated 01 Aug 2026 · Source: Local active-ingredient clinical extract; RxNorm (NLM RxNav); PubChem; Component monographs (multi-source pipeline)
Kenya market
Wholesale / list prices where loaded
Risk first
Contraindications
- Hypersensitivity to nitroimidazoles.
- First trimester use traditionally avoided unless essential (practice evolving — follow current obstetric guidance).
- Disulfiram within 2 weeks.
Precautions
- Avoid alcohol during and for 24–72 h after (disulfiram-like reaction).
- Neurologic toxicity with prolonged/high dose (neuropathy, seizures).
- Metallic taste common.
- Dark urine possible.
Point of care
Dosing
Adult
One pessary to be inserted into the vagina OD.
Paediatric
Weight-based — use paediatric formulary / SmPC.
Renal
Metabolites accumulate in renal failure; review dosing in ESRD.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Hepatic
Hepatic metabolism — reduce dose in severe liver disease.
Safety
Drug interactions
- Fixed-dose/multi-ingredient product.
- Clinical details partially inherited from component monographs: Metronidazole, Clotrimazole / Beclomethasone Dipropionate.
- Confirm combination SmPC for exact dosing.
Safety
Adverse effects
- [From component Metronidazole] GI discomfort, anorexia, metallic taste, dry mouth, headache, skin rash, vertigo, depression, insomnia, drowsiness, urethral discomfort, darkened urine, transient fall in BP, temporary leucopenia, bone marrow depression, transient epileptic seizure, furred tongue.
Use
Indications
- Vaginal infections like trichomoniasis, bacterial vaginosis and vulvovaginal candidiasis Clinical selection for Metronidazole / Clotrimazole Pessary should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Nitroimidazole antimicrobial / antiprotozoal.
- Confirm site-specific dose, duration and monitoring before prescribing.
Pharmacology
Mode of action
Combination product.
Full mechanism text
Combination product. Component mechanism (Metronidazole): Metronidazole, ornidazole and other imidazoles are selective for anaerobic bacteria due to their ability to intracellularly reduce imidazole which covalently binds to DNA, disrupt its helical structure, inhibiting bacterial nucleic acid synthesis
ADME
Pharmacokinetics & PD
| Onset | 1–2 hours |
|---|---|
| Duration | 8–24 hours |
| Route | ORAL / IV / TOPICAL / VAGINAL |
| Distribution | including abscesses and CSF. Hepatic |
Kenya
Brands & prices
| Brand | Company | Pack | KES |
|---|---|---|---|
| Infa-V Ointment | Questa Care Inc. | Standard Commercial Pack | — |
| Infa-V Pessaries | Questa Care Inc. | Standard Commercial Pack | — |
Special populations
Pregnancy & lactation
Pregnancy
Widely used in later pregnancy for BV/trichomoniasis in many protocols; avoid unnecessary first-trimester exposure — follow current guidance.
Lactation
Single-dose regimens often compatible with pumping/timing advice; prolonged high dose — review.
Diet
Food & alcohol
- Food
- Food
Trust
Sources & disclaimer
Source: Local active-ingredient clinical extract; RxNorm (NLM RxNav); PubChem; Component monographs (multi-source pipeline)
Last reviewed: 01 Aug 2026
Decision support only — not a substitute for clinical judgment, product SmPC, or Kenya STG/EML.