Meratin

Meratin is a medicine used in cases of amebiasis or other protozoan infections. It is a derivative of nitroimidazole, contains the active element ornidazole.

Ornidazole acts by disrupting the DNA structure of bacteria that are sensitive to its influence. The substance demonstrates activity against Helicobacter pylori, Trichomonas vaginalis, dysenteric amoeba and intestinal lamblia, as well as against individual anaerobes (clostridia, bacteroides and fusobacteria) with anaerobic cocci. [ 1 ]

Indications Meratin

It is used to treat trichomoniasis (urogenital infections associated with the activity of vaginal trichomonas), amebiasis (any intestinal lesions associated with the dysenteric amoeba (this includes the amoebic form of dysentery and any extraintestinal types of amebiasis, including liver abscess associated with amebic lesions)) and giardiasis.

Release form

The medicinal element is released in tablet form - 10 pieces inside a cellular package. Inside the pack - 1 such package.

Pharmacokinetics

When taken orally, ornidazole is absorbed in the gastrointestinal tract by 90%. Cmax values in plasma are noted after 3 hours. Protein synthesis of ornidazole is 13%. Taking into account the dosage regimen, the optimal level of the active element is within 6-36 mcg/l.

The processes of drug exchange are carried out with weak participation of the structure of hemoprotein P450. The drug in large volumes enters the cerebrospinal fluid and other fluids with tissues. [ 2 ]

The half-life is 13 hours. With a single administration of the drug, 85% of the substance is excreted in the first 5 days (mainly with urine (63%) and feces (22%)). About 4% of the dosage is excreted unchanged through the kidneys. [ 3 ]

The accumulation coefficient of the drug with repeated administration of a dose of 0.5 or 1 g (at 12-hour intervals) in volunteers was 1.5-2.5.

Dosing and administration

Meratin should be taken orally, after meals, with plain water.

Administration to people with trichomoniasis.

For trichomoniasis, the following dosage regimens are used:

• a) 1-day treatment cycle: for children weighing over 35 kg and adults – take 3 tablets at once in the evening; for children weighing 20-34 kg – take 25 mg/kg of the medicine once;
• b) 5-day therapy cycle: for children weighing over 35 kg and adults – take 1 tablet of the drug 2 times a day (in the morning and then in the evening). For children weighing less than 35 kg, the drug is not prescribed according to this scheme.

To prevent relapse, the patient’s sexual partner must also undergo the same course of therapy.

Use in persons with amebiasis.

In case of amebiasis, 3-day (in case of the amoebic variety of dysentery) or 5-10-day treatment cycles (in case of any form of amebiasis) can be carried out.

Dosage regimens:

• for the amoebic variety of dysentery, the 3-day course includes:
• evening intake of 3 tablets (children weighing over 35 kg and adults weighing up to 60 kg);
• 2-time use of 2 tablets in the morning and in the evening (adults weighing more than 60 kg);
• for a child weighing 13-24 kg – 2 tablets per dose;
• for a child weighing less than 13 kg – 1 tablet per 1-time use.
• for other types of amebiasis (5-10-day treatment cycle):
• for a child weighing more than 35 kg and an adult - 1 tablet 2 times a day (in the morning, and also in the evening);
• for a child weighing 20-34 kg – 2 tablets per 1 application;
• for a child weighing less than 20 kg – 1 tablet per dose.

Use for giardiasis.

For a child weighing more than 35 kg and an adult – 1 time intake of 3 tablets per day (in the evening).

For a child weighing less than 35 kg – 1 dose per day, calculated according to the scheme 40 mg/kg.

The therapy lasts for 1-2 days.

Use Meratin during pregnancy

Ornidazole does not have toxic or teratogenic effects on the fetus.

Controlled testing in pregnant women has not been performed, therefore the use of the drug in early pregnancy or during breastfeeding is permitted only under strict indications, when the probable benefit is more expected than the risks of complications for the fetus/infant.

Contraindications

Main contraindications:

• severe intolerance to the components of the medicinal substance or other nitroimidazole derivatives;
• disruption of the central nervous system (cerebral damage, epilepsy or multiple sclerosis);
• pathological blood lesions or other hematological disorders.

Side effects Meratin

Side effects include:

• disorders affecting the blood system and lymph: neutro- or leukopenia and symptoms of bone marrow damage;
• immune manifestations: symptoms of intolerance, including Quincke's edema and anaphylaxis;
• lesions of the epidermis and subcutaneous layer: itching, epidermal rashes and urticaria;
• problems of a neurological nature: fatigue, rigidity and agitation, coordination disorder, headaches, seizures and confusion. In addition, tremor, dizziness, transient loss of consciousness, drowsiness, symptoms of mixed or sensory polyneuropathy, disorientation in space and ataxia;
• systemic disorders: chills, dyspnea, fever and systemic weakness;
• gastrointestinal dysfunction: xerostomia, diarrhea, metallic taste, nausea, dyspepsia, loss of appetite, coated tongue, and in addition vomiting, pain in the epigastric region and taste disorders;
• lesions affecting the hepatobiliary system: development of hepatotoxicity. Deterioration of biochemical liver function tests, jaundice or increased liver enzyme values may be observed;
• infectious or invasive lesions: active phase of candidiasis;
• Others: darkening of the urine or disturbances in the functioning of the cardiovascular system (including a decrease in blood pressure).

Overdose

In case of poisoning, a potentiation of side effects is observed.

Meratin has no antidote. In case of seizures, diazepam should be used. Symptomatic actions are also performed.

Interactions with other drugs

It is prohibited to consume alcoholic beverages during the treatment cycle, and also for at least 3 days after stopping the medication.

Ornidazole can potentiate the activity of coumarin anticoagulants taken orally, so their dosage should be adjusted accordingly.

The drug prolongs the muscle relaxant effect of vecuronium bromide.

Use with phenobarbital and other enzyme inducers reduces the intraserum circulation term of ornidazole; at the same time, agents that slow down the action of enzymes (including cimetidine) prolong it.

Storage conditions

Meratin must be stored in a place closed to children. Temperature values should not exceed 25°C.

Shelf life

Meratin should be used within 36 months from the date of manufacture of the medicinal substance.

Analogues

Analogues of the drug are Ornigil, Metrogil with Tagera, Dazolik and Orzol with Protozal, and in addition to this Metressa and Metronidazole, Intezol with Ornigil and Meradazole. In addition, the list includes Ornisol and Efloran with Trichopolum, Metrid and Tinidazole, as well as Ornidazole, Fazizhin and Trikaside.

Reviews

Meratin, based on the reviews of various patients, is considered an effective medication. But it is recommended to use it in combination with other drugs, and the result of therapy should be confirmed by laboratory test results.