| Antibiotic |
Interacting Drug |
Comment |
|
Metronidazole
|
Warfarin |
Enhances anticoagulant effect of warfarin. Risk of bleeding. The INR should be checked frequently and warfarin dosage adjusted accordingly, particularly following initiation or discontinuation of metronidazole. |
| Lithium |
Plasma levels of lithium may be increased by metronidazole. Advise patients to report lithium adverse effects (tremor, dysarthria, ataxia, confusion). |
| Alcohol |
A disulfiram-like reaction can occur between metronidazole and alcohol. The reaction is generally more unpleasant than serious. Patients should be advised not to take alcohol (or drugs containing alcohol) during metronidazole therapy and up to 72 hours afterwards because of a disulfiram-like (antabuse effect) reaction (i.e. flushing, vomiting, tachycardia). |
