Flagyl..... in PREGNANCY ...TO USE or NOT - USMLE Forums
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Old 06-04-2011
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Drug Flagyl..... in PREGNANCY ...TO USE or NOT

HEY every reader
what about use of metronidazole in pregnancy 1st trimester and throughout 2nd, 3rd , and during nursing...??
kaplan notes gyn.... 2010 say ...it is safe EVEN in 1st trimester
a Q bank ... prohibit its use in 1st trimester ...???
there is a big conflict about the issue on many papers on net ...
....... i cannot take a decision

if anyone has a final recent proof about its USE ....??
anyone meet a Q in a recent Q bank that discuss ! issue ...??
if....YES...... PLZ pass and reply
thx 4 ur care
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Old 06-04-2011
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Metronidazole is safe to use in Pregnancy including the 1st trimester.

Source : Kaplan Lecture Notes 2008
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Metronidazole is actually a pregnancy category B drug and its use in the first trimester is controversial. In the 2nd, 3rd trimester its safer to use
http://reference.medscape.com/drug/f...azole-342566#5

However this article shows no teratogenic risk if used in recommended doses
http://www.ncbi.nlm.nih.gov/pubmed/11320529
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Old 06-04-2011
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Question

Quote:
Originally Posted by doc_study View Post
Metronidazole is safe to use in Pregnancy including the 1st trimester.

Source : Kaplan Lecture Notes 2008

i already mentioned this above.......
but while doind UW 2007 offline.... a Q said it is containdic. in 1st trimester...??!!

did u face such a Q in a new UW bank..??
or read about the problem in atext rather than kaplan ....??
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Warning! conflict

Quote:
Originally Posted by mle guy View Post
Metronidazole is actually a pregnancy category B drug and its use in the first trimester is controversial. In the 2nd, 3rd trimester its safer to use
http://reference.medscape.com/drug/f...azole-342566#5

However this article shows no teratogenic risk if used in recommended doses
http://www.ncbi.nlm.nih.gov/pubmed/11320529

this add a conflict to an already conflicting issue....
it seems it is still of controversy in real life
.................................................. ..................................................
then to the CK exam... what we can consider if it is a target of a Q...???
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Old 06-04-2011
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Flagyl is a category B drug so its use is not recommended in pregnancy.

However if a patient has Trichomoniasis,Bacterial Vaginosis or Giardiasis, not using Flagyl puts the fetus at a greater risk than using it. As it is the most effective drug for treating these conditions and no significant risk has been noted in various trials, it is used in almost all cases in the third trimester and most cases in second trimester of pregnancy.
But I believe cautious use is recommended in the first trimester.
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Old 06-05-2011
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Warning!

Quote:
Originally Posted by vienna4u View Post
Flagyl is a category B drug so its use is not recommended in pregnancy.

However if a patient has Trichomoniasis,Bacterial Vaginosis or Giardiasis, not using Flagyl puts the fetus at a greater risk than using it. As it is the most effective drug for treating these conditions and no significant risk has been noted in various trials, it is used in almost all cases in the third trimester and most cases in second trimester of pregnancy.
But I believe cautious use is recommended in the first trimester.

thx 4 ur care ..... by ur specification.. u remove some conflict
BUT ......UNFORTUNATELy...there is some
more is .... that i faced another Q establishing use of topical metronid or clindamycin in preg ...NOT systemic ttt...in ttt of B.Vaginosis....

While kaplan videoes emphasize on use of oral not topical ttt....

CDC 2010 establish use of it ORALLY ...NOT recommending topical ttt being less effective in pregnant(high risk of complictions)......................,the issue is NOT related 2 teratogenicity......, BUT 2 efficacy....

what about UW or any other bank......any one face these Qs... can share experience in this topic...?
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Here you go. This is the UW question which explains that its safe to use oral metronidazole even in the first trimester.
Vaginal metronidazole and clindamycin are alternatives.

Question id : 1643

Supported by these 2 meta-analysis
http://www.ncbi.nlm.nih.gov/pubmed/9278206
http://www.ncbi.nlm.nih.gov/pubmed/7856680
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Thumbs Up Bottom line ..........

Quote:
Originally Posted by mle guy View Post
Here you go. This is the UW question which explains that its safe to use oral metronidazole even in the first trimester.
Vaginal metronidazole and clindamycin are alternatives.

Question id : 1643

Supported by these 2 meta-analysis
http://www.ncbi.nlm.nih.gov/pubmed/9278206
http://www.ncbi.nlm.nih.gov/pubmed/7856680

thx 4 ur effort...
i think... this cleans any conlict ..... about the matter in the exam and real life as well...
flagyl is safe to use throughout the whole Pregnancy
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