Mistol Drug Interactions

Disulfiram: acute transient disorders with delirium (acute delirium onset, confused mental state) have been reported in patients who were using metronidazole and disulfiram concurrently.
Alcohol: alcoholic beverages and drugs containing alcohol should not be consumed during therapy and for at least one day afterwards because of the possibility of a disulfiram-like reaction (flushing, erythema, vomiting, tachycardia).
Oral anticoagulant therapy (warfarin type): potentiation of the effect of oral anticoagulants and increased hemorrhagic risk caused by decreased hepatic metabolism.
Prothrombin level and INR level (international normalized ratio) should be more frequently monitored. It is advised to adjust the dosage of oral anticoagulant during treatment with metronidazole and for 8 days after its discontinuation.
Lithium: Plasma levels of lithium may be increased by metronidazole. Plasma concentration of lithium, creatinine and electrolytes should be monitored in patients under treatment with lithium while they receive metronidazole.
Cyclosporin: there is risk of elevation of cyclosporin serum levels. Serum cyclosporin and serum creatinine should be closely monitored when co administration with metronidazole is necessary.
Phenytoin or phenobarbital: causes decrease of metronidazole plasma concentration.
5-fluorouracil: reduced clearance of 5-fluorouracil results in increased toxicity of 5-fluorouracil.
Busulfan: Plasma levels of busulfan may be increased by metronidazole, which may lead to severe busulfan toxicity.
Changes in the international normalized ratio (INR) level: Multiple incidents of potentiation of the anticoagulant effect after oral administration have been reported in patients undergoing antibacterial therapy. The risk factors of such potentiation tendency are determined by present infections or frank inflammation, age, general state of health. In such conditions it appears to be hard to determine to what extent infection or its treatment affects INR balance. However some classes of antibiotics play a major role, among them are fluoroquinolones, macrolides, cyclones, cotrimoxazole and some cephalosporins.
Laboratory report: Metronidazole may immobilize treponema and thus may lead to falsely positive Nelson's test.