Adverse Drug Reactions
- Disulfiram-like reaction with alcohol ingestion
Peripheral Neuropathy
- Starts after 4 weeks or 42 grams
- Free radicals causing nerve damage, and metronidazole causes degeneration
- Usually resolves in 2 weeks (but may take up to 24 weeks)
- Usually reversible (about 75%) but takes time
Neurotoxicity
- Can cause seizures and encephalopathy
- MRI may show bilateral symmetric T2 hyperintense lesions, which resolve after cessation of metronidazole
