Robasy Uses

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How do you administer this medicine?

Consists of Metronidazole, neomycin sulfate, nystatin

What is Metronidazole (Robasy)?

Metronidazole (Robasy) is used to treat bacterial infections in different areas of the body. The extended-release tablets are used to treat women with vaginal infections (bacterial vaginosis).

Metronidazole (Robasy) belongs to the class of medicines known as antibiotics. It works by killing bacteria or preventing their growth. However, Metronidazole (Robasy) will not work for colds, flu, or other virus infections.

Metronidazole (Robasy) is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, Metronidazole (Robasy) is used in certain patients with the following medical conditions:

  • Clostridium difficile diarrhea or colitis (antibiotic-associated colitis).
  • Crohn's disease (inflammatory bowel disease).
  • Gastritis or stomach ulcers due to Helicobacter pylori.
  • Giardiasis (parasite infection in the intestines).

Metronidazole (Robasy) indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Symptomatic Trichomoniasis

Metronidazole (Robasy) is indicated for the treatment of symptomatic trichomoniasis in females and males when the presence of thetrichomonad has been confirmed by appropriate laboratory procedures (wet smears and/or cultures).

Asymptomatic Trichomoniasis

Metronidazole (Robasy) is indicated in the treatment of asymptomatic females when the organism is associated with endocervi-citis, cervicitis, or cervical erosion. Since there is evidence that presence of the trichomonad can interfere with accurate assessment of abnormal cytological smears, additional smears should be performed after eradication of the parasite.

Treatment of Asymptomatic Consorts.

T. vagi-nalis infection is a venereal disease. Therefore, asymptomatic sexual partners of treated patients should be treated simultaneously if the organism has been found to be present, in order to prevent reinfection of the partner. The decision as to whether to treat an asymptomatic male partner who has a negative culture or one for whom no culture has been attempted is an individual one. In making this decision, it should be noted that there is evidence that a woman may become reinfected if her consort is not treated. Also, since there can be considerable difficulty in isolating the organism from the asymptomatic male carrier, negative smears and cultures cannot be relied upon in this regard. In any event, the consort should be treated with Metronidazole (Robasy) in cases of reinfection.

Amebiasis

Metronidazole (Robasy) is indicated in the treatment of acute intestinal amebiasis (amebic dysen-tery)and amebic liver abscess.

In amebic liver abscess, Metronidazole (Robasy) therapy does not obviate the need for aspiration or drainage of pus.

Anaerobic Bacterial Infections

Metronidazole (Robasy) is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Indicated surgical procedures should be performed in conjunction with Metronidazole (Robasy) therapy. In a mixed aerobic and anaerobic infection, antimicrobials appropriate for the treatment of the aerobic infection should be used in addition to Metronidazole (Robasy).

In the treatment of most serious anaerobic infections, Metronidazole (Robasy) I.V. (Metronidazole (Robasy) hydrochloride) or Metronidazole (Robasy) I.V. RTU® (Metronidazole (Robasy)) is usually administered initially. This may be followed by oral ther-apy with Metronidazole (Robasy) at the discretion of the physician.

INTRA-ABDOMINAL INFECTIONS, including peritonitis, intra-abdominal abscess, and liver abscess, caused by Bacteroides species including the B. fragilis group (B. fragilis, B. distasonis,B. ovatus, B. thetaiotaomicron, B. vulgatus), Clostrid-ium species, Eubacterium species, Peptococcus niger, and Peptostreptococcus species.

SKIN AND SKIN STRUCTURE INFECTIONS caused by Bacteroides species including the B. fragilis group, Clostridium species, Peptococcus niger,Peptostreptococcus species, and Fusobacte-rium species.

GYNECOLOGIC INFECTIONS, including endo-metritis, endomyometritis, tubo-ovarian abscess, and postsurgical vaginal cuff infection, caused by Bacteroides species including the B. fragilis group, Clostridium species, Peptococcusniger, and Pepto-streptococcus species.

BACTERIAL SEPTICEMIA caused by Bacteroides species including the B. fragilis group, and Clos-tridium species.

BONE AND JOINT INFECTIONS, as adjunctive therapy, caused by Bacteroides species including the B. fragilis group.

CENTRAL NERVOUS SYSTEM (CNS) INFECTIONS, including meningitis and brain abscess, caused by Bacteroides species including the B.fragilis group.

LOWER RESPIRATORY TRACT INFECTIONS, including pneumonia, empyema, and lung abscess, caused by Bacteroides species including the B. fragilis group.

ENDOCARDITIS caused by Bacteroides species including the B.fragilis group.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Metronidazole (Robasy) and other antibacterial drugs, Metronidazole (Robasy) should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

How should I use Metronidazole (Robasy)?

Use Metronidazole (Robasy) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with Metronidazole (Robasy). Talk to your pharmacist if you have questions about this information.
  • If you are using Metronidazole (Robasy) once daily, use it at bedtime.
  • Remove the cap from the tube and break the metal seal on the tube with the pointed tip of the cap. Screw the end of the applicator onto the tube. Slowly squeeze gel out of the tube and into the applicator. The plunger will stop when the applicator is full. Unscrew applicator and replace the cap on the tube.
  • You may insert Metronidazole (Robasy) lying on your back with your knees bent or in any comfortable position. Hold the filled applicator by the barrel, and gently insert into the vagina as far as it will comfortably go. Slowly press the plunger until it stops, and then remove the applicator.
  • If you will be using Metronidazole (Robasy) twice daily, you will need to clean the applicator after your first dose of the day and use it again for your second dose. To clean the applicator, pull the plunger out of the barrel. Wash both the plunger and barrel in warm, soapy water and rinse well. To put the applicator back together, gently push the plunger back into the barrel.
  • Wash your hands immediately after using Metronidazole (Robasy).
  • When you throw the applicator away, be sure that it is out of the reach of children and pets.
  • Using Metronidazole (Robasy) at the same time each day will help you remember to use it.
  • To clear up your infection completely, use Metronidazole (Robasy) for the full course of treatment. Keep using it even if you feel better in a few days.
  • If you miss a dose of Metronidazole (Robasy), use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Metronidazole (Robasy).

Uses of Metronidazole (Robasy) in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.
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Use: Labeled Indications

Amebiasis: Treatment of acute intestinal amebiasis (amebic dysentery) and extraintestinal amebiasis (liver abscess)

Limitations of use: When used for amebic liver abscess, may be used concurrently with percutaneous needle aspiration when clinically indicated.

Anaerobic bacterial infections (caused by Bacteroides spp., including the B. fragilis group):

Bacterial septicemia: Treatment of bacterial septicemia (also caused by Clostridium spp.)

Bone and joint infections: Treatment (adjunctive therapy) of bone and joint infections

CNS Infections: Treatment of CNS infections, including meningitis and brain abscess

Endocarditis: Treatment of endocarditis

Gynecologic infections: Treatment of gynecologic infections including endometritis, endomyometritis, tubo-ovarian abscess, and postsurgical vaginal cuff infection (also caused by Clostridium spp., Peptococcus spp., Peptostreptococcus spp., and Fusobacterium spp.)

Intra-abdominal infections: Treatment of intra-abdominal infections, including peritonitis, intra-abdominal abscess, and liver abscess (also caused by Clostridium spp., Eubacterium spp., Peptococcus spp., and Peptostreptococcus spp.)

Lower respiratory tract infections: Treatment of lower respiratory tract infections, including pneumonia, empyema, and lung abscess

Skin and skin structure infections: Treatment of skin and skin structure infections (also caused by Clostridium spp., Peptococcus spp., Peptostreptococcus spp., and Fusobacterium spp.)

Surgical prophylaxis (colorectal surgery): Injection: Preoperative, intraoperative, and postoperative prophylaxis to reduce the incidence of postoperative infection in patients undergoing elective colorectal surgery classified as contaminated or potentially contaminated

Trichomoniasis: Treatment of infections caused by Trichomonas vaginalis, including treatment of asymptomatic sexual partners

Off Label Uses

Balantidiasis

Data from a single case report of one immunocompromised patient with pulmonary infection treated with Metronidazole (Robasy) suggest that Metronidazole (Robasy) may be beneficial for the treatment of balantidiasis.

Metronidazole (Robasy) description

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Each 100 mL contains Metronidazole (Robasy) USP 500 mg, sodium chloride USP 0.72% w/v, water for injection USP as needed.

Metronidazole (Robasy) injection, USP is a parenteral dosage form of the synthetic antibacterial agent 1-(β-hydroxyethyl)-2-methyl-5-nitroimidazole. The empirical formula is C6H9N3O3 and the molecular weight is 171.15.

Metronidazole (Robasy) injection, USP in 100 mL is a sterile, nonpyrogenic, iso-osmotic, buffered solution of 500 mg Metronidazole (Robasy), USP, 790 mg sodium chloride, USP, 47.6 mg dried dibasic sodium phosphate, USP and 22.9 mg anhydrous citric acid, USP. Metronidazole (Robasy) injection, USP has an osmolarity of 310 mOsmol/L (calc) and a pH of 5.5 (4.5 to 7).

Metronidazole (Robasy) dosage

Usual Adult Dose for Acne Rosacea

Metronidazole (Robasy) topical 1% gel or cream: Apply a thin film to the affected area once a day.

Metronidazole (Robasy) topical 0.75% gel, cream, or lotion: Apply a thin film to the affected area twice a day.

Usual Adult Dose for Bacterial Vaginosis

Insert one applicatorful of Metronidazole (Robasy) topical 0.75% vaginal gel intravaginally once (at bedtime) or twice a day for 5 consecutive days.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Gel, cream, lotion: Data not available

Vaginal gel: The manufacturer recommends caution when administering this drug to patients with severe hepatic disease.

Dose Adjustments

The duration of topical therapy is 4 to 10 weeks depending on the nature and severity of the condition.

Precautions

Patients should be advised to use Metronidazole (Robasy) topical less frequently or discontinue use if a reaction suggesting local irritation occurs.

Convulsive seizures and peripheral neuropathy have been reported in patients receiving oral or IV Metronidazole (Robasy). If abnormal neurologic signs appear, Metronidazole (Robasy) topical vaginal gel should be discontinued at once. The use of Metronidazole (Robasy) topical 1% gel should be reevaluated at once if abnormal neurologic signs appear. Metronidazole (Robasy) topical should be used with caution in patients with central nervous system diseases.

Metronidazole (Robasy) topical should be used with caution in patients with evidence of, or history of blood dyscrasia.

Although disulfiram-like reactions have not been reported in patients receiving vaginal Metronidazole (Robasy), the manufacturer recommends that alcohol be avoided. Metronidazole (Robasy) topical vaginal gel should not be used in patients who have taken disulfiram within the last 2 weeks.

Safety and efficacy have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Metronidazole (Robasy) topical may cause eye irritation if applied too close to the eyes. Contact with the eyes should be avoided.

Topical areas to be treated should be washed with a mild cleanser prior to application.

The manufacturer recommends avoidance of vaginal intercourse during treatment with Metronidazole (Robasy) topical vaginal gel.

Metronidazole (Robasy) interactions

See also:
What other drugs will affect Metronidazole (Robasy)?

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Disulfiram

Psychotic reactions have been reported in alcoholic patients who are using Metronidazole (Robasy) and disulfiram concurrently. Metronidazole (Robasy) should not be given to patients who have taken disulfiram within the last two weeks.

Alcoholic Beverages

Abdominal cramps, nausea, vomiting, headaches, and flushing may occur if alcoholic beverages or products containing propylene glycol are consumed during or following Metronidazole (Robasy) therapy.

Warfarin And Other

Oral Anticoagulants

Metronidazole (Robasy) has been reported to potentiate the anticoagulant effect of warfarin and other oral coumarin anticoagulants, resulting in a prolongation of prothrombin time. When Metronidazole (Robasy) is prescribed for patients on this type of anticoagulant therapy, prothrombin time and INR should be carefully monitored.

Lithium

In patients stabilized on relatively high doses of lithium, short-term Metronidazole (Robasy) therapy has been associated with elevation of serum lithium and, in a few cases, signs of lithium toxicity. Serum lithium and serum creatinine levels should be obtained several days after beginning Metronidazole (Robasy) to detect any increase that may precede clinical symptoms of lithium intoxication.

Busulfan

Metronidazole (Robasy) has been reported to increase plasma concentrations of busulfan, which can result in an increased risk for serious busulfan toxicity. Metronidazole (Robasy) should not be administered concomitantly with busulfan unless the benefit outweighs the risk. If no therapeutic alternatives to Metronidazole (Robasy) are available, and concomitant administration with busulfan is medically needed, frequent monitoring of busulfan plasma concentration should be performed and the busulfan dose should be adjusted accordingly.

Drugs That Inhibit CYP450 Enzymes

The simultaneous administration of drugs that decrease microsomal liver enzyme activity, such as cimetidine, may prolong the half-life and decrease plasma clearance of Metronidazole (Robasy).

Drugs That Induce CYP450 Enzymes

The simultaneous administration of drugs that induce microsomal liver enzymes, such as phenytoin or phenobarbital, may accelerate the elimination of Metronidazole (Robasy), resulting in reduced plasma levels; impaired clearance of phenytoin has also been reported.

Drug/Laboratory Test Interactions

Metronidazole (Robasy) may interfere with certain types of determinations of serum chemistry values, such as aspartate aminotransferase (AST, SGOT), alanine aminotransferase (ALT, SGPT), lactate dehydrogenase (LDH), triglycerides, and glucose hexokinase. Values of zero may be observed. All of the assays in which interference has been reported involve enzymatic coupling of the assay to oxidation-reduction of nicotinamide adenine dinucleotide (NAD- NADH). Interference is due to the similarity in absorbance peaks of NADH (340 nm) and Metronidazole (Robasy) (322 nm) at pH 7.

Metronidazole (Robasy) side effects

See also:
What are the possible side effects of Metronidazole (Robasy)?

Two serious adverse reactions reported in patients treated with Metronidazole (Robasy) have been convulsive seizures and peripheral neuropathy, the latter characterized mainly by numbness or paresthesia of an extremity. Since persistent peripheral neuropathy has been reported in some patients receiving prolonged administration of Metronidazole (Robasy), patients should be specifically warned about these reactions and should be told to stop the drug and report immediately to their physicians if any neu-rologic symptoms occur.

The most common adverse reactions reported have been referable to the gastrointestinal tract, particularly nausea reported by about 12% of patients, sometimes accompanied by headache, anorexia, and occasionally vomiting; diarrhea; epi-gastric distress; and abdominal cramping. Constipation has also been reported.

The following reactions have also been reported during treatment with Metronidazole (Robasy):

Mouth: A sharp, unpleasant metallic taste is not unusual. Furry tongue, glossitis, and sto-matitis have occurred; these may be associated with a sudden overgrowth of Candida which may occur during therapy.

Hematopoietic: Reversible neutropenia (leuko-penia); rarely, reversible thrombocytopenia.

Cardiovascular: Flattening of the T-wave may be seen in electrocardiographic tracings.

Central Nervous System: Convulsive seizures, peripheral neuropathy, dizziness, vertigo, incoordination, ataxia, confusion, irritability, depression, weakness, and insomnia.

Hypersensitivity: Urticaria, erythematous rash, flushing, nasal congestion, dryness of the mouth (or vagina or vulva), and fever.

Renal: Dysuria, cystitis, polyuria, incontinence, and a sense of pelvic pressure. Instances of darkened urine have been reported by approximately one patient in 100,000. Although the pigment which is probably responsible for this phenomenon has not been positively identified, it is almost certainly a metabolite of Metronidazole (Robasy) and seems to have no clinical significance.

Other: Proliferation of Candida in the vagina, dyspareunia, decrease of libido, proctitis, and fleeting joint pains sometimes resembling &ldquoserum sickness.” If patients receiving Metronidazole (Robasy) drink alcoholic beverages, they may experience abdominal distress, nausea, vomiting, flushing, or headache. A modification of the taste of alcoholic beverages has also been reported. Rare cases of pan-creatitis, which generally abated on withdrawal of the drug, have been reported.

Crohn’s disease patients are known to have an increased incidence of gastrointestinal and certain extraintestinal cancers. There have been some reports in the medical literature of breast and colon cancer in Crohn’s disease patients who have been treated with Metronidazole (Robasy) at high doses for extended periods of time. A cause and effect relationship has not been established. Crohn’s disease is not an approved indication for Metronidazole (Robasy).

Metronidazole (Robasy) contraindications

See also:
What is the most important information I should know about Metronidazole (Robasy)?

Hypersensitivity

Metronidazole (Robasy) 375 mg are contraindicated in patients with a prior history of hypersensitivity to Metronidazole (Robasy) or other nitroimidazole derivatives.

In patients with trichomoniasis, Metronidazole (Robasy) 375 mg are contraindicated during the first trimester of pregnancy.

Psychotic Reaction with Disulfiram

Use of oral Metronidazole (Robasy) is associated with psychotic reactions in alcoholic patients who were using disulfiram concurrently. Do not administer Metronidazole (Robasy) to patients who have taken disulfiram within the last two weeks.

Interaction with Alcohol

Use of oral Metronidazole (Robasy) is associated with a disulfiram-like reaction to alcohol, including abdominal cramps, nausea, vomiting, headaches, and flushing. Discontinue consumption of alcohol or products containing propylene glycol during and for at least three days after therapy with Metronidazole (Robasy).

What is Neomycin sulfate (Robasy)?

Neomycin sulfate (Robasy) is an antibiotic that fights bacteria in the body.

Neomycin sulfate (Robasy) is used to reduce the risk of infection during surgery of your intestines. Neomycin sulfate (Robasy) is also used to reduce the symptoms of hepatic coma.

Neomycin sulfate (Robasy) may also be used for purposes not listed in this medication guide.

Neomycin sulfate (Robasy) indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Neomycin sulfate (Robasy) tablets and other antibacterial drugs, Neomycin sulfate (Robasy) tablets should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Suppression of Intestinal Bacteria

Neomycin sulfate (Robasy) tablets are indicated as adjunctive therapy as part of a regimen for the suppression of the normal bacterial flora of the bowel, e.g., preoperative preparation of the bowel. It is given concomitantly with erythromycin enteric-coated base.

Hepatic Coma (Portal-Systemic Encephalopathy)

Neomycin sulfate (Robasy) has been shown to be effective adjunctive therapy in hepatic coma by reduction of the ammonia-forming bacteria in the intestinal tract. The subsequent reduction in blood ammonia has resulted in neurologic improvement.

How should I use Neomycin sulfate (Robasy)?

Use Neomycin sulfate (Robasy) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take Neomycin sulfate (Robasy) by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Take Neomycin sulfate (Robasy) with plenty of water to avoid dehydration.
  • Do not take Neomycin sulfate (Robasy) for more than 2 weeks unless advised to do so by your health care provider.
  • Take Neomycin sulfate (Robasy) on a regular schedule to get the most benefit from it.
  • To clear up your infection completely, use Neomycin sulfate (Robasy) for the full course of treatment. Keep using it even if you feel better in a few days.
  • If you miss a dose of Neomycin sulfate (Robasy), take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If more than one dose is missed, contact your health care provider.

Ask your health care provider any questions you may have about how to use Neomycin sulfate (Robasy).

Uses of Neomycin sulfate (Robasy) in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.

Oral Neomycin sulfate (Robasy) is used before the operation of the gut to kill the bacteria which normally live in the gut that may cause a serious infection and in treatment of patients with coma due to liver disease (hepatic coma).

Neomycin sulfate (Robasy) description

Each mL of sterile ophthalmic suspension contains prednisolone acetate (microfine) 0.5 mg, Neomycin sulfate (Robasy) (equivalent to Neomycin sulfate (Robasy) base 0.35%) 0.5 mg, polymyxin B sulfate 10,000 units and Liquifilm (polyvinyl alcohol) 1.4%. It also contains thimerosal (1:100,000), polysorbate 80, propylene glycol, sodium acetate and purified water.

Neomycin sulfate (Robasy) dosage

To minimize the risk of toxicity, use the lowest possible dose and the shortest possible treatment period to control the condition. Treatment for periods longer than two weeks is not recommended.

Hepatic Coma

For use as an adjunct in the management of hepatic coma, the recommended dose is 4-12 grams per day given in the following regimen:

1. Withdraw protein from diet. Avoid use of diuretic agents.

2. Give supportive therapy, including blood products, as indicated.

3. Give Neomycin sulfate (Robasy) Tablets in doses of 4-12 grams of Neomycin sulfate (Robasy) per day (eight to 24 tablets) in divided doses. Treatment should be continued over a period of five to six days, during which time protein should be returned incrementally to the diet.

4. If less potentially toxic drugs cannot be used for chronic hepatic insufficiency, Neomycin sulfate (Robasy) in doses of up to four grams daily (eight tablets per day) may be necessary. The risk for the development of Neomycin sulfate (Robasy)-induced toxicity progressively increases when treatment must be extended to preserve the life of a patient with hepatic encephalopathy who has failed to fully respond. Frequent periodic monitoring of these patients to ascertain the presence of drug toxicity is mandatory. Also, Neomycin sulfate (Robasy) serum concentrations should be monitored to avoid potentially toxic levels. The benefits to the patient should be weighed against the risks of nephrotoxicity, permanent ototoxicity and neuromuscular blockade following the accumulation of Neomycin sulfate (Robasy) in the tissues.

Preoperative Prophylaxis for Elective Colorectal Surgery

Listed below is an example of a recommended bowel preparation regimen. A proposed surgery time of 8:00 am. has been used.

Pre-op Day 3: Minimum residue or clear liquid diet. Bisacodyl, 1 tablet orally at 6:00 p. m.

Pre-op Day 2: Minimum residue or clear liquid diet. Magnesium sulfate, 30 mL, 50% solution (15 g) orally at 10:00 a.m., 2:00 p.m., and 6:00 p.m. Enema at 7:00 p.m. and 8:00 p.m.

Pre-op Day 1: Clear liquid diet. Supplemental (IV) fluids as needed. Magnesium sulfate, 30 mL, 50% solution (15 g) orally at 10:00 a. m., and 2:00 p.m. Neomycin sulfate (Robasy) (1 g) and erythromycin base (1 g) orally at 1:00 p. m., 2:00 p.m. and 11:00 p.m. No enema.

Day of Operation: Patient evacuates rectum at 6:30 a.m. for scheduled operation at 8:00 a.m.

How supplied

Neomycin sulfate (Robasy) Tablets, USP, 500 mg (equivalent to 350 mg of Neomycin sulfate (Robasy) base per tablet) are available as round, off-white, unscored tablets, imprinted "BL" and "18", in bottles of 100 tablets.

Store at controlled room temperature 15°-30° C( 59°-86° F). Dispense in tight containers as defined in the USP/NF.

CAUTION: Federal law prohibits dispensing without prescription.

Neomycin sulfate (Robasy) interactions

See also:
What other drugs will affect Neomycin sulfate (Robasy)?

Caution should be taken in concurrent or serial use of other neurotoxic and/ or nephrotoxic drugs because of possible enhancement of the nephrotoxicity and/or ototoxicity of Neomycin sulfate (Robasy).

Caution should also be taken in concurrent or serial use of other aminoglycosides and polymyxins because they may enhance Neomycin sulfate (Robasy)'s nephrotoxicity and/or ototoxicity and potentiate Neomycin sulfate (Robasy)'s neuromuscular blocking effects.

Oral Neomycin sulfate (Robasy) inhibits the gastrointestinal absorption of penicillin V, oral vitamin B-12, methotrexate and 5-fluorouracil. The gastrointestinal absorption of digoxin also appears to be inhibited. Therefore, digoxin serum levels should be monitored.

Oral Neomycin sulfate (Robasy) may enhance the effect of coumarin in anticoagulants by decreasing vitamin K availability.

Neomycin sulfate (Robasy) side effects

See also:
What are the possible side effects of Neomycin sulfate (Robasy)?

The most common adverse reactions to oral Neomycin sulfate (Robasy) are nausea, vomiting and diarrhea. The "Malabsorption Syndrome" characterized by increased fecal fat, decreased serum carotene and fall in xylose absorption has been reported with prolonged therapy. Nephrotoxicity, ototoxicity and neuromuscular blockage have been reported.

Neomycin sulfate (Robasy) contraindications

See also:
What is the most important information I should know about Neomycin sulfate (Robasy)?

Neomycin sulfate (Robasy) oral preparations are contraindicated in the presence of intestinal obstruction and in individuals with a history of hypersensitivity to the drug.

Patients with a history of hypersensitivity or serious toxic reaction to other aminoglycosides may have a cross-sensitivity to Neomycin sulfate (Robasy).

Neomycin sulfate (Robasy) oral preparations are contraindicated in patients with inflammatory or ulcerative gastrointestinal disease because of the potential for enhanced gastrointestinal absorption of Neomycin sulfate (Robasy).

What is Nystatin (Robasy)?

Nystatin (Robasy) belongs to the group of medicines called antifungals. The dry powder, lozenge (pastille), and liquid forms of Nystatin (Robasy) are used to treat fungus infections in the mouth.

Nystatin (Robasy) is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, Nystatin (Robasy) is used in certain patients with the following medical condition:

  • Candidiasis, oral (fungus infection of the mouth) (prevention)

Nystatin (Robasy) indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.

Nystatin (Robasy) Cream USP is indicated in the treatment of cutaneous or mucocutaneous mycotic infections caused by Candida albicans and other susceptible Candida species.

Nystatin (Robasy) Cream USP is not indicated for systemic, oral, intravaginal or ophthalmic use.

How should I use Nystatin (Robasy)?

Use Nystatin (Robasy) Vaginal as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with Nystatin (Robasy) Vaginal. Talk to your pharmacist if you have questions about this information.
  • Nystatin (Robasy) Vaginal if for vaginal use only. Do not take this tablet by mouth.
  • Wash your hands before and immediately after using Nystatin (Robasy) Vaginal.
  • Use the applicator to insert Nystatin (Robasy) Vaginal high into the vagina.
  • Nystatin (Robasy) Vaginal works best if it is used at the same time every day.
  • To clear up your infection completely, use Nystatin (Robasy) Vaginal for the full course of treatment. Keep using it even if you feel better in a few days.
  • Continue to use Nystatin (Robasy) Vaginal even during your period.
  • If you miss a dose of Nystatin (Robasy) Vaginal, use it as soon as possible. If is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Nystatin (Robasy) Vaginal.

Uses of Nystatin (Robasy) in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.

This medication is used to treat fungal infections of the mouth or intestines. Nystatin (Robasy) is an antifungal that works by stopping the growth of fungus.

Nystatin (Robasy) powder for suspension should not be used to treat fungal infections of the blood.

How to use Nystatin (Robasy)

Measure the prescribed amount of powder and mix it into water as directed by your doctor. Stir well and divide the mixture into a number of smaller portions as directed. Use the mixture right way. Do not prepare a supply in advance.

Place one portion of the liquid in the mouth. Swish it around the mouth and gargle if so directed. Keep the liquid in your mouth for as long as possible, then swallow or spit out as directed. Use the other portions as your doctor directs. Ask your doctor or pharmacist for more details. Avoid eating for 5-10 minutes after using this medication.

This medication is most often used four times a day or as directed by your doctor. It may take from several days to several months to complete treatment. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same times each day. Dosage is based on your medical condition and response to therapy.

Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow the infection to continue, resulting in a return of the infection.

Inform your doctor if your condition persists after several days of treatment or worsens at any time.

Nystatin (Robasy) description

Nystatin (Robasy), sodium salt is a polyene antifungal drug to which many molds and yeasts are sensitive, including Candida spp. Nystatin (Robasy), sodium salt has some toxicity associated with it when given intravenously, but it is not absorbed across intact skin or mucous membranes. It is considered a relatively safe drug for treating oral or gastrointestinal fungal infections.

Nystatin (Robasy) dosage

Usual Adult Dose for Cutaneous Candidiasis

Apply Nystatin (Robasy) topical cream, ointment or powder in a quantity sufficient to cover the affected area and immediately surrounding skin 2 to 4 times a day.

The powder formulation is useful for the treatment of moist areas or lesions.

Therapy should be continued for 2 to 8 weeks, depending on the nature and severity of the infection.

Usual Adult Dose for Vaginal Candidiasis

Insert one Nystatin (Robasy) vaginal tablet (100,000 units) vaginally once a day, preferably at bedtime, for a total of 14 days.

Usual Pediatric Dose for Cutaneous Candidiasis

Apply Nystatin (Robasy) topical cream, ointment or powder in a quantity sufficient to cover the affected area and immediately surrounding skin 2 to 4 times a day.

The powder formulation is useful for the treatment of moist areas or lesions.

Therapy should be continued for 2 to 8 weeks, depending on the nature and severity of the infection.

Usual Pediatric Dose for Vaginal Candidiasis

>13 <18 years: Insert one Nystatin (Robasy) vaginal tablet (100,000 units) vaginally once a day, preferably at bedtime, for a total of 14 days.

Other Comments

For fungal infections of the feet caused by Candida, dust the powder freely on the feet as well as in shoes and socks.

The vaginal tablets should be used continuously, regardless of initiation of menses.

For external use only. Avoid contact with the eyes.

Nystatin (Robasy) interactions

See also:
What other drugs will affect Nystatin (Robasy)?

Your healthcare professionals (e.g., doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use.

Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

Nystatin (Robasy) side effects

See also:
What are the possible side effects of Nystatin (Robasy)?

Applies to Nystatin (Robasy): oral capsule, oral suspension, oral tablet

In addition to its needed effects, some unwanted effects may be caused by Nystatin (Robasy) (the active ingredient contained in Nystatin (Robasy)). In the event that any of these side effects do occur, they may require medical attention.

Minor Side Effects

Some of the side effects that can occur with Nystatin (Robasy) may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Less common:

  • Diarrhea
  • nausea or vomiting
  • stomach pain

Nystatin (Robasy) contraindications

See also:
What is the most important information I should know about Nystatin (Robasy)?

Do not use Nystatin (Robasy) topical to treat any skin condition that has not been checked by your doctor.

Nystatin (Robasy) topical (for the skin) is not for use to treat a vaginal yeast infection.

Avoid getting this medication in your eyes or mouth. If this does happen, rinse with water.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared.

Call your doctor if your symptoms do not improve, or if they get worse while using Nystatin (Robasy) topical.

Do not share this medication with another person, even if they have the same symptoms you have.

Active ingredient matches for Robasy:

Metronidazole/neomycin sulfate/nystatin in Vietnam.


Unit description / dosage (Manufacturer)Price, USD
Robasy 1 Blister x 10 Tablet

List of Robasy substitutes (brand and generic names):

Careginal 3 Blister x 4 Tablet
Dongdo Newgynan 2 Blister x 5 Tablet
Fungiact 1 Blister 10 Tablet

References

  1. DailyMed. "BISMUTH SUBCITRATE POTASSIUM; METRONIDAZOLE; TETRACYCLINE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DailyMed. "HYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  3. PubChem. "neomycin". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).

Reviews

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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