Likmez
Likmez (metronidazole) is an antibiotic that's used to treat certain infections in children and adults. It's available as a liquid that you swallow, and the dose can vary depending on the type of infection you have and your body weight. This liquid formulation of metronidazole is only available as a brand-name medication. Common side effects include nausea, diarrhea, and headache.
What is Likmez (metronidazole)?
What is Likmez (metronidazole) used for?
Trichomoniasis in adults
Infection caused by a certain parasite (amebiasis) in children and adults
Anaerobic bacterial infection in adults
How Likmez (metronidazole) works
Likmez (metronidazole) is a nitroimidazole antibiotic. It works by affecting the DNA (genetic material) of bacteria or parasites that are causing the infection. This causes the bacteria or parasite to die so the infection stops growing.
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What are the side effects of Likmez (metronidazole)?
Common Side Effects
- Nausea
- Metallic taste
- Lower appetite
- Diarrhea
- Stomach pain
- Stomach cramps
- Constipation
- Headache
Other Side Effects
- Dizziness
- Upper respiratory tract infection (e.g., common cold)
- Nerve pain in the legs and arms (peripheral neuropathy)
- Joint pain
- Rash
Serious Side Effects
- Severe skin reaction: rash, red skin, blistering or peeling of skin, hives, fever
- Nerve problems: tingling in your arms or legs, problems walking or talking, shakiness, uncontrolled movements, seizure
Source: DailyMed
More on Likmez (metronidazole) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dizziness, loss of balance or coordination, confusion or trouble speaking
- Fever, neck pain or stiffness, sensitivity to light, headache, nausea, vomiting, confusion, which may be signs of meningitis
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pain, tingling, or numbness in the hands or feet
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Seizures
- Severe diarrhea, fever
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Unusual vaginal discharge, itching, or odor
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Likmez (metronidazole)
Pros
Good option for people who have trouble swallowing pills
Can take with or without food
Conveniently stored at room temperature
Cons
Might need to take multiple times per day
Can cause unpleasant side effects, such as a metallic taste in your mouth, nausea, stomach pain, and headache
No lower-cost generic available
Pharmacist tips for Likmez (metronidazole)
Shake Likmez (metronidazole) liquid well each time before you use the medication. Always use an oral dosing syringe or cup provided by your pharmacy to measure the dose. Never use household spoons because this could cause you to take the wrong dose.
Tell your provider about all the medications you're taking. Likmez (metronidazole) can interact with many commonly used medications, such as lithium (Lithobid), phenytoin (Dilantin), and warfarin (Coumadin). Your provider can check that your medications are safe to take.
Avoid drinking alcohol or eating or drinking products containing propylene glycol while you're taking Likmez (metronidazole) and for 3 days after you've finished your course of treatment. Taking Likmez (metronidazole) with alcohol or propylene glycol can cause stomach cramps, nausea, vomiting, headache, and flushing.
Stop taking Likmez (metronidazole) and call your provider if you notice tingling in your arms or legs, problems walking or talking, or uncontrolled movements. Your provider will need to examine you to make sure you aren't having side effects from this medication.
Store Likmez (metronidazole) at room temperature. Don't freeze the medication because this could damage it. After 10 days of opening the bottle, throw it away even if it still has medication left inside.
Finish your entire treatment of Likmez (metronidazole) that's prescribed to you, even if you feel better. Your infection can come back and become harder to treat if you stop the medication too soon.
More on Likmez (metronidazole) tips
Frequently asked questions about Likmez (metronidazole)
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What are the risks and warnings for Likmez (metronidazole)?
Likmez (metronidazole) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Potential for cancer
Animal studies show that metronidazole might cause cancer in mice and rats. It's unclear whether this applies to humans. To be safe, your provider will make sure you take Likmez (metronidazole) when it's necessary. Don't use Likmez (metronidazole) longer than what's been prescribed by your provider.
Seizure or problems with brain function
Although rare, some people taking metronidazole can have seizures or problems with normal brain function. Cases of brain damage (encephalopathy) and aseptic meningitis (inflammation of the linings of the brain) have been reported with taking metronidazole. Symptoms might appear within hours of taking the medication. Typically, these symptoms get better once the medication is stopped, but can take days or weeks. Symptoms include not being able to walk straight, dizziness, not being able to speak, shaking, and uncontrolled movements of your body. Contact your provider or go to the emergency room right away if you experience anything like this while you're taking Likmez (metronidazole).
Nerve damage
Some people who've taken metronidazole have had nerve damage. Symptoms include burning, tingling, numbness, pain, or not being able to tolerate heat or cold in parts of your body. Tell your provider right away if you have any of these symptoms.
Problems with blood cell count
Risk factors: History of blood problems
In clinical studies, there were a few cases of a low white blood cell count with metronidazole use. To be safe, tell your provider if you have a history of low blood cell counts. Your provider might check your blood cell count before and after taking Likmez (metronidazole).
Fungal infection
Risk factors: Current fungal infection
Taking Likmez (metronidazole) can cause new fungal infections or symptoms of a current fungal infection to worsen. Some examples of fungal infections include genital yeast infections and thrush. Let your provider know right away if you have new symptoms of a yeast infection, such as white patches in your mouth; redness or soreness; pain while eating or swallowing; thick, white discharge in your vagina; or vaginal itching.
Likmez (metronidazole) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 200ml of 500mg/5ml | 1 bottle | $335.04 | $335.04 |
Typical dosing for Likmez (metronidazole)
Each 5 mL of liquid contains 500 mg of metronidazole.
Trichomoniasis
One-day treatment for adults: The typical dose is 20 mL (4 teaspoonfuls) by mouth as a single dose. Another dosing option is 10 mL (2 teaspoonfuls) taken twice on the same day.
Seven-day treatment for adults: The typical dose is 2.5 mL (one-half teaspoonful) by mouth 3 times a day for 7 days.
Amebiasis
Adults:
Intestinal (gut) infection: The typical dose is 7.5 mL (one and a half teaspoonfuls) by mouth 3 times a day for 5 to 10 days.
Liver infection: The typical dose is 5 mL (one teaspoonful) or 7.5 mL (one and a half teaspoonfuls) by mouth 3 times a day for 5 to 10 days.
Children: The provider will calculate the dose based on your child's weight. The typical dose is 35 mg/kg to 50 mg/kg of weight by mouth per day, split up into 3 doses during the day. Likmez (metronidazole) is taken for 10 days. The maximum amount of medication your child can take per dose is 7.5 mL (one and a half teaspoonfuls).
Anaerobic bacterial infections
Adults only: Your provider will calculate the dose based on your weight. The typical dose is 7.5 mg/kg of weight by mouth every 6 hours for 7 to 10 days. The maximum amount of medication you can take in a 24-hour period is 40 mL (8 teaspoonfuls).
Your dose might differ if you have liver or kidney problems.
How much does Likmez (metronidazole) cost?
Likmez (metronidazole) contraindications
Have taken disulfiram within 2 weeks of starting Likmez (metronidazole)
Consuming alcohol or products containing propylene glycol during treatment with Likmez (metronidazole) and for 3 days after
History of a rare genetic condition called Cockayne syndrome (because of risk of serious liver damage)
What are alternatives to Likmez (metronidazole)?
Trichomoniasis in adults
Infection caused by a certain parasite (amebiasis) in children and adults
Anaerobic bacterial infection in adults
Trichomoniasis ("trich")
Giardiasis (parasitic gut infection)
Amebiasis (parasitic gut infection)
Bacterial vaginosis (BV)
Skin infections (e.g., cellulitis)
Lower respiratory tract infections (e.g., pneumonia, bronchitis)
Pelvic and genital tract infections
Bloodstream infections
Bone and joint infections - injection form only
What is the latest news about Likmez (metronidazole)?
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References
Best studies we foundAgency for Toxic Substances and Disease Registry. (2014). Public health statement for propylene glycol.
Centers for Disease Control and Prevention. (2020). Spoons are for soup, milliliters are for medicine.
Kaur, H., et al. (2022). Aseptic meningitis. StatPearls.
Kesin Pharma Corporation. (2024). Likmez- metronidazole oral suspension [package insert]. DailyMed.
Koss, C. A., et al. (2012). Investigation of metronidazole use during pregnancy and adverse birth outcomes. Antimicrobial Agents and Chemotherapy.
National Organization for Rare Disorders. (2022). Cockayne syndrome.
Noor, A., et al. (2023). Anaerobic infections. StatPearls.
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