Cresac

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Cresac

The identity of Cresac is defined by its core component, Metronidazole, a synthetic compound that serves as a specialized anti-infective agent.

Property Description
Active ingredient Metronidazole (C6H9N3O3)
Form Tablet, Capsule, Intravenous Solution, Topical Formulations
Pharmacological class Nitroimidazole Antimicrobial
Common use Elimination of anaerobic bacteria and protozoal organisms
Origin Synthetic

Classification: A Synthetic Nitroimidazole Antimicrobial

Cresac is a pharmaceutical product primarily defined by its sole active ingredient, Metronidazole, which is classified as a Synthetic Nitroimidazole Antimicrobial and functions as both an effective Antibacterial Agent and an Antiprotozoal Agent. This dual capacity positions it uniquely among medicines designed to control specific infections.

The active compound is a synthetic derivative, not sourced from nature. Metronidazole is specifically directed against anaerobic bacteria—microorganisms that thrive without oxygen—and certain protozoal organisms. Metronidazole is often characterized as a "gold standard" against which other antibiotics with anaerobic activity are compared. This status indicates the long-standing role this class of drug holds for targeted microbial elimination.


Composition, Forms, and General Purpose

Cresac is supplied as a single-ingredient product (monotherapy) where the active agent, Metronidazole, is formulated into diverse dosage forms for various routes of administration. These forms include systemic options like tablets, capsules, and intravenous solution, as well as local preparations such as topical formulations (gel, cream, lotion) and suppositories. The versatility of forms allows for treatment across diverse patient groups, including specific considerations for pediatric and adult populations.

The general therapeutic benefit of Metronidazole stems from its unique physiological action as a prodrug that damages the DNA of its target organisms. This selective mechanism results in a highly effective bactericidal effect and cytotoxicity, making the medicine essential for actively counteracting microbial invasions caused by susceptible pathogens. Metronidazole belongs to the class of nitroimidazole antimicrobials and works by stopping the growth of bacteria. The medicine is designed to neutralize infection-causing agents directly and is typically employed when infections are confirmed to be caused by susceptible anaerobic or protozoal species.

Regulatory References

  1. NIH DailyMed

What side effects are possible with Cresac?

Possible Side Effects and Safety Information for Cresac

The safety profile of Cresac is officially documented in governmental regulatory labeling (such as the FDA Prescribing Information or the EMA Summary of Product Characteristics), which categorizes undesirable effects based on a suspected causal relationship to the medicinal product.

Adverse Reactions Classification

Adverse Drug Reactions (ADRs) are defined as noxious and unintended responses to the drug where a causal relationship is considered at least a reasonable possibility. Reactions are typically categorized by System Organ Class (e.g., Nervous System Disorders, Gastrointestinal Disorders) and by frequency using the standard regulatory framework:

  • Very Common (ge 1/10)
  • Common (ge 1/100 to < 1/10)
  • Uncommon (ge 1/1,000 to < 1/100)
  • Rare (ge 1/10,000 to < 1/1,000)

Serious Adverse Events and Safety Warnings

Serious Adverse Events (SAEs) are specifically defined as any untoward medical occurrence that results in death, is life-threatening, requires inpatient hospitalization, results in persistent or significant disability/incapacity, or is a congenital anomaly/birth defect. The most critical risks associated with Cresac are highlighted in the Warnings and Precautions section of the official label, sometimes including a Boxed Warning for potentially life-threatening risks.

Official documents also detail Contraindications—situations where the drug must not be used due to an unacceptable risk—and provide Population-Specific Safety Considerations, such as restrictions or mandatory monitoring for use in pediatric, geriatric, or renally impaired patient populations. These regulatory requirements inform the overall risk management plan for the drug.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory profile for Cresac (Metronidazole) overdose is defined by specific gastrointestinal and neurological manifestations, necessitating immediate medical attention.

Documented Overdose Manifestations

High single doses of Metronidazole, such as 15 g, have been officially associated with the onset of nausea, vomiting, and ataxia (loss of muscle coordination). Severe neurological outcomes, including convulsive seizures and peripheral neuropathy (e.g., numbness of an extremity), have been reported following high-dose regimens administered over several days.


Emergency Actions and Required Management

Official guidance requires that users seek immediate medical attention if overdose is suspected due to the risk of severe neurotoxic effects. Management should consist of symptomatic and supportive therapy, as the regulatory documents state that no specific antidote for Metronidazole overdose is known.

In cases of accumulation, hemodialysis is an officially documented procedure that can effectively remove a significant amount of the drug and its metabolites. Special monitoring is recommended for patients with End-Stage Renal Disease or Severe Hepatic Impairment, as these conditions can lead to increased accumulation of the drug and its metabolites, potentially exacerbating the risks of overexposure.

Therapeutic Uses of Cresac

What Cresac Treats: Main Uses and Benefits

The therapeutic role of Cresac (Metronidazole) is centered on addressing infections caused by susceptible anaerobic bacteria and protozoal organisms. This capability is commonly used to help manage a wide spectrum of infections and the symptoms related to systemic imbalance and localized physical discomfort they cause.

Common Therapeutic Applications

Cresac is applied across domains where additional symptomatic support is needed for addressing severe intra-abdominal abscesses, septicaemia, bone/joint infections, and specific protozoal diseases like Amebiasis and Giardiasis. It is also relevant in clinical settings for conditions such as Bacterial Vaginosis, Trichomoniasis, and managing the inflammatory lesions of Rosacea. The medication is used to support the management of severe systemic conditions, which may contribute to maintaining stability and comfort during symptomatic periods.

Core Therapeutic Benefit

“Cresac is relevant when supportive symptom management is appropriate, as it addresses symptom clusters that may become intense or disruptive, especially in acute infection phases.”

The therapeutic action of Cresac plays a role in managing a wide array of infections and is relevant for addressing symptoms such as pain, fever, and localized swelling associated with infection. It is applied in scenarios where short-term symptomatic assistance is needed, often during acute or unstable symptom patterns, such as postoperative infection prophylaxis or assisting with severe GI distress related to C. difficile.

Quick Fact: Relief for Acute Systemic Symptoms Cresac is commonly used to help with symptoms related to systemic imbalance, such as fever, and localized physical discomfort, including pain and swelling, during acute infection episodes. The general benefit is supportive relief that helps patients cope more steadily.

Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Who Can and Cannot Use Cresac? — Official Regulatory Information

The eligibility for using Cresac (Metronidazole) is strictly defined by government regulatory documents, outlining specific contraindications and required restrictions.

Contraindications

Use is strictly prohibited in patients with a history of hypersensitivity to metronidazole or other nitroimidazole derivatives. The medicine is also contraindicated in patients with Cockayne syndrome due to the risk of severe hepatotoxicity. Use is prohibited if alcohol or products containing propylene glycol are consumed during treatment and for at least three days afterward, or if the patient has taken disulfiram within the last two weeks.

Age and Physiological Restrictions

Metronidazole is contraindicated for the treatment of trichomoniasis during the first trimester of pregnancy. While generally permitted for adults and geriatric patients (with monitoring recommended), safety and efficacy for certain formulations are not established across the entire pediatric population. The extended-release form is restricted in teenage females who have not started menstruation.

Condition-Based Limitations

Use is conditional in patients with pre-existing conditions. Those with severe hepatic impairment (Child-Pugh C) or end-stage renal disease (ESRD) require close monitoring and may need a dosage adjustment. Caution is also required for patients with active or chronic severe CNS disease or a history of blood dyscrasias.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Cresac (an NSAID related to ketorolac) is associated with several serious drug-drug interactions documented in regulatory labeling. The total duration of use of Cresac, including both injectable and oral formulations, must not exceed five days due to the potential for increased risk of adverse events.

Contraindicated Combinations

Concomitant use with other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), including aspirin (analgesic doses), is strictly contraindicated due to a cumulative risk of serious NSAID-related side effects, particularly gastrointestinal bleeding, ulceration, and perforation. Use is also contraindicated in patients for whom hemostasis (blood clotting) is critical.

Other Significant Interactions

Cresac may impact the efficacy and safety of several cardiovascular and renal medications:

  • Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARBs): Concomitant use may diminish the antihypertensive effect and, in volume-depleted or renally impaired patients, may increase the risk of worsening kidney function. Close monitoring is required.
  • Diuretics (e.g., furosemide, thiazide diuretics): Cresac can reduce the water-losing (natriuretic) and blood pressure-lowering effects of these medications.
  • Digoxin: Cresac may increase the serum concentration of digoxin, potentially leading to toxicity. Monitoring of digoxin levels is necessary during co-administration.

Monitoring of blood pressure, renal function, and specific drug levels (such as digoxin) is advised when Cresac is administered alongside these interacting drug categories.

Mechanism of Action

Cresac's mechanism is defined by a two-step process that provides mechanistic selectivity against susceptible microbes. The drug acts as an inert prodrug until it enters the low-oxygen, low-redox potential environment found exclusively within certain anaerobic bacteria and protozoa.

The mechanism requires the presence of ferrodoxin-like electron-transport proteins in these microbes, which donate electrons to the drug's nitro group (R- NO2). This reduction chemically transforms the drug into highly reactive nitro-free radicals. This electron-dependent activation results in a functionally selective mechanism, as human cells and aerobic organisms lack the necessary activating enzymes.

Once formed, these cytotoxic radicals rapidly attack their primary molecular target: the pathogen's DNA. The radicals cause immediate, irreparable DNA strand breakage, which disrupts replication and repair. This lethal genotoxicity results in a direct bactericidal and cytotoxic effect against the microbe. This action causes the molecular and cellular breakdown of the pathogen, which is the direct physiological consequence.

Dosage and Administration Information

Cresac (Metronidazole) is administered via multiple routes: oral (tablet, capsule, suspension), intravenous (IV) infusion, topical, and vaginal. The official dosing regimen for established systemic infections typically involves an initial loading dose of 15 mg/ kg (IV) followed by a maintenance dose of 7.5 mg/ kg (IV or oral) administered on a fixed schedule, often every 6 or 8 hours. For specific indications, the drug is used in a single 2 g dose or a multi-day course of 250 mg to 750 mg per dose. The total treatment duration is usually 7 to 10 days for many established infections.

Administration requires adherence to specific protocols. Immediate-release oral tablets are generally taken with or after food, while the 750 mg extended-release tablet is designed to be taken on an empty stomach. The extended-release form must be swallowed whole and should not be crushed or chewed. For pediatric use, dosing is determined based on body weight.

The standard adult dose requires adjustment in specific populations: for patients with severe hepatic impairment, a 50% dose reduction is recommended. Similarly, the dose is re-administered immediately after a hemodialysis session to account for drug removal. IV administration is performed slowly over 30 to 60 minutes and requires adherence to specific dilution steps and material constraints, such as avoiding contact with aluminum-containing equipment.

Recent Clinical Evidence

Research evidence / Overview of studies for Cresac

The research available for Cresac (Metronidazole) primarily involves clinical trials and meta-analyses exploring its use in treating specific infections caused by anaerobic bacteria and protozoa. This overview summarizes the types of studies conducted and the patterns observed in the data, while also highlighting areas where research is still emerging or limited.


Evidence for Anaerobic Bacterial Infections

Research for anaerobic infections, which include intra-abdominal abscesses, gynecologic infections, and some bone and joint infections, includes Randomized Controlled Trials (RCTs) and comprehensive Systematic Reviews. These studies research examined how the medicine was evaluated in patients, often as part of a combination regimen alongside another antibiotic.

Researchers primarily monitored outcomes related to systemic or functional imbalance, such such as fever, and physical discomfort, seeking to measure bacteriological clearance, which means laboratory confirmation that the target organisms are no longer detectable. A key limitation is that many of the core studies involved metronidazole as just one component in a treatment plan, which means separating its singular impact from the effects of the combination was observed in some studies to be challenging. Furthermore, follow-up durations were often limited to the acute treatment period, meaning long-term outcomes are not well characterized beyond the duration of the study.


Evidence for Protozoal Infections (Amebiasis, Giardiasis, and Trichomoniasis)

Cresac was studied for its use against protozoal infections. For these conditions marked by functional limitations, research relies on RCTs and Comparative Studies designed to evaluate its application against the specific organisms. In these research scenarios, the primary endpoints studied were direct measurements of parasitological clearance and outcomes related to physical discomfort. Studies report how symptoms evolved in the observed populations during the period of treatment. The available research provides context, but there is generally limited information for long-term outcomes related to preventing recurrence. Additionally, while the agent was observed in some studies involving adults, the research exploring outcomes in severely affected pediatric populations remains less detailed in certain contexts.

Frequently Asked Questions (FAQ)

Common questions about Cresac (FAQ)


Q: How long does it usually take for Cresac to start showing a noticeable effect?

Regulatory knowledge suggests that the active ingredient in Cresac is absorbed quickly. However, a patient may not feel a noticeable improvement in symptoms until after a couple of days of treatment. The timeframe described is a common expectation during the course of antimicrobial therapy.


Q: Is Cresac meant to be a temporary or a long-term treatment?

According to official product labeling, Cresac is typically prescribed for finite treatment periods, often lasting 7 to 10 days for many infections. Using this medication for a prolonged or intensive course requires close surveillance by a healthcare professional.


Q: Is Cresac considered a first-line treatment for the condition it addresses?

The active ingredient in Cresac is generally recognized as a 'gold standard' in the medical community. Official therapeutic reviews note that it is the benchmark against which other similar antibiotics are compared for activity against anaerobic bacteria.


Q: What are the key health markers that are expected to change when taking Cresac?

Regulatory documents mention that monitoring may be required for certain health markers, including changes in blood counts, specifically looking for leukopenia (low white blood cells). Additionally, when taken with certain interacting drugs, monitoring of kidney function, blood pressure, or drug levels may be considered.


Q: Is the name 'Cresac' a brand name or a generic name?

Cresac is the name used for the pharmaceutical product. The active ingredient within it is Metronidazole, which is the chemical's generic name.


Q: Is a mild headache a commonly expected side effect when starting Cresac?

Yes, a headache is classified as a common side effect in the official product information for Cresac. This means it occurs in at least 1 out of every 100 patients. Other common effects include nausea and abdominal pain.


Q: How quickly do the typical side effects of Cresac usually go away?

Mild side effects have been observed to resolve within a few days to a couple of weeks. Should more serious nervous system effects occur, such as peripheral neuropathy, these are generally observed to be reversible within days or weeks after the medicine is stopped.


Q: What are the signs of a severe allergic reaction to Cresac?

Regulatory warnings highlight that signs of a severe allergic reaction are listed as potential emergency symptoms. These symptoms can include hives, itching, fever, joint pain, difficulty breathing, or swelling in the face or throat.


Q: Does Cresac cause weight gain or weight loss in patients?

Official patient information lists weight loss as a potential side effect of Cresac.


Q: Can Cresac affect a person's sleep patterns?

Insomnia (trouble sleeping) is a reported side effect found in the official product information for Cresac.


Q: Is dizziness a side effect that requires seeking medical attention?

Dizziness is a commonly reported side effect. However, according to official documents, if dizziness is severe or occurs alongside symptoms like confusion, problems with coordination, or seizures, these are symptoms that should be promptly reported to a healthcare provider.


Q: Are any of the side effects of Cresac irreversible?

Most reported adverse effects, including peripheral neuropathy (nerve damage) and leukopenia (low white blood cells), have been observed to be generally reversible. This reversal typically occurs after the medicine has been discontinued.


Q: What happens if a patient accidentally takes too much Cresac?

Symptoms of an overdose may include nausea, vomiting, loss of muscle coordination, and sensations like numbness or tingling in the hands or feet, and possibly seizures. Official information states there is no specific antidote, and management described in official documents consists of symptomatic and supportive care.


Q: Is it considered normal to experience fatigue when on Cresac treatment?

Official patient information lists unusual tiredness or weakness (fatigue) as a common side effect of Cresac.


Q: Is Cresac safe for use by the elderly population?

Regulatory documents state that Cresac is generally permitted for the elderly population. However, due to the potential for reduced liver and kidney function in older adults, caution is advised, and close monitoring may be necessary according to official recommendations.


Q: Can people with high blood pressure safely take Cresac?

The official interaction warnings state that Cresac may reduce the effectiveness of blood pressure-lowering medicines, such as ACE inhibitors, ARBs, and diuretics. If a person has high blood pressure and uses these medicines, close monitoring of blood pressure and kidney function may be warranted to address the interaction.


Q: How does Cresac interact with common blood thinners or anti-coagulants?

Official regulatory documents report that Cresac can enhance the effect of common oral anticoagulants, such as warfarin. This interaction can potentially increase the risk of bleeding, and the dosage of the anticoagulant medication may be subject to review or adjustment by the prescribing physician.


Q: Is Cresac suitable for women who are planning to become pregnant?

Regulatory documents do not contain clear evidence suggesting that Cresac reduces fertility in either men or women. Decisions about use when planning conception should be discussed with a qualified healthcare provider.


Q: Are there restrictions on driving or operating machinery while taking Cresac?

Official safety information advises that patients should not drive or operate machinery if they experience certain reported side effects. These include dizziness, drowsiness, confusion, blurred vision, or general unsteadiness.


Q: Is it necessary to take Cresac at the exact same time every day?

Regulatory dosing guidelines indicate that Cresac is prescribed on a fixed schedule to ensure a consistent level of the drug in the bloodstream. Following the prescribed frequency (e.g., every 8 hours) as closely as possible is important to maximize its effectiveness.


Q: What is the process if a patient realizes they have missed a dose of Cresac?

Official guidance suggests that if a dose is missed, it may be taken as soon as it is remembered. However, if it is nearly time for the next scheduled dose, the regulatory instruction indicates skipping the missed dose to avoid a double dose.


Q: How is Cresac processed and eliminated from the body?

Official pharmacokinetic information states that Cresac is primarily processed (metabolized) by the liver. The major way the drug and its components are eliminated from the body is through the urine, accounting for 60 to 80% of the dose.


Q: What is the half-life of Cresac?

The average elimination half-life of Cresac, which is the time it takes for half the drug to be eliminated from the bloodstream, is reported in regulatory documents to be approximately eight hours in healthy adults.


Q: Does Cresac affect fertility in men or women?

Based on the available regulatory information, there is no clear evidence to suggest that Cresac negatively affects or reduces fertility in men or in women.

How should Cresac be stored and disposed of?

How to Store and Dispose of Cresac?

The storage and disposal of Cresac (Metronidazole) must strictly follow the requirements documented in official regulatory labeling to ensure product stability and safety.

Storage and Handling Requirements

  • Temperature: Cresac tablets, capsules, and IV solutions must be stored at Controlled Room Temperature, typically 20 C to 25 C (68 F to 77 F). The product must be kept from freezing.
  • Protection: The medicine must be protected from light during storage to maintain chemical integrity.
  • Packaging: Capsules require a well-closed container with a child-resistant closure.
  • Stability: If using the oral liquid form, any unused medicine remaining must be discarded ten days after it is first opened.
  • Child Safety: All forms of this medicine must be stored out of the sight and reach of children.

Disposal Instructions

Official guidelines state that unused or expired Cresac must not be flushed down the toilet or poured down a sink. Instead, if a take-back program is unavailable, it should be disposed of in the household trash after being mixed with an undesirable substance (such as dirt or coffee grounds) and sealed in a container.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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