METRIL-VS (intrauterine suspension)

Suspension ranging from white to light yellow in colour with a slight odour of its components; separates on storage.

1 syringe-tube (28 g) contains the active substance:

- cefapirin (as benzathine salt) — 500 mg.

Excipients: glycerol, emulsifying wax, xanthan gum, liquid paraffin (mineral oil), stearic acid, sodium benzoate, methyl parahydroxybenzoate (nipagin), butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), purified water.

ATC vet classification code QG51 — antimicrobial and antiseptic veterinary preparations for intrauterine use. QG51AA05 — Cefapirin.

Cefapirin belongs to the cephalosporin group of antibiotics and exhibits a broad spectrum of bactericidal activity against Gram-positive microorganisms, including: Staphylococcus pneumoniae, Staphylococcus aureus, Streptococcus pyogenes, Streptococcus dysgalactiae, Streptococcus uberis, and certain Gram-negative microorganisms (Escherichia coli, Klebsiella pneumoniae, Actinobacillus spp., Salmonella spp., Corynebacterium spp., Enterobacter spp., Pasteurella spp., Proteus mirabilis, Proteus vulgaris, Fusobacterium spp., Neisseria spp., Shigella spp., Clostridium perfringens, Haemophilus influenzae). Cefapirin inhibits bacterial cell wall synthesis. By inhibiting the activity of transpeptidase and carboxypeptidase enzymes, cefapirin disrupts osmotic balance, leading to bacterial death during the growth phase. Cefapirin is resistant to the enzyme penicillinase and retains its activity under both aerobic and anaerobic conditions.

Following intrauterine administration, cefapirin readily penetrates the endometrial tissue, where it maintains the minimum inhibitory concentration for 24 hours. Under these conditions, cefapirin is virtually absent from the systemic circulation and exerts no systemic effect; the maximum plasma concentration is 0,11–0,13 µg/mL. The drug is eliminated primarily via the urine in unchanged form and as the metabolite desacetylcefapirin, which also possesses antibacterial activity, and to a lesser extent via bile.

Treatment of cows with subacute and chronic forms of endometritis (not earlier than 14 days after calving) caused by microorganisms susceptible to cefapirin.

Prior to administration, the external genitalia and the base of the tail are cleaned and sanitised. If necessary, the uterine cavity is cleared of inflammatory exudate. Before use, the syringe-tube containing the medicinal product should be warmed to 37 °C. The product is administered to cows as a single intrauterine dose of one syringe-tube. Before administration, the syringe is connected to a catheter, and a single-use polyethylene glove is put on the hand for rectal fixation of the cervix. The catheter is carefully passed through the cervix into the uterine cavity, and the contents of the syringe-tube are expelled. If necessary, administration may be repeated after 48 hours at the same dose. In animals that have been inseminated, the product may be used one day after insemination.

Do not administer to animals with hypersensitivity to cefapirin or to other beta-lactam antibiotics.

Administration during pregnancy in cows is prohibited.

Do not use concurrently with antibiotics of other groups.

No adverse effects or complications have been observed when the product is used at the recommended doses.

The product should be used taking into account the susceptibility of microorganisms isolated from the affected animal to cefapirin. Use in horses and other equines is prohibited.

Do not use during pregnancy. May be used during lactation. The product should be used not earlier than 14 days after calving.

Slaughter of animals for meat is permitted 24 hours after the last administration of the product. Meat obtained prior to this period shall be disposed of or fed to non-productive animals, subject to the opinion of a veterinarian. Milk is permitted for human consumption without restriction.

Cardboard boxes containing 10 polymer syringe-tubes of 28 g each, packed in cellophane bags, complete with single-use catheters and gloves.

Store in a dry, dark place, out of reach of children, at a temperature of 15 °C to 25 °C.

24 months.