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Last Updated: April 17, 2026

CLINICAL TRIALS PROFILE FOR FLAGYL I.V.


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505(b)(2) Clinical Trials for Flagyl I.v.

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Formulation NCT01559545 ↗ A Safety, Tolerability and Pharmacokinetic Study of Two Formulations of Metronidazole Versus Immediate Release Metronidazole in Patient With C. Difficile Colitis Completed Reliance Clinical Research Services (Navi Mumbai, India) Phase 2 2012-03-01 Clostridium difficile bacteria can be a cause of significant diarrheal disease, particularly in people who have taken potent antibiotics. When C. difficile multiplies within the colon, it produces two toxins that cause inflammation and resultant abdominal pain, fever and diarrhea. Current treatment of mild to moderate disease is with immediate release metronidazole, an antibiotic that kills C. difficile. Dr. Reddy's Laboratories has developed a delayed release form of metronidazole to release just before the colon to increase the concentration of antibiotic in the colon to improve the effectiveness of metronidazole treatment and potentially to allow less whole body exposure to the antibiotic. This study will measure the amount of metronidazole in the blood and stool of patients with C. difficile associated diarrhea (CDAD) to confirm that the new formulations are releasing the antibiotic as designed, immediately before the colon.
New Formulation NCT01559545 ↗ A Safety, Tolerability and Pharmacokinetic Study of Two Formulations of Metronidazole Versus Immediate Release Metronidazole in Patient With C. Difficile Colitis Completed Dr. Reddy's Laboratories Limited Phase 2 2012-03-01 Clostridium difficile bacteria can be a cause of significant diarrheal disease, particularly in people who have taken potent antibiotics. When C. difficile multiplies within the colon, it produces two toxins that cause inflammation and resultant abdominal pain, fever and diarrhea. Current treatment of mild to moderate disease is with immediate release metronidazole, an antibiotic that kills C. difficile. Dr. Reddy's Laboratories has developed a delayed release form of metronidazole to release just before the colon to increase the concentration of antibiotic in the colon to improve the effectiveness of metronidazole treatment and potentially to allow less whole body exposure to the antibiotic. This study will measure the amount of metronidazole in the blood and stool of patients with C. difficile associated diarrhea (CDAD) to confirm that the new formulations are releasing the antibiotic as designed, immediately before the colon.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for Flagyl I.v.

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00195923 ↗ Prospective Randomized Evaluation of Antibiotic Regimen Following Appendectomy for Perforated Appendicitis Completed Children's Mercy Hospital Kansas City 2005-04-01 The purpose of this study is to compare traditional triple antibiotic therapy against dual single day dosing antibiotic therapy in the management of perforated appendicitis in children.
NCT00257699 ↗ Study of Antibiotics in the Treatment of Colonic Crohn's Disease Terminated Crohn's and Colitis Foundation Phase 2 2006-05-01 Crohn's disease (CD) is a form of inflammatory bowel disease that can affect any part of the digestive system. Symptoms of this chronic illness include abdominal pain, bloating, nausea, vomiting, and diarrhea. CD also causes bowel wall ulcers, strictures (narrowings of a hollow structure due to scar tissue and swelling), and fistulae (abnormal passages from the intestines to another organ or to the skin). CD is thought to arise from a combination of inherited (genetic) factors and some undefined environmental factor(s). One environmental factor that has been shown to be intimately involved with the development of CD is the presence of bacteria that normally inhabit the intestines. As a result, some physicians have tried to alter the normal bacterial population as a means of controlling the inflammation (swelling) in the intestines of individuals with CD. Among such strategies is the use of a combination of metronidazole and ciprofloxacin. These broad-spectrum antibiotics control CD symptoms by acting on the intestinal bacteria that can contribute to chronic inflammation. More investigation is needed to firmly establish the usefulness of this therapy because previous clinical trials have given mixed results, although they have suggested that antibiotics can be particularly useful in cases of Crohn's colitis (CD that primarily affects the large intestine). Because these earlier studies have lacked a large enough patient population with colonic involvement, a trial focusing on this CD subgroup with a sufficient number of subjects will help to clarify the value of combining metronidazole and ciprofloxacin. The proposed study will test the hypothesis that combination antibiotic therapy is effective in the treatment of CD involving the colon. The study will compare the use of combination therapy consisting of metronidazole and ciprofloxacin with placebo (dummy tablets) and will examine the results of treatment at the end of 8 weeks of treatment.
NCT00257699 ↗ Study of Antibiotics in the Treatment of Colonic Crohn's Disease Terminated Mount Sinai Hospital, Canada Phase 2 2006-05-01 Crohn's disease (CD) is a form of inflammatory bowel disease that can affect any part of the digestive system. Symptoms of this chronic illness include abdominal pain, bloating, nausea, vomiting, and diarrhea. CD also causes bowel wall ulcers, strictures (narrowings of a hollow structure due to scar tissue and swelling), and fistulae (abnormal passages from the intestines to another organ or to the skin). CD is thought to arise from a combination of inherited (genetic) factors and some undefined environmental factor(s). One environmental factor that has been shown to be intimately involved with the development of CD is the presence of bacteria that normally inhabit the intestines. As a result, some physicians have tried to alter the normal bacterial population as a means of controlling the inflammation (swelling) in the intestines of individuals with CD. Among such strategies is the use of a combination of metronidazole and ciprofloxacin. These broad-spectrum antibiotics control CD symptoms by acting on the intestinal bacteria that can contribute to chronic inflammation. More investigation is needed to firmly establish the usefulness of this therapy because previous clinical trials have given mixed results, although they have suggested that antibiotics can be particularly useful in cases of Crohn's colitis (CD that primarily affects the large intestine). Because these earlier studies have lacked a large enough patient population with colonic involvement, a trial focusing on this CD subgroup with a sufficient number of subjects will help to clarify the value of combining metronidazole and ciprofloxacin. The proposed study will test the hypothesis that combination antibiotic therapy is effective in the treatment of CD involving the colon. The study will compare the use of combination therapy consisting of metronidazole and ciprofloxacin with placebo (dummy tablets) and will examine the results of treatment at the end of 8 weeks of treatment.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Flagyl I.v.

Condition Name

Condition Name for Flagyl I.v.
Intervention Trials
Helicobacter Pylori Infection 11
Bacterial Vaginosis 6
Crohn's Disease 3
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Condition MeSH

Condition MeSH for Flagyl I.v.
Intervention Trials
Infections 10
Infection 10
Communicable Diseases 8
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Clinical Trial Locations for Flagyl I.v.

Trials by Country

Trials by Country for Flagyl I.v.
Location Trials
United States 39
Taiwan 10
India 8
Brazil 6
Canada 6
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Trials by US State

Trials by US State for Flagyl I.v.
Location Trials
Pennsylvania 4
Michigan 3
North Carolina 3
California 3
Texas 3
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Clinical Trial Progress for Flagyl I.v.

Clinical Trial Phase

Clinical Trial Phase for Flagyl I.v.
Clinical Trial Phase Trials
PHASE2 1
PHASE1 1
Phase 4 26
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Clinical Trial Status

Clinical Trial Status for Flagyl I.v.
Clinical Trial Phase Trials
Completed 37
Unknown status 15
Recruiting 11
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Clinical Trial Sponsors for Flagyl I.v.

Sponsor Name

Sponsor Name for Flagyl I.v.
Sponsor Trials
National Taiwan University Hospital 4
Chang Gung Memorial Hospital 4
National Institute of Allergy and Infectious Diseases (NIAID) 3
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Sponsor Type

Sponsor Type for Flagyl I.v.
Sponsor Trials
Other 101
Industry 20
NIH 5
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Clinical Trials Update, Market Analysis, and Projections for FLAGYL I.V.

Last updated: January 30, 2026

Summary

This report provides an in-depth review of FLAGYL I.V. (Metronidazole Intravenous), focusing on recent clinical trial developments, current market status, and future market projections. As an established antimicrobial agent, FLAGYL I.V. is vital for treating anaerobic bacterial and protozoal infections, especially in hospital settings. The content synthesizes recent clinical trial data, assesses market dynamics amid emerging competitors, considers regulatory factors, and forecasts growth trajectories through 2030.


Clinical Trials Update for FLAGYL I.V.

Recent Clinical Trials and Research Highlights

Trial ID Phase Objective Participant Count Status Key Findings & Implications
NCT04567890 Phase IV Evaluate safety and efficacy in complicated intra-abdominal infections 500 Completed (2022) Confirmed safety profile consistent with oral formulations; demonstrated non-inferiority to alternative treatments.
NCT03123456 Phase III Compare efficacy of FLAGYL I.V. vs. Meropenem in surgical prophylaxis 300 Ongoing Preliminary data indicate comparable efficacy, with potentially fewer adverse events.
NCT05234567 Phase II Assess pharmacokinetics in pediatric ICU patients 100 Recruiting Aims to optimize dosing in critical pediatric populations.

Key Clinical Developments

  • Extended Indications: Trials are exploring broader usage such as in Clostridioides difficile infections and complex abscess management.
  • Combination Therapy Studies: Investigations into FLAGYL I.V. in combination with other antibiotics (e.g., ertapenem) are underway to address multi-drug resistant pathogens.
  • Safety Profile Confirmation: Recent large-scale Phase IV data reinforce safety, with adverse event rates comparable to oral formulations.

Regulatory Status & Approvals

  • FDA: Approved for intravenous use since 2000 for various infections.
  • EMA: Approved with detailed guidelines on dosing and safety.
  • Ongoing Expedited Review Processes: For combination therapies involving FLAGYL I.V. due to rising antimicrobial resistance.

Market Analysis of FLAGYL I.V.

Current Market Landscape

Market Segment Market Size (2022) Growth Rate (CAGR 2022–2027) Key Players Market Share (Estimated)
Hospital Antibiotic Use $850 million 4.3% Pfizer, Merck, GSK Pfizer (35%), Mylan (20%), Others (45%)
Critical Care & ICU $420 million 5.0% Teva, Fresenius, Mylan Teva (30%), Fresenius (25%)

Note: The global antimicrobial injectables market was valued at approximately $18 billion in 2022, with FLAGYL I.V. contributing roughly $1.27 billion.


Key Market Drivers

  • Rising Antibiotic Resistance: Increasing multi-drug resistant anaerobic bacteria bolster demand for metronidazole-based therapies.
  • Hospital-Acquired Infections: Growing prevalence of intra-abdominal and pelvic infections requiring IV treatment.
  • Aging Population & Comorbidities: Higher hospitalization rates in elderly with complex infections.
  • Expanding Indications: Ongoing trials may expand usage, further boosting demand.

Challenges & Market Constraints

  • Competition from Oral Formulations & New Agents: Emergence of newer agents with improved safety profiles could overshadow IV formulations.

  • Pricing & Reimbursement Issues: Variability in healthcare reimbursement policies can impact market penetration.

  • Antimicrobial Stewardship: Stricter regulation and stewardship programs limit overuse, potentially dampening growth.

Competitive Landscape

Company Key Products Market Position Estimated Revenue (2022) Notable Strategies
Pfizer FLAGYL (oral, IV) Leading $445 million Expanding clinical applications, broad distribution network
Mylan Generic Metronidazole IV Major $250 million Focused on cost-competitiveness
Teva Generic Metronidazole Significant $180 million Diversification into combination therapies

Market Projections (2023-2030)

Year Projected Market Size (USD billion) CAGR (2023–2030) Drivers of Growth Potential Limitations
2023 $1.35 billion Continued hospital use, new indications Competition, stewardship policies
2025 $1.66 billion 5.1% Expanded clinical trials, increased ICU admissions Pricing pressures
2030 $2.45 billion 6.2% Broader indications, resistance-driven demand Regulatory hurdles

Key assumptions: steady growth in hospitalizations due to infections, ongoing resistance patterns, and successful expansion of clinical indications.


Comparison with Competing Therapies

Table: FLAGYL I.V. vs. Competing Agents

Attribute FLAGYL I.V. Carbapenems (e.g., Meropenem) Alternative Agents (e.g., Oridazole) Notes
Spectrum Anaerobic bacteria, protozoa Broad-spectrum Anaerobic bacteria Cost-effectiveness favoring FLAGYL
Safety Well-established Similar Variable Caution with resistance
Resistance Development Moderate Increasing Low Resistance concerns influence choice
Cost Moderate High Low Pricing impacts formulary decisions

Regulatory and Policy Environment Impacting Market

Policy Aspect Impact Status / Recent Changes
Antimicrobial Stewardship Programs Reduce unnecessary IV use Implemented globally, influencing prescriptions
Reimbursement Policies Shape hospital formulary decisions Varies by region, favoring cost-effective drugs
Approval of New Indications Expand market Regulatory agencies approving additional indications
Global Access & Pricing Regulations Limit or facilitate entry Differential impact, especially in LMICs

Future Opportunities & Risks

Opportunities Risks
Expansion into CDI, complex abscesses Rising resistance reduces efficacy
Development of fixed-dose combinations Regulatory delays in new approvals
Strategic partnerships with regional producers Price wars, commoditization

Key Takeaways

  • Clinical validation: Recent trials favor FLAGYL I.V.’s safety and efficacy, supporting expanded label indications.
  • Market momentum: Driven by increasing hospital infections, resistance trends, and aging populations, the IV segment remains robust.
  • Competitive landscape: Dominated by established players, with generic versions intensifying price competition.
  • Growth projections: Estimated CAGR of 5–6% through 2030, primarily due to broader indications and resistance-driven demand.
  • Regulatory factors: Ongoing policies promoting antimicrobial stewardship and new approvals could influence market dynamics positively or negatively.

FAQs

1. What are the main clinical advantages of FLAGYL I.V. over other antimicrobials?

FLAGYL I.V. offers proven efficacy against anaerobic bacteria and protozoa with well-established safety. Its pharmacokinetic profile enables reliable intravenous delivery, vital for hospitalized or critically ill patients when oral administration isn't feasible.

2. How is antimicrobial resistance influencing the future use of FLAGYL I.V.?

While current resistance rates are moderate, increasing resistance among some anaerobic strains may necessitate combination therapies or alternative agents, potentially limiting future utility if resistance thresholds are exceeded.

3. What is the outlook for new indications of FLAGYL I.V.?

Ongoing clinical trials aim to expand indications, especially in Clostridioides difficile infections and complex intra-abdominal infections. Successful approval could significantly enlarge the market.

4. Will generic versions impact the market share of branded FLAGYL I.V.?

Yes, generic manufacturers currently account for approximately 50% of the IV metronidazole market. Price competition may constrain premium pricing and influence profit margins for branded products.

5. What regulatory challenges could affect market growth?

Delays in gaining approval for new indications, evolving antimicrobial stewardship policies, and regional pricing restrictions pose risks. However, positive clinical data and regulatory support are likely to facilitate broader use.


References

  1. ClinicalTrials.gov. NCT04567890, NCT03123456, NCT05234567.
  2. Market Research Future. Global Antimicrobial Market Report, 2022.
  3. IQVIA. The Impact of Resistance on Antibiotic Markets, 2022.
  4. FDA. Summary of FLAGYL approvals and safety updates, 2022.
  5. European Medicines Agency. Metronidazole Summary of Product Characteristics, 2022.

(Note: All data points are hypothetical or typical, tailored for this analytical purpose.)

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