Metronidazole

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Flagyl, Metrazole, Metrogel V (vaginal cream), Rosex (gel), Trichazole

Drug group:

Antibacterial drug and antiprotozoal drug

Prescription needed?

Yes

What does it do?

Metronidazole is an antibacterial/antiprotozoal drug used in the treatment of a variety of infections:

• Trichomonas infection of the vagina – this is a sexually transmitted infection that may not cause any symptoms, a simultaneous course of treatment for the sexual partner is advised
• Infections of the pelvis and gums, septicaemia, infected leg ulcers and pressure sores
• Clostridium difficile infections associated with antibiotic use.
• Brain abscesses – high doses of the drug can penetrate the brain
• Gastrointestional infections - amoebic dysentery, giardiasis

How should it be used?

Tablets should be taken after meals and swallowed whole with plenty of water

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

• Formulation and dose varies depending on condition being treated
• Usually 3 x daily for 5–10 days, topical preparations 1–2 x daily, sometimes a single large dose is prescribed
• Total daily dose for adults: tablets 600–2000mg daily, suppositories 3g daily, injection 1.5g daily

How quickly will it start to work?

Within an hour, but it may be 1–2 days before you notice an improvement in symptoms.  
                              

How long will the effects last?

6–12 hours  
                             

When should I stop using it?

Complete the full course as prescribed.    
       

Is it safe for prolonged use?

Not usually prescribed for longer than 10 days.

If used for longer the drug may cause temporary loss of sensation in the hands and feet and reduced production of white blood cells.

What are the possible side effects?

The following have been reported:

• More common: nausea, loss of appetite, dark urine
• Less common: dry mouth, metallic taste in the mouth, headache, dizziness
• Report to your doctor before taking your next dose if you experience: numbness/tingling

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: liver/kidney problems, history of seizures/epilepsy, porphyria
• Other medicines: Oral anticoagulants, ciclosporin, cimetidine, fluorouracil , lithium, phenytoin, phenobarbital
• Pregnancy and breast-feeding: Safety in pregnancy not established, normal doses are unlikely to negatively affect the breastfed baby but the drug may give the milk a bitter taste
• Children: Reduced dose necessary
• Over 60: No special problems
• Driving and hazardous work: Caution, the drug can cause drowsiness
• Alcohol: Avoid, if taken with metronidazole, alcohol may cause flushing, nausea, vomiting, abdominal pain, and headache