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Metronidazole is an antibiotic that fights bacteria.
Metronidazole is used to treat bacterial infections of the vagina, stomach or intestines, liver, skin, joints, brain, heart, and respiratory tract. Metrogel (topical metronidazole) is also used to treat rosacea, a skin condition. Vaginal metronidazole gel is also used to treat bacterial infections of the vagina.
Metronidazole will not treat a vaginal yeast infection.
You should not use metronidazole if you are allergic to it, or if you have taken disulfiram (Antabuse) within the past 2 weeks.
Do not drink alcohol or consume foods or medicines that contain propylene glycol while you are taking metronidazole and for at least 1 day after you stop taking it. You may have unpleasant side effects such as fast heartbeats, warmth or redness under your skin, tingly feeling, nausea, and vomiting.
Seizures and other nervous system abnormalities have been reported in patients treated with metronidazole. You should stop metronidazole immediately for any neurological symptoms such as seizures, headaches, visual changes, weakness, numbness, or tingling.
This medicine will not treat a viral infection such as the common cold or flu.
In animal studies (mice and rats), this medicine caused certain types of cancers or tumors. It is not known whether these effects would occur in people using this medicine. Ask your doctor about your risk.
You should not take metronidazole if you are allergic to it, or if you have taken disulfiram (Antabuse) within the past 2 weeks.
Using metronidazole during the first trimester of pregnancy could harm the unborn baby. Tell your doctor if you are pregnant or if you become pregnant while using this medicine.
To make sure metronidazole is safe for you, tell your doctor if you have ever had:
liver or kidney disease;
nervous system disease;
Cockayne syndrome (a rare genetic disorder);
a stomach or intestinal disease such as Crohn's disease;
a blood cell disorder such as anemia (lack of red blood cells) or low white blood cell (WBC) counts;
a fungal infection anywhere in your body; or
a nerve disorder.
In animal studies, metronidazole caused certain types of tumors, some of which were cancerous. However, very high doses are used in animal studies. It is not known whether these effects would occur in people using regular doses. Ask your doctor about your risk.
Metronidazole can pass into breast milk. It is not known whether metronidazole can harm a nursing baby. Let your doctor know if you are breastfeeding prior to taking metronidazole.
Do not give this medicine to a child without medical advice.
Take metronidazole exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
Do not crush, chew, or break an extended-release tablet. Swallow it whole.
If you are treating a vaginal infection, your sexual partner may also need to take metronidazole (even if no symptoms are present) or you could become reinfected.
Metronidazole is usually given for up to 10 days in a row. You may need to repeat this dosage several weeks later.
Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Metronidazole will not treat a viral infection such as the flu or a common cold.
Metronidazole can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using this medicine.
Store at room temperature away from moisture and heat.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include nausea, vomiting, dizziness, loss of balance or coordination, numbness and tingling, or seizures (convulsions).
Do not drink alcohol or consume food or medicines that contain propylene glycol while you are taking metronidazole. You may have unpleasant side effects such as headaches, stomach cramps, nausea, vomiting, and flushing (warmth, redness, or tingly feeling).
Avoid alcohol or propylene glycol for at least 3 days after you stop taking this medicine. Check the labels of any medicines or food products you use to make sure they do not contain alcohol or propylene glycol
Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.
Get emergency medical help if you have signs of an allergic reaction to metronidazole: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
diarrhea;
painful or difficult urination;
trouble sleeping, depression, irritability;
headache, dizziness, weakness;
a light-headed feeling (like you might pass out); or
blisters or ulcers in your mouth, red or swollen gums, trouble swallowing.
Stop taking the medicine and call your doctor right away if you have neurologic side effects (more likely to occur while taking metronidazole long term):
numbness, tingling, or burning pain in your hands or feet;
vision problems, pain behind your eyes, seeing flashes of light;
muscle weakness, problems with coordination;
trouble speaking or understanding what is said to you;
a seizure; or
fever, neck stiffness, and increased sensitivity to light.
Metronidazole can cause life-threatening liver problems in people with Cockayne syndrome. If you have this condition, stop taking metronidazole and contact your doctor if you have signs of liver failure - nausea, stomach pain (upper right side), dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).
Side effects may be more likely in older adults.
Common metronidazole side effects may include:
nausea, vomiting, loss of appetite, stomach pain;
diarrhea, constipation;
headache;
unpleasant metallic taste;
rash, itching;
vaginal itching or discharge;
mouth sores; or
swollen, red, or "hairy" tongue.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Tell your doctor about all your current medicines and any you start or stop using, especially:
busulfan;
lithium; or
a blood thinner - warfarin, Coumadin, Jantoven.
phenytoin or phenobarbital
This list is not complete. Other drugs may interact with metronidazole, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Further informationRemember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use metronidazole only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Metronidazole (www.drugs.com/metronidazole.html).
Applies to metronidazole: oral capsule, oral powder for suspension, oral tablet
Other dosage forms:
Oral route (Tablet; Tablet, Extended Release; Capsule)
Metronidazole has been shown to be carcinogenic in mice and rats. Unnecessary use of the drug should be avoided. Its use should be reserved only for conditions for which it is approved.
Along with its needed effects, metronidazole may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking metronidazole:
More common
Less common
Rare
Incidence not known
Some side effects of metronidazole may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Rare
Incidence not known
For Healthcare Professionals
Applies to metronidazole: compounding powder, intravenous powder for injection, intravenous solution, oral capsule, oral suspension, oral tablet, oral tablet extended release
GeneralThe most serious side effects reported were convulsive seizures, encephalopathy, aseptic meningitis, optic neuropathy, and peripheral neuropathy (characterized by numbness/paresthesia of an extremity).
Nervous systemVery common (10% or more): Headache (up to 18%)
Common (1% to 10%): Dysgeusia/taste perversion (e.g., metallic taste, sharp unpleasant metallic taste, taste of alcoholic beverages modified), dizziness
Rare (0.01% to 0.1%): Encephalopathy (e.g., confusion, fever, headache, hallucinations, paralysis, light sensitivity, disturbances in sight and movement, stiff neck), aseptic meningitis, seizure, somnolence, peripheral neuropathy, ataxia
Very rare (less than 0.01%): Subacute cerebellar syndrome (e.g., ataxia, dysarthria, gait impaired, nystagmus, tremor), drowsiness, convulsions, incoordination
Frequency not reported: Dysarthria, hypoesthesia, paresthesia, peripheral sensory neuropathy, transient epileptiform seizures, hearing impaired/hearing loss (including sensorineural), tinnitus, taste disorders/unpleasant taste in mouth, nystagmus, convulsive seizure, numbness, syncope, vertigo, paralysis
GastrointestinalVery common (10% or more): Nausea (up to 10%)
Common (1% to 10%): Abdominal pain, diarrhea, dry mouth, stomatitis, glossitis
Rare (0.01% to 0.1%): Pancreatitis, upper abdominal pain/epigastralgia, vomiting
Frequency not reported: Constipation, tongue discoloration, oral mucositis, furry/furred tongue, gastrointestinal disturbances (e.g., epigastric pain/distress), proctitis, sudden overgrowth of Candida in mouth, abdominal cramping, dyspepsia, pseudomembranous colitis, mucositis
GenitourinaryVery common (10% or more): Vaginitis (up to 15%)
Common (1% to 10%): Genital pruritus, abnormal urine, dysmenorrhea, moniliasis, urinary tract infection
Rare (0.01% to 0.1%): Chromaturia
Very rare (less than 0.01%): Darkened urine
Frequency not reported: Vaginal dryness, vulva dryness, dysuria, vaginal candidiasis, dyspareunia, polyuria, incontinence, cystitis, pyuria, proliferation of Candida in vagina
OtherCommon (1% to 10%): Bacterial infection, influenza-like symptoms
Uncommon (0.1% to 1%): Asthenia
Rare (0.01% to 0.1%): Mucosal inflammation, pyrexia/fever
Very rare (less than 0.01%): Flushing
Frequency not reported: Malaise, face edema, peripheral edema, chest pain, chills, overgrowth of Candida, disulfiram-like reaction, weakness, sensation of pelvic pressure
RespiratoryCommon (1% to 10%): Upper respiratory tract infection, rhinitis, sinusitis, pharyngitis
Frequency not reported: Dyspnea, nasal congestion, hiccup
MusculoskeletalCommon (1% to 10%): Myalgia
Very rare (less than 0.01%): Arthralgia
Frequency not reported: Muscle spasms, fleeting joint pain, stiff neck
HematologicUncommon (0.1% to 1%): Leukopenia
Rare (0.01% to 0.1%): Neutropenia, thrombocytopenia, pancytopenia, agranulocytosis
Frequency not reported: Eosinophilia, bone marrow aplasia, bone marrow depression, blood dyscrasia
DermatologicRare (0.01% to 0.1%): Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, erythema multiforme
Very rare (less than 0.01%): Skin rash, pustular eruptions, acute generalized exanthematous pustulosis, pruritus
Frequency not reported: Fixed drug eruption, swelling face, urticaria, hyperhidrosis, erythema, drug reaction with eosinophilia and systemic symptoms (DRESS), erythematosus rash, mild erythematous eruptions, pustulosis
HepaticRare (0.01% to 0.1%): Cholestatic hepatitis
Very rare (less than 0.01%): Increased liver enzymes (AST, ALT, alkaline phosphatase), cholestatic/mixed hepatitis, hepatocellular liver injury, jaundice, liver failure requiring liver transplant, abnormal liver function tests
Frequency not reported: Increased liver enzyme, hepatotoxicity/liver failure in patients with Cockayne syndrome, drug-induced hepatitis
HypersensitivityRare (0.01% to 0.1%): Anaphylaxis, anaphylactic shock, Jarisch-Herxheimer reaction
Frequency not reported: Serum sickness-like reaction, immediate/delayed hypersensitivity reactions, anaphylactic reaction, hypersensitivity
PsychiatricRare (0.01% to 0.1%): Hallucinations
Very rare (less than 0.01%): Confusion/confusional state, psychotic disorders
Frequency not reported: Depression, insomnia, depressed mood, decreased libido, irritability, psychosis, disorientation, psychotic reaction
OcularRare (0.01% to 0.1%): Optic neuropathy, diplopia, myopia
Very rare (less than 0.01%): Vision disorders (e.g., diplopia, myopia)
Frequency not reported: Optic neuropathy/neuritis, saccadic eye movement, blurred vision, decreased visual acuity, changed color vision, light sensitivity
CardiovascularFrequency not reported: Flattening of T-wave on ECG, tachycardia, palpitations, QT interval prolonged on ECG
MetabolicFrequency not reported: Anorexia, decreased appetite
OncologicAn increased incidence of gastrointestinal and certain extraintestinal cancers have been reported in patients with Crohn's disease. Breast and colon cancer have been reported in medical literature in Crohn's disease patient treated with high doses of this drug for a prolonged duration; causality was not established.
Frequency not reported: Breast cancer, colon cancer, gastrointestinal cancer, certain extraintestinal cancers
LocalFrequency not reported: Injection site reaction, thrombophlebitis
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Metronidazole (www.drugs.com/metronidazole.html).
August 5, 2020
November 24, 2020
December 2, 2020
November 15, 2020
December 2, 2020
December 1, 2020