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Metronidazole is a prescription medication used to treat infections of the reproductive system, gastrointestinal tract, respiratory system, skin, bones and joints, and other areas of the body. Metronidazole may also be used to prevent postoperative infections.

Metronidazole is also available as an over-the-counter medication. The over-the-counter form is used to treat bacterial infections of the vagina. This medication page refers to the prescription forms of metronidazole.

Metronidazole belongs to a group of drugs called nitroimidazole antibiotics. These work by killing organisms that cause infections.

Metronidazole comes in oral, topical, and injectable forms. The directions and frequency of use will vary with the indication for metronidazole.

Do not chew, divide, or break extended release metronidazole tablets. Swallow these tablets whole.

The injectable form of metronidazole will be given directly into a vein (IV) by a healthcare professional.

Common side effects of metronidazole include vomiting, upset stomach, diarrhea, loss of appetite, dry mouth or mouth irritation, and numbness or tingling of the hands and feet.

Metronidazole can also cause dizziness. Do not drive or operate heavy machinery until you know how metronidazole affects you.

Oral forms:

Metronidazole tablets and capsules are prescription medications used to treat infections of the reproductive system, gastrointestinal tract, respiratory system, skin, bones and joints, and other areas of the body.

Topical forms:

Metronidazole creams and gels are prescription medications used to treat inflammatory lesions associated with acne rosacea (adult acne).

Injectable forms:

Injectable forms of metronidazole are prescription medications used to treat infections of the reproductive system, gastrointestinal tract, respiratory system, skin, bones and joints, and other areas of the body.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with metronidazole. See the “Metronidazole Precautions” section.

Oral forms:

Common side effects of oral metronidazole include the following:

• Vomiting
• Diarrhea
• Upset stomach
• Loss of appetite
• Dry mouth
• Sharp, unpleasant metallic taste
• Dark or reddish-brown urine
• Mouth or tongue irritation
• Numbness or tingling of hands or feet

Topical forms:

Common side effects of topical metronidazole include the following:

• Skin irritation, including redness, dryness, burning, or stinging, at the site of application

Injectable forms:

Common side effects of injectable metronidazole include the following:

• Vomiting
• Diarrhea
• Upset stomach
• Loss of appetite
• Dry mouth
• Sharp, unpleasant metallic taste
• Dark or reddish-brown urine
• Mouth or tongue irritation
• Numbness or tingling of hands or feet

This is not a complete list of metronidazole side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• Warfarin (Coumadin)
• Astemizole (Hismanal)
• Disulfiram (Antabuse)
• Busulfan (Busulfex, Myleran)
• Lithium (Lithobid)
• Phenobarbital
• Phenytoin (Dilantin)
• Cimetidine (Tagamet)
• Vitamins        

This is not a complete list of metronidazole drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with oral, topical, and injectable forms of metronidazole including the following:

• Rash
• Itching
• Stuffy nose
• Fever
• Joint pain

Metronidazole can cause dizziness. Do not drive or operate heavy machinery until you know how metronidazole affects you.

Do not drink alcohol during therapy or after therapy with metronidazole.  If you drink alcohol, you can experience stomach cramps, severe nausea and vomiting, headaches, and flushing.

Do not take metronidazole if you:

• are allergic to metronidazole or to any of its ingredients
• have trichomaniasis and are in the first trimester of pregnancy
• have taken disulfuram (Antabuse) within the last 2 weeks

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of metronidazole, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking metronidazole, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to metronidazole or to any of its ingredients
• have or have had Crohn’s disease
• have or have had liver problems
• have or have had kidney problems
• have or have had blood disorders
• have or are being treated for alcohol dependence
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Metronidazole falls into category B. There are no well-done studies that have been done in humans with metronidazole. In animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Metronidazole has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from metronidazole, a choice should be made whether to stop nursing or to stop use of this medication. The importance of the drug to the mother should be considered.

Take or use metronidazole exactly as prescribed. Do not drink alcohol while taking or using any form of metronidazole. Alcohol can cause upset stomach, vomiting, stomach cramps, headaches, sweating, and flushing when used at the same time as metronidazole.

Oral forms:

Metronidazole comes in tablet and capsule forms and is taken two or three times a day. Take metronidazole with food to minimize stomach upset.  Do not chew, divide, or break extended release metronidazole tablets. Swallow metronidazole tablets whole.

Topical forms:

Metronidazole comes in gel, cream, and lotion forms and is applied to the skin one or two times a day. The affected skin should be washed with mild soap 15-20 minutes before applying metronidazole. The gel, cream, or lotion should be applied in a thin layer and gently rubbed into the skin. Moisturizers and cosmetics may be applied once the gel, cream, or lotion has dried.

Topical metronidazole may increase sensitivity to sunlight. Avoid unnecessary or prolonged exposure to sunlight. Wear protective clothing, sunscreen, and sunglasses.

Injectable forms:

Metronidazole is available in an injectable form to be given directly into a vein (IV) by a healthcare professional.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of metronidazole at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age

Oral forms:

The recommended dose of metronidazole for the treatment of trichomoniasis is 375 mg two times a day.

The recommended dose of metronidazole for the treatment of amebiasis in adults is 750 mg three times a day.

Topical forms:

The recommended dose of metronidazole for the treatment of rosacea is two applications daily, usually in the morning and evening.

Injectable forms:

The recommended dose range of metronidazole for the treatment of amebiasis in children is 35 to 50 mg/kg every day, divided into three doses.

The recommended dose of metronidazole for the treatment of anaerobic bacterial infections is 7.5 mg/kg every 6 hours. A maximum of 4 grams should not be exceeded within a 24-hour period.

If you take too much metronidazole, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If metronidazole is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

• Store metronidazole at room temperature, away from excess heat and moisture.
• Keep this and all medicines out of the reach of children.
• Protect topical forms of metronidazole from exposure to light.

Metronidazole has been shown to be carcinogenic in mice and rats. Unnecessary use of the drug should be avoided.