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Metronidazole (Flagyl)



Metronidazole is an antibiotic used to treat a variety of infections along with rocacea. It is active against anaerobic bacteria and is able to interfere with the DNA of these organisms.



How to Use


Take this medication by mouth with a glass of water, it can be taken with or without food.


Take it exactly as directed, do not take it more than directed.


It is important to finish the entire course of this medication. Do not stop taking it because you are feeling better unless directed by a doctor.


If you miss a dose, take it as soon as you can. If it is already almost time for your next dose, take only that next dose. Do not double up on any dose.




Important Information


DO NOT CONSUME ANY ALCOHOL WHILE TAKING THIS MEDICATION AND FOR 3 DAYS AFTER STOPPING IT. Consuming alcohol while taking metronidazole will make you feel very dizzy and sick.


Consult with your doctor if symptoms do not improve while taking this medication.


If this medication is being used to treat a sexually transmitted disease, avoid sexual contact until completion of the therapy. It is possible that your sexual partner will require treatment.


Do not operate heavy machinery, drive a car, or engage in other activity that requireS fine motor skills until you are sure of how this medication affects you.


Stand and sit slowly first first starting this medication to avoid dizziness.



Be sure that your prescribing doctor is aware if you have any of the the following conditions before taking this medication


Seizures, anemia or blood conditions, yeast or fungal infections, liver disease, alcohol consumption, allergy history, nervous system diseases, pregnancy, breastfeeding, trying to become pregnant.



Side effects that should be immediately reported to your healthcare provider


Allergic reactions(hives, itching, rash, swelling of the face or mouth), trouble breathing, sore or discolored mouth, dizziness, fever, infection, painful tingling or numbness in the hands or feet, changes in the passing of urine, any loose, red or peeling skin, seizures, fatigue, vaginal irritation, vaginal dryness, or discharge.



Other Side Effects


Diarrhea, metallic taste, stomach pain, sleep changes, irritability, nausea.



Adult Dose


Bacterial Vaginosis


Extended Release Tablets: 750 mg by mouth daily for 7 days.


0.75% vaginal gel: 37.5mg(1 applicator), used intravaginally 1-2 times per day for 5 days.


Regular Tablets: 500 mg by mouth twice daily for 7 days. 



Clostridium Difficile Diarrhea or Pseudomebraneous Colitis


Mild to Moderate or First Recurrence: 500 mg by mouth 3 times daily for 10-14 days.


Severe or Complicated Cases: 500 mg by IV every 8 hours. This is given along with vancomycin.



Pelvic Inflammatory Disease


500 mg by mouth twice per day for 14 days. For this conditions, metronidazole is given along with doxycycline 100 mg by mouth twice daily for 14 days, and either ceftriaxone 250 mg as a single intramuscular injection, or 2 grams of cefoxitin given intramuscularly one time along with 1 gram of probenecid by mouth.





1. Centers for Disease Control and Prevention (CDC): Sexually transmitted diseases (STDs): prevention. Centers for Disease Control and Prevention (CDC). Atlanta, GA. 2015.


2. Cohen SH , Gerding DN , Johnson S , et al: Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol 2010; 31(5):431-455.


3. Vandazole (metronidazole vaginal gel 0.75%) [package insert]. Minneapolis, MI: Upsher-Smith Laboratories, Inc.; 2011.


4. Metrogel-Vaginal (metronidazole gel) [package insert]. Bristol, TN: Graceway Pharmaceuticals, LLC; 2007.

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