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Brand Name(s): MetroGel^® Vaginal, Nuvessa^®, Vandazole^®; also available generically

WHY is this medicine prescribed?

Metronidazole is used to treat vaginal infections such as bacterial vaginosis (an infection caused from too much of certain bacteria in the vagina). Metronidazole is in a class of medications called nitroimidazole antimicrobials. It works by stopping the growth of bacteria.

Are there OTHER USES for this medicine?

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

HOW should this medicine be used?

Metronidazole comes as a gel to be used in the vagina. Metronidazole is usually used as a single dose at bedtime (Nuvessa) or once daily for 5 consecutive days at bedtime (MetroGel Vaginal, Vandazole). Metronidazole is also used twice daily for 5 days (MetroGel Vaginal). Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use metronidazole exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Be careful not to get metronidazole gel in your eyes, mouth, or on your skin. If you do get it in your eyes, wash them with cool water and contact your doctor.

Do not have vaginal intercourse or use other vaginal products (such as tampons or douches) during your treatment with the vaginal gel.

Metronidazole gel for the vagina comes with a special applicator. Read the instructions provided with it and follow these steps:

1. Fill the special applicator that comes with the gel to the level indicated.
2. Lie on your back with your knees drawn upward and spread apart.
3. Gently insert the applicator into your vagina and push the plunger to release all of the medication.
4. Withdraw the applicator and dispose of it properly. If you are instructed to reuse the applicator, wash it with soap and warm water.
5. Wash your hands promptly to avoid spreading the infection.

What SPECIAL PRECAUTIONS should I follow?

Before using metronidazole,

• tell your doctor and pharmacist if you are allergic to metronidazole, secnidazole (Solosec), tinidazole (Tindamax), any other medications, parabens, or any of the ingredients in metronidazole topical preparations. Ask your pharmacist for a list of the ingredients.

• tell your doctor if you are taking or have taken disulfiram (Antabuse). Your doctor may tell you not to use metronidazole if you are taking disulfiram or have taken it within the past 2 weeks.

• tell your doctor and pharmacist what prescription, nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven) and lithium (Lithobid).

• tell your doctor if you have or have ever had a central nervous system condition (diseases of the spinal cord or brain) or a blood disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using metronidazole, call your doctor.

• do not drink alcoholic beverages or take products with alcohol or propylene glycol while using this medication and for at least 3 days after your final dose. Alcohol and propylene glycol may cause nausea, vomiting, stomach cramps, headache, sweating, and flushing (redness of the face) when taken with metronidazole.

What SIDE EFFECTS can this medicine cause?

Metronidazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• stomach discomfort
• unusual taste
• headache
• nausea
• diarrhea
• vomiting

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• vaginal irritation, discharge, or itching
• numbness, pain, burning, or tingling in your hands or feet
• seizures
• rash
• itching
• hives
• peeling or blistering skin

Metronidazole may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not freeze or refrigerate it.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are using metronidazole.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. If you still have symptoms of infection after you finish the metronidazole, call your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. represents that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. makes no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. does not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS^® Patient Medication Information™. © Copyright, 2024. The American Society of Health-System Pharmacists^®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Selected Revisions: December 15, 2017.