(me troe ni' da zole)

Brand Name(s): Flagyl^®, Flagyl^® 375, Likmez; also available generically

IMPORTANT WARNING:

Metronidazole can cause cancer in laboratory animals. Talk to your doctor about the risks and benefits of taking this medication.

WHY is this medicine prescribed?

Metronidazole is used to treat infections of the reproductive system, gastrointestinal (GI) tract, skin, heart, bone, joint, lung, blood, nervous system, and other areas of the body. It is also used to treat certain sexually transmitted diseases (STDs). Metronidazole is also used to treat bacterial vaginosis (an infection caused by too much of certain types of harmful bacteria in the vagina) in women. Metronidazole is in a class of medications called nitroimidazole antimicrobials. It works by stopping the growth of bacteria.

Antibiotics will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

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 tablet, a capsule, and suspension (liquid) to take by mouth. Metronidazole tablets and suspension are usually taken as a one-time dose (or divided into two doses on 1 day) or two to four times daily for up to 10 days or longer. Metronidazole capsules are usually taken two to four times daily for up to 10 days or longer. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take metronidazole exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the oral suspension well before each use to mix the medication evenly. Use a dosing spoon, oral syringe, or measuring cup to measure the correct amount of medication. You may not receive the correct amount of medication if you use a household spoon to measure your dose.

Swallow the extended-release tablets whole; do not split, chew, or crush them.

Continue to take this medication even if you feel well. Do not stop taking it without talking to your doctor. If you stop taking this medication too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

What SPECIAL PRECAUTIONS should I follow?

Before taking metronidazole,

tell your doctor if you or your child has Cockayne syndrome (an inherited condition that causes sensitivity to light, premature aging, failure to gain weight and grow, and delayed development). Your doctor will probably tell you that you or your child should not take metronidazole.

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

• tell your doctor or pharmacist if you are taking the following medication or have stopped taking it within the past two weeks: disulfiram.

• tell your doctor and pharmacist what prescription, nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• The following nonprescription or herbal products may interact with metronidazole: cimetidine (Tagamet HB). Be sure to let your doctor and pharmacist know that you are taking this medication before you start taking metronidazole. Do not start this medication while taking metronidazole without discussing with your healthcare provider.

• tell your doctor if you have or have ever had Crohn's disease, blood problems, or kidney or liver disease. Also, tell your doctor if you have a yeast infection or a medical condition that affects your brain.

• tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking metronidazole, call your doctor. Women who are pregnant generally should not take metronidazole during the first trimester (first 3 months) of pregnancy.

• tell your doctor if you are breastfeeding or plan to breastfeed. If you take metronidazole while you are breastfeeding, your baby may receive some metronidazole in breast milk. If you are breastfeeding, your doctor may tell you to pump and discard your milk while you are taking metronidazole and for 48 hours after your final dose. Talk to your doctor about the best way to feed your baby while you are taking metronidazole.

• do not drink alcoholic beverages or take products with alcohol or propylene glycol while taking 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 should I do IF I FORGET to take a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

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:

• vomiting
• nausea
• diarrhea
• constipation
• upset stomach
• stomach cramps
• loss of appetite
• headache
• dry mouth
• sharp, unpleasant metallic taste
• furry tongue; mouth or tongue irritation

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

• numbness, pain, burning, or tingling in your hands or feet
• seizures
• rash
• itching
• hives
• peeling or blistering skin
• flushing
• stuffy nose, fever, sore throat, or other signs of infection
• dizziness
• difficulty speaking
• problems with coordination
• confusion

Metronidazole may cause other side effects. Call your doctor if you have any unusual problems while taking 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 light, excess heat and moisture (not in the bathroom).

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 should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• nausea
• vomiting
• loss of muscle coordination
• numbness, pain, burning, or tingling in your hands or feet
• seizures

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to metronidazole.

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

Do not let anyone else take your medication. Your prescription is probably not refillable. 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, 2023.