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Flagyl vs. Bactrim

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Metronidazole (Flagyl) and sulfamethoxazole/trimethoprim (Bactrim) are both antibiotics, but they belong to different classes and treat different types of infections. Metronidazole is a nitroimidazole antibiotic that targets bacterial and parasitic infections, such as bacterial vaginosis and trichomoniasis. In contrast, sulfamethoxazole/trimethoprim is a combination of a sulfonamide and an antifolate, used for infections like urinary tract infections (UTIs) and ear infections. Metronidazole is typically taken two to three times a day, while sulfamethoxazole/trimethoprim is usually taken twice a day. Both medications are available as lower-cost generics. However, metronidazole has a serious interaction with alcohol, requiring you to avoid it during treatment and for three days after. Sulfamethoxazole/trimethoprim can make your skin more sensitive to the sun and is not recommended if you have a sulfa allergy. Both medications have their own sets of side effects and specific warnings, so it's important to follow your healthcare provider's instructions closely.

Metronidazole

(Flagyl)

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Sulfamethoxazole/trimethoprim

 

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Summary for Flagyl

Prescription only

Metronidazole (Flagyl) is an oral antibiotic for adults and children. It's used to treat certain bacterial and parasitic infections, including bacterial vaginosis (a type of vaginal bacteria infection) and trichomoniasis (a sexually transmitted infection, or STI). Metronidazole (Flagyl) is taken by mouth, typically 3 times a day. Some common side effects of this medication include diarrhea, nausea, and vomiting. Avoid drinking alcohol while taking and for 3 days after stopping metronidazole (Flagyl) because this combination can cause a serious reaction. Metronidazole (Flagyl) is available as a lower-cost generic.

Indications for Flagyl

Treatment of certain bacterial and parasitic infections, including:

Pros and Cons for Flagyl

Pros

  • Taken by mouth
  • Available as a lower-cost generic medication
  • Can be used to treat different types of bacterial infection
  • Immediate-release formulations can be taken with or without food

Cons

Common Side Effects for Flagyl

Please note: These are common side effects reported by people who took extended-release metronidazole (Flagyl)

  • Headache (18%)
  • Inflammation of the vagina (15%)
  • Nausea (10%)
  • Metallic taste (9%)
  • Flu-like symptoms (6%)

Warnings for Flagyl

  • Possible risk of cancer
  • Serious allergic reactions
  • Brain and nerve problems
  • Liver and kidney problems
  • Risk of fungal infection
  • Risk of drug resistance
  • Lower white blood cell counts
  • Interaction with other medications

Summary for Bactrim

Prescription only

Sulfamethoxazole/trimethoprim (sometimes known as SMZ/TMP) is a combination medication containing an antifolate and sulfa antibiotic. It's used to treat different types of infections, such as urinary tract infections (UTIs), ear infections, and lung infections. This antibiotic has two different brand names, Bactrim and Septra, and it's also available as a lower-cost generic. It's a tablet that's taken by mouth, typically twice daily for most types of infections. This antibiotic also comes as a suspension under the brand name Sulfatrim for people who can't swallow tablets and as an injection for people in the hospital. Common side effects include nausea, diarrhea, and rash.

Indications for Bactrim

Pros and Cons for Bactrim

Pros

  • Treats many types of bacterial infections
  • Can be given to children as young as 2 months old to treat certain infections
  • Available as a lower-cost generic

Cons

  • Can upset your stomach and make your skin more sensitive to the sun
  • Not the best choice for people with liver or kidney problems
  • Not recommended if you're pregnant
  • Can't take if you have a sulfa allergy

Common Side Effects for Bactrim

Warnings for Bactrim

  • Not for use during pregnancy
  • Severe allergic reactions and skin reactions
  • Low platelet counts and risk for bleeding
  • Diarrhea from Clostridioides difficile infection
  • Low sodium levels and high potassium levels
  • Blood cell-related problems
  • Problems with processing phenylalanine - for people with phenylketonuria (PKU) only

Prices with our coupons for Flagyl vs. Bactrim

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Metronidazole14 tablets / 500mg
$10.73$14.99
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Sulfamethoxazole/Trimethoprim14 tablets / 800mg/160mg
$8.90$10.89
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