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Flagyl vs. Xifaxan

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

Key takeaways

Metronidazole (Flagyl) and Xifaxan (rifaximin) are both antibiotics, but they treat different types of infections. Metronidazole is a nitroimidazole antibiotic used to treat various bacterial and parasitic infections, such as bacterial vaginosis and trichomoniasis. It is available as a lower-cost generic and is typically taken three times a day. In contrast, Xifaxan is a rifamycin antibiotic used to treat travelers' diarrhea caused by *E. coli*, irritable bowel syndrome with diarrhea (IBS-D), and to prevent hepatic encephalopathy (HE). Xifaxan is taken two to three times a day, depending on the condition, and does not have a generic form. Metronidazole has a serious interaction with alcohol, while Xifaxan does not, although it's still advised to avoid alcohol due to potential liver issues. Common side effects of metronidazole include diarrhea, nausea, and a metallic taste, whereas Xifaxan can cause swelling, dizziness, and fatigue. Both medications require a prescription and should be taken exactly as directed by your healthcare provider.

Metronidazole

(Flagyl)

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Xifaxan

(rifaximin)

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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 Xifaxan

Prescription only

Xifaxan (rifaximin) is a rifamycin antibiotic that's used to treat people 12 years and older with travelers' diarrhea caused by Escherichia coli (E. coli). The medication can also treat irritable bowel syndrome with diarrhea (IBS-D) and prevent hepatic encephalopathy (HE) in adults. Xifaxan (rifaximin) is a tablet that's taken by mouth 2 to 3 times per day, depending on the medical condition you're using it for. Side effects generally include swelling, dizziness, and fatigue.

Indications for Xifaxan

Pros and Cons for Xifaxan

Pros

  • Works well for travelers' diarrhea, HE, and IBS-D
  • Can treat travelers' diarrhea in children 12 years and older
  • Can take with or without food

Cons

  • Need to take 2 to 3 times per day, depending on why you're taking it
  • Only available as tablets
  • Might not be the best option for people with severe liver problems

Common Side Effects for Xifaxan

Travelers' diarrhea:

  • Headache (10%)

IBS-D:

  • Nausea (2-3%)

HE:

  • Swelling in hands and feet (15%)
  • Nausea (14%)
  • Dizziness (13%)
  • Tiredness (12%)
  • Extra stomach fluid and swelling (11%)

Warnings for Xifaxan

  • Worsening of travelers' diarrhea
  • Diarrhea from Clostridioides difficile infection

Prices with our coupons for Flagyl vs. Xifaxan

Price Card Drug Icon
Metronidazole14 tablets / 500mg
$10.73$14.99
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Xifaxan42 tablets / 550mg
$2,717.43$3,391.90
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