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Compare Metronidazole vs. Miconazole

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

Metronidazole (Flagyl)
Monistat (miconazole)
Metronidazole (Flagyl)
Monistat (miconazole)

Summary of Metronidazole vs. Miconazole

Summary for Nitroimidazole antibiotic
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.

Summary for Antifungal

Monistat (miconazole) is a medication that's used to treat vaginal yeast infections. It comes as creams, inserts, and suppositories that are placed into the vagina. Common side effects include mild vaginal burning, irritation, and itching. It's best not to have sex while using Monistat (miconazole) and to wait until your infection has gone away. There are several brand names of this medication (e.g., Monistat 1 Combination Pack, Monistat 3, Monistat 7), with the number representing how many days you have to take it. You can find Monistat (miconazole) over the counter, and it doesn't require a prescription from your provider.

Indications of Metronidazole vs. Miconazole

Indications for

Treatment of certain bacterial and parasitic infections, including:

•Trichomoniasis
•Amebiasis (parasitic gut infection)
•Serious bacterial infections, such as:
•Abdominal infection (including peritonitis)
•Skin infections
•Gynecological infections (including endometritis)
•Bloodstream infection (septicemia)
•Bone and joint infections
•Central nervous system infections (meningitis)
•Lung infections (lower respiratory tract infections)
•Heart infection (endocarditis)
Indications for
•Treatment of vaginal yeast infection
•Relief of vaginal yeast infection symptoms (itching and irritation outside of the vagina)

Pros and Cons of Metronidazole vs. Miconazole

Pros and Const for Nitroimidazole antibiotic
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
•Immediate-release formulations needs to be taken multiple times a day for most infections
•Serious interaction with alcohol
•Can cause metallic taste in mouth
•Not recommended while breastfeeding
Pros and Const for Antifungal
Pros
•Works as well as certain prescription options
•Has mild side effects
•Can use the 7-day version if you're pregnant
•Available without a prescription
Cons
•Can cause vaginal burning, itching, or irritation
•Can stain clothes and bedsheets
•Can't use tampons, douches, or spermicides while using Monistat (miconazole)
•Interferes with Coumadin (warfarin) and raise the risk of bleeding or bruising

Common Side Effects of Metronidazole vs. Miconazole

Common Side Effects for

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%)
Common Side Effects for
•Vaginal burning
•Vaginal irritation
•Vaginal itching

Warnings of Metronidazole vs. Miconazole

Common Side Effects for
•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
Common Side Effects for
•Damage to condoms and diaphragms
•Treatment failure

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