How Much Is Metronidazole Without Insurance?
Key takeaways:
Metronidazole (Flagyl) is a low-cost generic antibiotic that comes in several forms, including topical cream, lotion, gels, oral tablets, and IV infusions. It can treat conditions such as skin infections and lower respiratory infections in adults and children, as well as infections of the gastrointestinal and reproductive systems.
Metronidazole works by interacting with the DNA of bacteria in the body, causing the bacteria to die. It’s available under different brand names, including Flagyl, Metrogel, Likmez, and Nuvessa.
Without insurance, a typical course of 14 tablets of 500 mg oral metronidazole could cost as little as $15.74.
Table of contents
Bacteria can cause infections after entering your body through many ways: You can inhale them, they can enter through cuts and other openings in the skin, and they can be consumed through food and water. Certain medications work by killing bacteria and stopping their growth in the body. Metronidazole (Flagyl) is a generic antibiotic that works by interacting with the DNA of bacteria, causing them to die. The medication works in the same way to treat conditions caused by parasites.
Metronidazole can treat many bacterial infections, including skin infections, lower respiratory infections, and bacterial vaginosis (a common vaginal infection). It is also prescribed for infections in other areas of the body, including the gastrointestinal tract, heart, and nervous system.
Metronidazole basics
Metronidazole comes in oral, topical, and injectable forms. It is the generic of brand-name antibiotics, including Flagyl, Metrogel, Likmez, and Nuvessa, which are all used in the U.S.
The chart below provides a summary of basic information about metronidazole.
Metronidazole Basics
| Generic name | Metronidazole |
| Brand names | |
| Forms |
|
| FDA-approved uses | Metronidazole is approved for a range of infections, including:
|
| Benefits |
|
| Possible side effects | Oral metronidazole:
Topical metronidazole:
Vaginal metronidazole:
IV metronidazole:
In some circumstances, severe side effects include temporary decreases in blood cell counts, heart rhythm problems, liver problems, nervous system conditions, and severe skin reactions. Metronidazole also has an FDA boxed warning, which means the medication has serious risks associated with it. The warning is based on a risk of cancer, which was found in mice and rats that ingested the medication. But this risk hasn’t been confirmed in human studies. |
Is metronidazole covered by insurance?
Most insurers cover generic metronidazole, including nearly all Medicaid and Medicare plans and commercial plans, including those purchased through an Affordable Care Act (ACA) marketplace.
If you have insurance, review your plan’s summary of benefits and coverage and formulary (its list of covered medications) to determine whether generic metronidazole is covered. If not, contact your prescription plan provider and ask about your coverage options. You can also discuss alternatives with your prescriber or a pharmacist.
How insurance covers metronidazole
The following charts show the likelihood of coverage for metronidazole tablets and vaginal gel, based on the type of insurance plan.
Most health insurance plans don’t require enrollees to get prior authorization or do step therapy. But prior authorization and step therapy is required for some people covered by Medicaid.
Insurance Coverage for Metronidazole (Oral Tablet, 500 mg)
Insurance type | Enrollees covered for 500 mg metronidazole oral tablet | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
Commercial (not including plans purchased through an ACA marketplace) | 98.6% | 0% | 0% |
85.5% | 0% | 0% | |
Medicare, including original Medicare and Medicare Advantage plans | 96.6% | 0% | 0% |
Medicaid, including state-run and managed care plans | 99.9% | 5.2% | 0% |
Source: Managed Markets Insight & Technology, LLC™, as of December 13, 2024. (See methodology below.)
Metronidazole (Flagyl) side effects: Most side effects of metronidazole are well tolerated, though rare but serious side effects could occur with longer use.
Interactions with metronidazole: Alcohol, certain blood thinners, and lithium (Lithobid) are among the substances you should talk to your prescriber about before taking metronidazole.
Metronidazole dosage information: Metronidazole dosages for adults vary based on the condition being treated. But for children, dosages for metronidazole are typically based on body weight.
Insurance Coverage for Metronidazole (Vaginal Gel, 0.75%)
Insurance type | Enrollees covered for 0.75% metronidazole vaginal gel | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
Commercial (not including plans purchased through an ACA marketplace) | 97.5% | 0% | 0% |
ACA plans | 85.2% | 0.2% | 0.31% |
Medicare, including original Medicare and Medicare Advantage plans | 96.3% | 0% | 0% |
Medicaid, including state-run and managed care plans | 99.9% | 8.1% | 0.92% |
Source: Managed Markets Insight & Technology, LLC™, as of December 13, 2024. (See methodology below.)
Tips if your medication isn’t covered by insurance
Here are a few options if your health insurance doesn’t cover metronidazole:
If your prescription isn’t covered, ask your prescriber about a less costly option that may meet your needs.
Discuss switching to a lower-cost generic if you were prescribed a brand-name version of metronidazole.
Request an exception from your prescription medication formulary. This may require you to do step therapy or get prior authorization to be covered.
If you request a formulary exception and are denied coverage, file an appeal with your plan.
Use a GoodRx coupon.
During your next open enrollment period, weigh your options. You may be eligible for another plan with better prescription medication coverage.
How much does metronidazole cost without insurance?
Metronidazole is considered a low-cost generic medication. Without insurance, what you pay for metronidazole depends on several factors, including your:
Specific pharmacy
Geographic location
Fill amount
Prescribed dosage
Also, you’ll likely pay more if you receive IV metronidazole because your medication must be administered by a healthcare professional. Whether you have the IV drug administered at a hospital or a clinic would also likely affect the cost.
The following table shows what you might pay for different quantities, doses, and forms of metronidazole.
Metronidazole Costs
Metronidazole forms and doses | Average cash price |
|---|---|
Capsule (375 mg), 14 capsules | |
Cream (45 g of 0.75%), 1 tube | |
Lotion (59 mL of 0.75%), 1 bottle | |
Tablets (250 mg), 14 tablets | |
Tablets (500 mg), 14 tablets | |
Topical gel (45 g of 0.75%), 1 tube | |
Topical gel (55 g of 1%), 1 pump | |
Topical gel (60 g of 1%), 1 tube | |
Vaginal gel (70 g of 0.75%), 1 package |
Metronidazole is also available as brand-name Flagyl in its oral capsule form and as Nuvessa and Vandazole for the brand-name vaginal gel. Brand-name medications cost more than generics.
Ways to save on metronidazole without insurance
Here are four ways to save on metronidazole without insurance.
1. Use a GoodRx coupon
With a GoodRx coupon, you may be able to pay a lower price for your metronidazole prescription. For example, you could get 14 tablets of metronidazole 500 mg for as little as $5.33 at certain pharmacies with a free GoodRx coupon.
Here’s how to get a coupon:
Visit www.goodrx.com, or download the GoodRx app on your mobile device.
Type “metronidazole” in the search field.
Select the correct quantity, dosage type, and location.
Choose to receive your coupon via email or text, or print it out.
Show the coupon at the pharmacy when you pick up your medication. If you present the coupon to your pharmacy staff early in the filling process, such as when you first receive your prescription, this could prevent delays at the pickup counter.
Since the injectable form of metronidazole is administered in the office of a healthcare professional, you cannot use a GoodRx coupon for that version of the medication.
2. Compare prices at various pharmacies
With GoodRx, you can easily compare costs at different pharmacies to find the best metronidazole price in your area.
3. Ask your prescriber about alternatives
If you’re concerned about the cost of metronidazole, speak with a pharmacist or your prescriber. There may be another medication that adequately treats your condition and fits your budget.
4. Use tax-advantaged healthcare funds
If you have a flexible spending account, a health savings account, or a health reimbursement arrangement, consider using those funds to buy your medication. This can lower your out-of-pocket costs through tax savings.
The bottom line
Metronidazole (Flagyl) is a low-cost generic antibiotic used to treat many bacterial infections, including skin infections, lower respiratory tract infections, and bacterial vaginosis.
The cost of metronidazole depends on the pharmacy, location, quantity, dosage form, your insurance coverage, and other factors. If you don’t have insurance, a typical course of 14 tablets of 500 mg metronidazole tablets could cost as little as $5.33 with a GoodRx coupon. Other forms, such as topical or vaginal creams and gels, may cost more or less. The IV form of the medication could cost more since it must be administered by a healthcare professional.
If your insurance doesn’t cover metronidazole, another way to save money is to use a GoodRx coupon. You could also use tax-advantaged funds from a healthcare account or compare prices at several pharmacies. Ask your prescriber if you can use an alternative medication that costs less.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of December 2024.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including the ACA, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
Bausch Health US. (2020). Noritate- metronidazole cream [package insert].
Crader, M. F., et al. (2023). Preoperative antibiotic prophylaxis. StatPearls.
Exeltis USA. (2023). Nuvessa- metronidazole gel [package insert].
Galderma Laboratories. (2023). Metrogel - metronidazole gel [package insert].
Hospira. (2024). Metronidazole- metronidazole injection, solution [package insert].
Medicaid.gov. (n.d.). Managed care. Centers for Medicare & Medicaid Services.
MedlinePlus. (2024). Bacterial infections.
National Toxicology Program. (n.d.). Metronidazole. U.S. Department of Health and Human Services.
Pfizer Laboratories Div Pfizer. (2024). Flagyl- metronidazole capsule [package insert].
RPK Pharmaceuticals. (2023). Vandazole- metronidazole gel [package insert].
Samuelson, J. (1999). Why metronidazole is active against both bacteria and parasites. Antimicrobial Agents and Chemotherapy.
Saptalis Pharmaceuticals. (2024). Likmez (metronidazole) oral suspension [package insert].
Weir, C. B., et al. (2023). Metronidazole. StatPearls.
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