Metronidazole vaginal gel is a prescription medication used to treat an infection of the vagina called bacterial vaginosis. It comes as prefilled vaginal applicators that are good for one-time use. Your dosing and length of treatment for metronidazole vaginal gel depend on your condition and what brand of metronidazole vaginal gel you're using. But typically, treatment lasts around 5 days.
Bacterial vaginosis (BV)
Metronidazole vaginal gel is a nitroimidazole antibiotic. It works by damaging the DNA in bacteria and stopping the growth of bacteria in the vagina.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Cramps
dizziness or lightheadedness
dryness of the mouth
feeling of a furry tongue
headache
loss of appetite
metallic taste or other change in taste sensation
mild skin dryness and burning
skin irritation
temporary skin redness
vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Considered a first-choice treatment option for bacterial vaginosis
Brand Nuvessa treats BV in a single dose
Less side effects compared to oral metronidazole (Flagyl)
Available as a lower-cost generic (0.75% strength only)
Should avoid alcohol
Not recommended for use while breastfeeding
Need to avoid sexual intercourse and use of vaginal products during treatment
Requires a prescription
Before using metronidazole vaginal gel, read the instruction guide to better understand how to use it properly. Metronidazole vaginal gel should be inserted and applied vaginally while lying on your back with your knees bent or in any comfortable position.
If you're using metronidazole vaginal gel once a day, insert the dose at bedtime.
While using metronidazole vaginal gel, don't have sex or use tampons or other vaginal products until you've finished the treatment.
If you get metronidazole vaginal gel in your eyes, rinse your eyes with cool tap water and call your provider because it can cause burning.
Contact your provider if you experience vaginal irritation after using metronidazole vaginal gel. Your provider might need prescribe a different medication for you.
Metronidazole vaginal gel comes with one-time use, prefilled applicators, so throw away each applicator after using it.
Let your provider know all of the medications you're taking so they can check for interactions with metronidazole vaginal gel.
It isn't known if metronidazole vaginal gel is safe to use during pregnancy. If you're pregnant or thinking of becoming pregnant, speak to your provider before using metronidazole vaginal gel.
Metronidazole vaginal gel can pass into breast milk. If you're breastfeeding, discuss with your provider other ways to feed your baby during treatment with this medication. They might recommend that you pump and discard breastmilk while you're using metronidazole vaginal gel and for 2 days after your last dose.
Store the medication in a closed container at room temperature, away from heat, moisture, and direct light. Don't freeze metronidazole vaginal gel because this could damage the medication.
Metronidazole vaginal gel can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Using metronidazole vaginal gel can raise your risk for vaginal yeast infections. This is because the medication can also affect the good bacteria in your vagina that usually keep fungi from overgrowing. When fungi overgrow in your vagina, it can sometimes result in a yeast infection. There are many different over-the-counter and prescription treatments available for vaginal yeast infections. Let your provider know if you have redness, pain, or burning around your vagina, or if you have thick, white vaginal discharge. These could be signs of a vaginal yeast infection, and you might need treatment for it.
Risk factors: Use of oral and IV metronidazole | History of nervous system problems
Certain nervous system problems (e.g. seizures, numbness and tingling of the hands and feet, damage to the eye) have been reported in people who use oral or intravenous (IV) metronidazole. Let your provider know if you have a history of nervous system problems before using metronidazole vaginal gel.
Animal studies show that there's a link between oral metronidazole and cancer. There hasn't been any cancer studies with metronidazole vaginal gel, but keep in mind that it gets absorbed much less in your body compared to the oral version of this medication. Make sure you use metronidazole vaginal gel exactly as prescribed to you. If you have concerns about the possible risk of cancer, speak with your provider.
Nuvessa (metronidazole 1.3%) vaginal gel: The typical dose is to insert 1 applicatorful into the vagina at bedtime as a one-time dose.
Vandazole (metronidazole 0.75%) vaginal gel: The typical dose is to insert 1 applicatorful into the vagina daily at bedtime for 5 days.
Generic metronidazole 0.75% vaginal gel: The typical dose is to insert 1 applicatorful into the vagina once or twice daily for 5 days.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Allergy to parabens
Have taken disulfiram (Antabuse) in the past 2 weeks
Alcohol use
Vaginal bacterial infections (bacterial vaginosis)
Trichomoniasis ("trich")
Giardiasis (parasitic gut infection)
Amebiasis (parasitic gut infection)
Bacterial vaginosis (BV)
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