Zidoval (Metronidazole Gel)

Zidoval is a prescription-only antibiotic gel that is inserted into the vagina to stop the growth of bacteria that causes bacterial vaginosis. It contains the active ingredient metronidazole, which works by reducing the growth of harmful bacteria in your vagina. This helps to relieve symptoms of bacterial vaginosis such as unusual discharge, fishy vaginal odour, and itchiness.

How long does Zidoval take to work?

Zidoval will start to work as soon as you use it with most people feeling some relief from their bacterial vaginosis symptoms within 2 to 3 days. However, even if you do feel better after a few days, it is important to finish your full 5-day course of treatment as prescribed to stop the infection coming back.

How effective is Zidoval?

Zidoval gel is an effective alternative treatment for bacterial vaginosis: clinical research shows that metronidazole gel (Zivodal) cured up to 91% of bacterial vaginosis infections in a crossover trial.

Zidoval gel use has been associated with significant increases in Lactobacilli, important bacteria that help to maintain a healthy balance in the vagina and prevent infections.

Zidoval gel is an antibiotic that works by targeting and killing the harmful bacteria in the vagina that causes bacterial vaginosis.. Zidoval is applied directly inside the vagina and kills the bacteria at the site of infection, helping to effectively relieve unpleasant symptoms of BV.

To use Zidoval, insert a single 5g dose of gel into your vagina using an applicator once a day. You should only use Zidoval gel in your vagina with the applicators provided.

The usual course of treatment is for 5 days. It’s better to apply the gel at bedtime to give the medicine time to work.

Always wash your hands before and after using Zidoval gel. Make sure you use a new applicator for each dose and dispose of any used applicators.

To prepare an applicator:

• take the cap off the tube of gel
• use the pointed end of the cap to pierce the sealed end of the tube
• place the open end of the applicator onto the tube of gel and screw it into place
• fill the applicator by squeezing the tube slowly from the bottom
• the plunger will stop moving when the applicator has filled at 5g
• unscrew the applicator from the tube
• replace the cap on the tube of gel

To apply the gel, it might be easier to lie down and bend your knees for ease of application.

• insert the applicator gently into your vagina as far as is comfortable
• push the plunger slowly into the applicator until the plunger stops
• remove the applicator from your vagina and throw it away

If you forget to use a dose of Zidoval, do not apply a double dose. Apply Zidoval the following day at your regular dosing time.

Make sure you complete the 5 day course. This is important to ensure the infection has cleared completely.

Try to avoid having sex if you have BV and especially when you are using Zidoval.

You can get Zidoval from most UK pharmacies with a prescription from a doctor. You can request Zidoval gel from trusted online doctor services like ZAVA and it may be available on the NHS at your local GP surgery.

Can I buy Zidoval online?

Yes, you can buy Zidoval online. It is a prescription-only medication, so you will need a prescription from a doctor to obtain it. Zidoval is available online from ZAVA.

Getting Zidoval gel with a prescription from ZAVA is quick and convenient, without the need for a face-to-face appointment. To request Zidoval gel, you’ll simply need to:

1. Complete a short online medical questionnaire – Share details about your health so our doctors can ensure Zidoval is right for you.
2. Order and pay online – Sign in or create your ZAVA account, select Zidoval, and securely make your payment.
3. Doctor review and approval – A UK-licensed doctor will check your health information and approve your prescription request if Zidoval is safe and appropriate for you.
4. Fast and discreet delivery – If approved, Zidoval will be delivered discreetly to your home or a local post office for collection.

Can I buy Zidoval over the counter?

No, you will need a prescription from a doctor to buy Zidoval.

Can I get Zidoval on the NHS?

Yes, it may be possible to get Zidoval on the NHS, but you will need to make an appointment with your GP so they can make sure it is safe and suitable for you.

You may experience some side effects when using Zidoval gel. These will usually disappear after a few hours.

Common side effects include:

• headaches
• dizziness
• stomach cramps
• being sick
• an unpleasant taste in your mouth
• an unusual feeling on your tongue
• dry or itchy skin
• vaginal thrush (candidiasis)
• vaginal discharge
• discomfort around the pelvis
• decrease in appetite

If you cannot tolerate the side effects, speak to your doctor or pharmacist before stopping treatment.

Uncommon side effects include:

• nausea
• diarrhoea or constipation
• feeling irritable or depressed
• tiredness
• difficulty sleeping
• an unusual feeling in the fingers and toes
• bloated stomach
• thirst or dry mouth
• dark urine
• urinary tract infections
• swelling of the outside of your vagina (vulva)
• changes to your periods such as bleeding in between periods or discomfort when you have your period

If you notice the signs of a urinary tract infection, speak to your doctor. This includes a burning sensation when you pee, or needing to pee more frequently.

You can find further information on the side effects of Zidoval in the patient information leaflet.

Zidoval is suitable for women over the age of 18 with symptoms of bacterial vaginosis.

You should not use Zidoval if you have an allergy to:

• metronidazole or any of the other ingredients found in Zidoval
• any similar nitroimidazole antibacterials
• parabens (a preservative)

Before using Zidoval, you should speak to your doctor if you:

• are pregnant or think you might be pregnant
• are breastfeeding
• are under 18 or over 65
• have ever had any blood problems or a disease affecting your blood
• think you may have vaginal thrush
• are currently on your period

You should also let your doctor or nurse know if you are using Zidoval and are having any blood tests. Zidoval can interfere with some blood test results.

You should only use Zidoval for as long as your doctor recommends.

Zidoval can interact with other medications you might be taking. Let your doctor or pharmacist know if you are taking other medicines including over the counter products.

Zidoval can interact with the following medicines:

• blood thinning medicines such as warfarin or acenocoumarol
• lithium, used to treat mental illness
• ciclosporin, a medicine that suppresses the immune system
• 5-fluorouracil which is used to treat some skin problems and some cancers

Alcohol can interact with metronidazole. It’s best to avoid drinking alcohol while using Zidoval and for 2 days after finishing the course. Drinking alcohol while using Zidoval can make you feel sick, confused or have a strong headache.

There are other ways to treat bacterial vaginosis if Zidoval isn't suitable for you.

Alternatives to Zidoval gel include:

Metronidazole tablets

Metronidazole tablets are an oral antibiotic that can be used to treat bacterial vaginosis, and contain the same active ingredient as Zidoval gel. Unlike Zidoval gel which must be applied directly to the vagina, metronidazole tablets are taken orally. twice a day for 7 days. They are up to 95% effective for those who take them.

Dalacin cream

Dalacin cream is an antibiotic vaginal cream that contains clindamycin. It works similarly to Zidoval gel, and may be suitable for you if you are unable to take metronidazole. Dalacin cream is applied in the same way as Zidoval, but is taken for 7 days instead of 5 days. Studies have shown that it successfully treats 75% of cases of BV.

If you’ve got symptoms of BV, there are a few self care tips you can try to help speed up recovery:

• wash your genitals with only water and a soap-free product if needed
• dry the area thoroughly, but pat dry and avoid rubbing
• avoid using any vaginal hygiene products such as deodorants, sprays or douches
• try to avoid sex until the infection has cleared up
• wear loose fitting trousers or cotton underwear