Zidoval (Metronidazole gel)

Zidoval is a vaginal gel used to treat an infection of the vagina called bacterial vaginosis.

Bacterial vaginosis occurs when the balance of natural bacteria in your vagina is disrupted. While BV is not a sexually transmitted infection (STI), it can increase your risk of getting an STI.

The most common symptom of BV is a change to your vaginal discharge. Your vaginal discharge can:

• have a strong fishy odour, especially after having sex
• appear watery, thin or grey

Half of women with an overgrowth of bacteria do not have any symptoms, and this doesn’t necessarily need treatment.

You may find it confusing to figure out whether you have thrush (a fungal infection) or BV. You can read our bacterial vaginosis guide to find out more.

Zidoval gel contains the antibiotic metronidazole. Metronidazole directly treats the infection to get rid of the overgrowth of bacteria.

If you have BV and are pregnant or think you might be pregnant, speak to your doctor. In most cases BV does not cause problems in pregnancy but there can be a small risk of complications such as premature birth.

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.

Zidoval works by correcting the imbalance of bacteria in your vagina.

Your vagina naturally has some bacteria that maintain its health. When this balance is disrupted, it can cause certain types of bacteria to grow more than others.

The active ingredient metronidazole targets the overgrowth of bacteria that causes bacterial vaginosis.

By applying Zidoval into your vagina, the antibiotic will treat the infection directly by killing the overgrown bacteria.

Zidoval is effective in treating the cause of bacterial vaginosis. You should notice an improvement in your symptoms after a couple of days. Even if you see an improvement, you should finish the course to make sure the infection is completely treated.

If your symptoms have not improved after 5 days of treatment with Zidoval, speak to your doctor.

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.

You can try metronidazole tablets that are taken by mouth. Metronidazole tablets are usually taken twice a day for 7 days.

You can also request Dalacin cream from ZAVA. Dalacin cream contains an antibiotic called clindamycin. Clindamycin may be suitable for you if you are unable to take metronidazole.

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

Some women find BV recurs after treatment. If this happens to you, speak to your doctor. You may be able to use Zidoval again or need to use a different treatment for bacterial vaginosis.