Metronidazole

Metronidazole is a type of antibiotic. It can be used for a number of different conditions when recommended by a doctor, such as:

• skin infections
• infections in the mouth, including dental abscesses
• preventing infections, for example, if you are having surgery
• stomach ulcers, as part of a regime with other medications
• some complications of Crohn’s disease

At ZAVA, we offer metronidazole to treat bacterial vaginosis (BV), a condition that is caused by an imbalance in the different types of naturally occurring bacteria found in your vagina. We also offer metronidazole for treating trichomoniasis and metronidazole gel for treating rosacea.

Metronidazole is a broad-spectrum antibiotic that can treat a wide range of bacterial infections, including the ones that cause bacterial vaginosis. It does this by killing the bacteria causing the infection and preventing it from growing and spreading.

How long does metronidazole take to work on bacterial vaginosis?

Your bacterial vaginosis symptoms should get better by the end of the 7-day course of metronidazole, or within 1 week of taking the single-dose treatment. If you still have symptoms such as abnormal vaginal discharge after this time, it’s best to speak to a doctor to make sure you don’t have another type of infection.

You should take metronidazole tablets with or after food and swallow the tablet(s) whole with a full glass of water.

You should not crush or chew a metronidazole tablet before you take it.

Metronidazole can be taken either as a:

• 7-day course of tablets – 1 tablet is taken twice a day for 7 days
• single dose treatment – 5 tablets are taken all at once as a single dose

Both courses of treatment are effective for treating bacterial vaginosis. The single-dose treatment may cause more side effects as it is a high dose taken all at once.

Avoid drinking alcohol while you are taking metronidazole and for the 2 days after you have finished your course of treatment. Alcohol can react with metronidazole, causing some severe side effects such as feeling sick, vomiting, palpitations, flushes and headaches.

Remember to continue taking the full treatment course of metronidazole, even if you start to feel better after taking a few tablets.

How effective is metronidazole at clearing up bacterial vaginosis?

Metronidazole is highly effective in clearing up bacterial vaginosis and works in up to 90% of cases. Metronidazole is the first-line treatment for bacterial vaginosis because it is so effective, and clears up the infection within a week.

Sometimes bacterial vaginosis may come back after a few months. If this happens, your doctor may recommend metronidazole for longer than 7 days. They will talk to you about any potential triggers that may be causing the infection to come back.

You can get a prescription for metronidazole online from ZAVA to treat bacterial vaginosis, provided it is approved by one of our doctors.

To get started, fill out our simple online questionnaire. Our doctors will review this to make sure metronidazole is the right treatment for you. We will then post the medicines to your preferred address or you can collect them from your local post office.

Is metronidazole available over the counter?

Metronidazole is not available to buy over the counter. It is a prescription-only medication, and a doctor needs to check if you need to take it before they prescribe it for you.

You can take metronidazole to treat bacterial vaginosis in 2 different ways. You should either take:

• 5 of the 400mg metronidazole tablets together at the same time as a 2000mg dose, or
• 1 metronidazole 400mg tablet twice a day for 7 days

Both courses of treatment are effective for treating bacterial vaginosis. The single-dose treatment may cause more side effects as it is a high dose taken all at once.

Common side effects

There are very few common side effects of metronidazole.

You may feel sick after you take your first dose, but this should clear up within a few hours. Make sure you take metronidazole after food as this will reduce the chance of feeling sick.

Uncommon and rare side effects

Very rare side effects of metronidazole include:

• feeling sleepy or dizzy
• headache
• visual problems, such as blurred vision
• darkening of your urine

Stop taking the tablets and contact 999 immediately if you experience:

• swelling of your hands, feet, lips or throat
• difficulty breathing
• rashes with blisters or bleeding around your eyes, nose, mouth, lips or genitals (Steven-Johnson Syndrome)
• stiff neck, headache, feeling confused or developing a fever (encephalopathy)

You can take metronidazole if this has been prescribed for you by a doctor. Some people are not able to use metronidazole because of allergies or other health conditions. Your doctor will assess your suitability before prescribing.

You should not take metronidazole if you have:

• an allergy to metronidazole
• a liver problem
• a need for dialysis for your kidneys
• a disease that affects your nerves
• chronic alcoholism and will not be able to stop drinking alcohol while using it

Speak to your doctor if you’re affected by any of these conditions. They may prescribe an alternative antibiotic to treat your infection.

You should speak to your doctor if you’re taking any of these medicines:

• blood-thinning medicines called anticoagulants, such as warfarin or rivaroxaban
• lithium
• epilepsy treatment, such as phenytoin or phenobarbital
• cancer treatment, such as 5-fluorouracil or busulfan
• ciclosporin to prevent organ rejection after a transplant
• disulfiram to treat alcohol dependence

These medicines may interact with metronidazole and stop it from working properly.

There are alternative ways to treat bacterial vaginosis. If you prefer a treatment that will work directly where the infection is, you can choose an antibiotic cream or vaginal gel. Alternative treatments to metronidazole tablets include:

• Zidoval Gel – A branded metronidazole vaginal gel that is inserted into your vagina with an applicator.
• Dalacin Cream – A branded clindamycin cream, a different antibiotic than metronidazole that works in the same way. This is also inserted directly into your vagina with an applicator.

BV creams and gels are used at night before bed, so you’ll be lying down after using them.

You can also help relieve your symptoms by:

• having showers and not baths
• using only water and unperfumed soap to wash around your vaginal area
• avoiding vaginal washes, douches or deodorants, as these can irritate the area
• using a gentle detergent for sensitive skin to wash your underwear

Stopping smoking can also reduce the risk of recurring bacterial vaginosis. Speak to your pharmacist or doctor to help you quit smoking.