metronidazole, Flagyl

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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DRUG INTERACTIONS:

  • Alcohol should be avoided because metronidazole and alcohol together can cause severe nausea, vomiting, cramps, flushing, and headache.
  • Metronidazole can increase the blood thinning effects of warfarin (Coumadin) and increase the risk of bleeding probably by reducing the breakdown of warfarin.
  • Cimetidine (Tagamet) increases blood levels of metronidazole while cholestyramine (Questran, Questran Light) reduces blood levels of metronidazole by reducing its absorption.
  • Metronidazole should not be combined with amprenavir (Agenerase) for treating human immunodeficiency disease (infection with HIV) because amprenavir contains propylene glycol.
  •  Metronidazole blocks the breakdown of propylene glycol in the liver leading to accumulation of propylene glycol in blood. Accumulation of propylene glycol could cause seizures, increased heart rate, and lead to kidney failure.
  • Metronidazole increases the blood levels of carbamazepine (Tegretol, Tegretol XR, Equetro, Carbatrol), lithium (Eskalith, Lithobid) and cyclosporine though unknown mechanisms. Serious reactions may occur if these drugs are taken with metronidazole.

PREGNANCY: Metronidazole is not used in early pregnancy because of potential adverse effects on the fetus.

NURSING MOTHERS: Metronidazole is excreted in breast milk. Females who are nursing, because of potential adverse effects on the newborn, should not use metronidazole.

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 12/17/2014

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