metronidazole gel, Metrogel, Metrocream, Metrolotion, Metrogel Vaginal, Vandazole
Omudhome Ogbru, PharmD
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:
GENERIC NAME: metronidazole gel/cream/lotion
BRAND NAME: Metrogel, Metrocream, Metrolotion, Metrogel Vaginal, Vandazole
DRUG CLASS AND MECHANISM: Metronidazole is a man-made drug that is effective against certain bacteria and parasites (protozoa). The topical forms of metronidazole are used for treating vaginal infections with protozoa such as Trichomonas vaginalis, ameba, and Giardia and also is effective against anaerobic bacterial infections. (Anaerobic bacteria are a type of bacteria that can grow without the presence of oxygen.) Metronidazole gel also is used for treating rosacea, a type of skin rash. Metronidazole was approved by the FDA in 1963.
GENERIC AVAILABLE: Yes
PREPARATIONS: Topical gel (0.75%, 1%), cream or lotion (0.75%): Vaginal gel (0.75%)
STORAGE: Topical forms of metronidazole should be stored at room temperature, 15-30 C (59-86 F).
PRESCRIBED FOR: Metronidazole topical gel, cream, and lotion are used for treating rosacea. Metronidazole vaginal gel is used for the treatment of bacterial vaginosis (also referred to as Hemophilus vaginitis, Gardnerella vaginitis, or nonspecific vaginitis), a bacterial infection of the vagina. It is not effective in treating another common vaginal infection, Candidal vaginosis ("yeast infection").
DOSING: To treat rosacea, a thin film of metronidazole gel should be rubbed on affected areas once or twice daily. The usual dose of vaginal metronidazole gel is one applicator full (containing 37.5mg of metronidazole) intravaginally twice daily for five days. It should be applied once in the morning and once in the evening.
DRUG INTERACTIONS: Alcoholic beverages should not be consumed while being treated with metronidazole vaginal gel since this may result in headache, nausea, weakness, confusion, and even psychosis. This is the same reaction (disulfiram reaction) that occurs in alcoholics who drink alcohol while taking disulfiram (Antabuse), a drug used to discourage alcoholics from drinking alcohol.
Oral metronidazole interacts with warfarin (Coumadin), increasing the latter's blood-thinning properties. Little metronidazole is absorbed topically or from the vagina, and it is not known if the low blood levels achieved with topical or vaginal metronidazole can result in this interaction.
PREGNANCY: Animal studies have not demonstrated a risk to the fetus, but there are no adequate studies in pregnant women.
NURSING MOTHERS: Orally administered metronidazole is secreted in breast milk in concentrations that are similar to concentrations in the mother's blood. Although metronidazole concentration in blood after vaginal or topical administration is small, potential effects on the infant still should be considered.
SIDE EFFECTS: Adverse reactions include skin irritation, allergic reaction, and candida vaginitis during or shortly after therapy, vaginal vulvar itching, gastrointestinal cramps or pain, nausea, and metallic taste.
Reference: FDA Prescribing Information
Last Editorial Review: 7/12/2010
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