Metronidazole (Flagyl®)

The condition used to be referred to as Gardnerella vaginitis; because Gardnerella is a type of bacteria that sometimes causes the infection. A vaginal pH greater than 4. A higher pH level means that the vagina is less acidic — and less able to keep bacteria under control.

And yet studies find that as many as one-third of women entering obstetric clinics have a BV infection. Patients had either a genotypically HLA-identical donor, a partially HLA-matched extended family donor, or a volunteer matched unrelated donor according to the German consensus criteria. There may be burning, irritation, redness, and swelling of the vulva. What difference does it make whether I have BV or a yeast infection? Taking other medicines Tell your doctor if you are taking any other medicines, including medicines you buy without prescription from a pharmacy, supermarket or health food shop. Metronidazole vaginal is often given as a single dose.

  • If your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist.
  • The manufacturer's leaflet will give you more information about metronidazole, and it will also explain how to use the gel and applicator.
  • Metronidazole may be taken orally with or without food.
  • Follow-up may be needed during the pregnancy.
  • If you have a painful rash that spreads and blisters or shedding of the top layer of your skin, call 911 or go to the nearest emergency room immediately.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur.  Notify the prescribing doctor if you become pregnant while you are taking Flagyl. Treating vaginal infections The treatment of your vaginal infection will differ depending on what type of infection you have. Metronidazole may also cause your urine to become dark which goes away when you stop using the medicine. Unfortunately, our website is currently unavailable in most European countries. Lie on your side and raise your knee to your chest. Especially for pregnant women who are high-risk for preterm labor, only oral medicines are used to treat bacterial vaginosis. Your doctor will decide the right dose for you.

For more information, please see the MotherToBaby fact sheet Paternal Exposures and Pregnancy at https: Metronidazole is effective in vitro against several species of anaerobic bacteria, particularly Bacteroides fragilis and other species of bacteroides, and other species such as fusobacteria, eubacteria, clostridia, and anaerobic streptococci. Cultures are helpful in women with recurrent or complicated vulvovaginal candidiasis, because species other than Candida albicans (e. )This information should not be used for diagnosing or treating a health problem or disease, or prescribing any medication.

Clindamycin (Cleocin, Clindesse, others). If you have trouble breathing, call 911. This agent is effective and generally well tolerated,42 but has not been approved by the U. You may report side effects to FDA at 1-800-FDA-1088. Using alcohol or tobacco with certain medicines may also cause interactions to occur. A disease that is spread by sexual contact, including chlamydial infection, gonorrhea, genital warts, herpes, syphilis, and infection with human immunodeficiency virus (HIV), the cause of acquired immunodeficiency syndrome (AIDS). If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

  • A change in the normal balance can allow either yeast or bacteria to increase and result in vaginitis.
  • The dryness isn't permanent, of course, but it can be uncomfortable.
  • Treatment with topical estrogen is effective.
  • Metronidazole is commonly used to treat certain types of vaginal infections.
  • A fishy odor on the whiff test suggests bacterial vaginosis.


Flagyl or any other nitroimidazoles any of the ingredients listed at the end of this leaflet Some symptoms of an allergic reaction include skin rash, itching, shortness of breath or swelling of the face, lips or tongue, which may cause difficulty in swallowing or breathing. However, elderly patients are more likely to have unwanted effects and age-related liver problems, which may require caution and an adjustment in the dose for patients receiving metronidazole. Also, if you're using intravaginal forms of clindamycin, the oil-based medication may weaken latex condoms or diaphragms. In JS Berek, ed. After a few days of treatment, most people start to feel better, but that does not mean the infection is entirely gone. The possibility of uncontrolled diabetes mellitus or immunodeficiency should be considered in women with recurrent vulvovaginal candidiasis.

  • But changes in the balance of the different kinds of bacteria in your vagina can lead to bacterial vaginosis (BV).
  • Do not douche.
  • This medicine may also cause alcoholic beverages to taste different.
  • Cackovic suggests that part of this may be that simply having more sexual partners increases your risk for both BV and STDs in general.
  • A UTI is the overgrowth of bacteria in the bladder.
  • Your doctor can diagnose bacterial vaginosis based on your history of symptoms, a vaginal exam , and a sample of the vaginal discharge.
  • Half of all African-American women aged 14 to 49 in the United States have BV.


Metronidazole vaginal may also be used for purposes not listed in this medication guide. If you think you have BV and you have a male sexual partner, there is no need for your partner to get tested or seek medical treatment. Read more of our Sexual Health Series: Female partners may need treatment, however. However, you might need to use the medicine for 5 nights in a row. Single colonies were identified by conventional biochemical tests. Atrophic vaginitis results from estrogen deficiency. If you have ever had an allergic reaction to a medicine or to a skin preparation.

Planning to have a hysterectomy or surgical abortion.

Dose advice: How to use Flagyl

Flagyl does pass into breast milk and could affect a nursing infant. It is also used to prevent or treat certain infections that may occur during surgery. How long to take/use it For treating infection, Flagyl tablets and suspension are usually taken for 7 days, however, your doctor may decide to reduce or extend your treatment.

You may need to repeat this dosage several weeks later. Once this imbalance occurs, the body has difficulty getting back to normal. Children—Use and dose must be determined by your doctor.

The main symptom of thrush is a white vaginal discharge that resembles cottage cheese. As temperatures drop, the number of people sneezing, sniffling, and coughing rises. Sexual intercourse during treatment for a vaginal infection is not recommended. Be sure to make and go to all appointments, and call your doctor if you are having problems. Tinidazole or Tindamax – This is an oral medication. In most cases, treatment works in time. 75% gel (MetroGel-Vaginal) 5 g intravaginally once daily for 5 days No* Clindamycin 2% vaginal cream (Cleocin) 5 g intravaginally once daily at bedtime for 7 days No* Alternative regimens Metronidazole tablets 2 g orally in a single dose No† Clindamycin tablets 300 mg orally twice daily for 7 days 300 mg twice daily for 7 days Clindamycin ovules 100 g intravaginally once daily at bedtime for 3 days No† TABLE 2 Recommended Treatments for Bacterial Vaginosis Agents Dosage Use in pregnancy Recommended regimens Metronidazole tablets (Flagyl) 500 mg orally twice daily for 7 days 250 mg three times daily for 7 days Metronidazole 0.

Oral Medicines

Even among health professionals, the diagnosis is difficult to make based only on clinical signs and symptoms. Bacterial vaginosis (BV) is a condition in which the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain bacteria. Are pregnant and have symptoms. Treatment also may reduce the risk of human immunodeficiency virus (HIV) transmission. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed. How do I know if I need to see my health care professional?

Vaginal Medicines

The bacteria that cause bacterial vaginosis occur naturally in the vagina. Do not leave your medicine in the car or on windowsills. Do you have trouble giving your dog medication? The suppository takes about one hour to be completely absorbed and do its work.

According to guidelines from the Centers for Disease Control and Prevention (CDC),10 treatment of bacterial vaginosis is indicated to reduce symptoms and prevent infectious complications associated with pregnancy termination and hysterectomy. Bornstein J (2020). It’s not very common, but a man can get a yeast infection. Read the instructions provided with it and follow these steps: Tell your doctor as soon as possible if you have any problems while taking/using Flagyl, even if you do not think the problem is connected with the medicine or is not listed here. Occasionally, T. This information should not take the place of medical care and advice from your health care provider. Healing a candida overgrowth naturally, some of these remedies use ingredients that you might already have in your home. How do I treat BV?

Related Health

BV is widespread but its prevalence varies widely. Home remedies for bacterial vaginosis are available to treat this condition. Severe allergic reaction: If you think that you may have BV and want to know how to get rid of bacterial vaginosis, you may want to consider seeing your gynecologist or another medical professional. How to treat a penile yeast infection: 11 steps (with pictures). If this is the case, the patient should be seen when symptoms are flaring. If you do get it in your eyes, wash them with cool water and contact your doctor.

Bacterial vaginosis, or BV, is the most common vaginal infection in women ages 15 to 44. Up to 75% of women will experience an inflammatory condition of the vagina at some point in their lives. Side effects are also listed in the information that comes with your medicine. So yeah, you’re not alone. If bacterial vaginosis was a simple infection, treatment with metronidazole or clindamycin should be very effective. For some conditions, metronidazole is the only drug of choice and it is especially important to treat vaginal infections during pregnancy. Current recommendations are for a 7-day course of antifungal topical therapy.

Why does excessive douching increase the risk of developing BV? This is because dairy lactobacillus is not the kind of bacteria that normally live in the vagina. Normal vaginal pH is somewhere between 3. Your doctor may replace your suppositories with oral tablets or suspension as soon as possible. Make sure you use all of the medicine the way your doctor says, even if your symptoms go away sooner. This is not an indication of a security issue such as a virus or attack.

  • 9 If patients relapse from this regimen, then the vaginitis should be retreated with fluconazole 150 mg orally every 72 hours for 3 doses, followed by fluconazole 150 mg weekly for 12 months.
  • Stewart said, “Candida does what it wishes,” but other causes of vaginitis can be ruled out.
  • Do not store Flagyl or any other medicine in the bathroom or near a sink.

Medically Reviewed by Jack D. Sobel, MD

A very serious allergic reaction to this drug is rare. In addition, vaginal discharge may be a symptom of more serious gynecological diseases and should be evaluated through a professional examination. The manufacturer recommends that if you have been taking disulfiram, you should wait two weeks before starting metronidazole. 5, however, doesn't positively rule in an infection. This means condoms and diaphragms may break, and you may not be protected from sexually transmitted infections (STIs) or pregnancy.

The risk of meningitis typically goes away after treatment with metronidazole is stopped. Therefore, the current recommendations against screening and treating asymptomatic pregnant women may be reevaluated. Oral antibiotics have been used to treat vaginal infections during pregnancy, especially high-risk pregnancies (e. )It's a chronic problem that isn't going to go away.

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Because these are powerful medications with known side effects, it is important to establish the diagnosis before starting treatment. Lube is more often associated with yeast infections, but ones that stay in the vagina for longer can lead to bacterial vaginosis, too. If you take/use too much (overdose) Immediately telephone your doctor or Poisons Information Centre (telephone 131126) or go to Accident and Emergency at your nearest hospital if you think that you, or anyone else, has taken/used too much Flagyl, even if there are no signs of discomfort or poisoning. “This might help because it works more locally rather than drying things up all over. Complete the new medication information form (PDF)(What is a PDF document?) The gold standards for diagnosis of a vulvovaginal disorder are the history and physical, pH and saline wet mount, a whiff test and a biopsy (if indicated), Dr. Exams and Tests Your doctor may test you for bacterial vaginosis if you: Adults—Dose is based on body weight and must be determined by your doctor.

Once your doc determines you indeed have a bacterial infection, he or she will prescribe you antibiotics to knock it out. Something is up with your vagina: The most common therapies are metronidazole (Flagyl), and clindamycin (Cleocin).

Microbiologic Analysis

The OWH helpline does not provide medical advice. However, family physicians should be aware that one recent study24 demonstrated a significant reduction in spontaneous preterm birth and late miscarriage after treatment with oral clindamycin, 300 mg twice daily for five days, in women with asymptomatic bacterial vaginosis who were at 12 to 20 weeks of gestation. Avoid alcohol or propylene glycol for at least 3 days after you stop taking metronidazole. What to think about If your doctor finds other problems during the exam, such as a possible sexually transmitted infection (STI), appropriate treatment will be recommended. GoodRx is not available outside of the United States. Do I need to refrain from sexual contact while I am being treated? A National Institutes of Health study found that pregnant women with BV were more likely to deliver a baby with low birthweight than those without the infection.

Also, pregnant women may have an increased risk of.

Why Flagyl Is Prescribed

If you notice other effects not listed above, contact your doctor or pharmacist. When estrogen levels are lower, vaginal pH levels tend to be higher. It works by destroying the germs that cause infection. Thrush: symptoms, treatment and prevention, the pain lasts for a short time, usually around one week. Bacterial vaginosis is actually more common in women having sex with women, because the vaginal bacteria can be passed from one partner to the other in that situation.

RECURRENT BACTERIAL VAGINOSIS Recurrent bacterial vaginosis is common and requires longer treatment (10 to 14 days) with any of the recommended or alternative therapies9 (Table 2). Vaginal candidiasis, but what if this isn’t your first yeast infection rodeo? It is normal for a small amount of clear or cloudy white fluid to pass from a woman’s vagina. This keeps the tissue moist and healthy. What is bacterial vaginosis? Have symptoms. It is important to continue taking the full dosage of antibiotics as your doctor prescribed.

“No one can just look at vaginal secretions and say that they know [what they are],” she said.

Vaginitis is among the most common conditions for which women seek medical care, with vaginal discharge accounting for approximately 10 million office visits each year. Some women infected with BV may have up to 1,000 times more anaerobic bacteria (bacteria that require no oxygen to live) than uninfected women. Fluconazole is a synthetic PO antifungal agent (a broad-spectrum bistriazole) that selectively inhibits fungal cytochrome P-450 and sterol C-14 alpha-demethylation. Can you treat a yeast infection with yogurt? Cool the Milk:. Flagyl passes into breast milk and may harm a nursing baby. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms. 5; positive whiff test (the discharge typically has a fishy smell); and presence of clue cells in the vaginal fluid on light microscopy. All it takes is a test to check the level of acidity, or pH, in the vagina. In women with candidal vaginitis, treatment with oral fluconazole has been shown to be safe and as effective as seven days of treatment with intravaginal clotrimazole.

How Much To Take/use

Can a Yeast Infection Go Away on Its Own? Stewart recommended reviewing the Amstel criteria: Metronidazole comes as a gel to be used in the vagina. Vaginal creams and suppositories for treatment of "yeast" (Candida) infections do not treat BV. There is a link between bacterial vaginosis and both preterm delivery and low birth weight in babies, so it's important to be treated quickly if you're pregnant. In any case, pregnant women who are going to be screened should have this done during the first prenatal visit. What is the most important information I should know about metronidazole?

But having sex with a new partner, or multiple partners, may increase your risk for BV. Alcohol may increase the side effects of Flagyl. Boric acid can be fatal if swallowed rather than used intravaginally. ” Using lubricant in place of your own natural wetness is also an option. Using this medicine with any of the following is not recommended.

Women Who Are Pregnant

The 1200 mg formulation (Monistat 1) is applied once for one night. A yeast infection, also known as candida vulvovaginitis, is usually brought on by an overgrowth of a fungus called Candida albicans. The dose of this medicine will be different for different patients. Your doctor may have prescribed Flagyl for another reason. Rinse with plain water after 30 minutes. Such a treatment would not only capture a huge slice of the estimated $140 million BV market in the US, but would also bring real relief to women shopping among those shelves of deodorizers, wipes and cleansers that do nothing to help cure the infection.

The applicator should be washed with warm soap and water after each use. For more information, see What Increases Your Risk. You should not use metronidazole if you have taken disulfiram (Antabuse) within the past 2 weeks. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. A recent analysis3 found that examination of wet-mount preparations is neither highly sensitive nor specific for vulvovaginal candidiasis. About 50 percent to 75 percent of women with BV have no symptoms.

Metronidazole immediate-release and extended-release tablets and capsules are taken by mouth and are absorbed through the stomach. 19 In fact, the CDC10 advises that topical clindamycin cream may increase the risk of prematurity and neonatal infections. These data have been published. Metronidazole can pass into breast milk and may harm a nursing baby. Flagyl, known generically as metronidazole or by the brand name Protostat, is an antibacterial drug that is classified as a broad-spectrum antibiotic. Recurrence is usually caused by reinfection with the same organism from a vaginal reservoir.

Statistical Analysis

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. Genitourinary infections and sexually transmitted diseases. This drug may make you dizzy. But surveys find that the majority of health care professionals don't routinely test for or treat BV.

Bacterial vaginosis is generally not considered a sexually transmitted infection (STI). Thanks for visiting! Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. Both metronidazole and clindamycin are available by prescription in oral (pill) form, and metronidazole is available in a gel (MetroGel-Vaginal), and clindamycin is available in a cream (such as Clindesse) that you insert into the vagina. Do not crush, chew, or break an extended-release tablet.

Three of these four are necessary for diagnosis, she noted. Intestinal inflammation, parasites, bacterial infections, and their accompanying symptoms, such as diarrhea, are serious adversaries for our dogs. Like most antibiotics, metronidazole is prescribed to treat a variety of conditions, and to relieve their symptoms, such as: Douching upsets the normal pH balance of the vagina.