Metronidazole side effects how long do they last

Contents

Flagyl

Brand Names: FIRST Metronidazole, Flagyl, Flagyl 375, Flagyl ER, Metryl, Protostat

Generic Name: metronidazole

  • What is metronidazole?
  • What are the possible side effects of metronidazole?
  • What is the most important information I should know about metronidazole?
  • What should I discuss with my healthcare provider before taking metronidazole?
  • How should I take metronidazole?
  • What happens if I miss a dose?
  • What happens if I overdose?
  • What should I avoid while taking metronidazole?
  • What other drugs will affect metronidazole?
  • Where can I get more information?

Metronidazole is an antibiotic that is used to treat bacterial infections of the vagina, stomach, liver, skin, joints, brain, and respiratory tract. Metronidazole will not treat a vaginal yeast infection.

Metronidazole may also be used for purposes not listed in this medication guide.

What are the possible side effects of metronidazole?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • diarrhea;
  • painful or difficult urination;
  • trouble sleeping, depression, irritability;
  • headache, dizziness, weakness;
  • a light-headed feeling (like you might pass out); or
  • blisters or ulcers in your mouth, red or swollen gums, trouble swallowing.

Stop taking the medicine and call your doctor right away if you have neurologic side effects (more likely to occur while taking metronidazole long term):

  • numbness, tingling, or burning pain in your hands or feet;
  • vision problems, pain behind your eyes, seeing flashes of light;
  • muscle weakness, problems with coordination;
  • trouble speaking or understanding what is said to you;
  • a seizure; or
  • fever, neck stiffness, and increased sensitivity to light.

Metronidazole can cause life-threatening liver problems in people with Cockayne syndrome. If you have this condition, stop taking metronidazole and contact your doctor if you have signs of liver failure–nausea, stomach pain (upper right side), dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Side effects may be more likely in older adults.

Common side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about metronidazole?

You should not use metronidazole if you have taken disulfiram (Antabuse) within the past 2 weeks.

Do not drink alcohol or consume foods or medicines that contain propylene glycol while you are taking metronidazole and for at least 3 days after you stop taking it.

About metronidazole

Type of medicine Antimicrobial agent (antibiotic)
Used for To treat or prevent infection
Also called Flagyl®
Available as Tablets, oral liquid medicine, suppositories, and injection

Metronidazole is used to treat a wide variety of infections caused by certain types of germ (anaerobic bacteria) and types of micro-organisms called protozoa. These types of organisms often cause infections in areas of the body such as the gums, pelvic cavity and tummy (stomach or intestines) because they do not need oxygen to grow and multiply.

Metronidazole is commonly prescribed to treat an infection called bacterial vaginosis. It is also prescribed before gynaecological surgery and surgery on the intestines to prevent infection from developing. It can safely be taken by people who are allergic to penicillin.

Metronidazole is also used, alongside other medicines, to get rid of Helicobacter pylori, a bacterial infection often associated with stomach ulcers.

Metronidazole is available as a skin preparation also. This leaflet does not give information about metronidazole when it is used for skin conditions, but there is more information available in a separate leaflet called Metronidazole skin gel and cream.

Before taking metronidazole

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking metronidazole it is important that your doctor or dentist knows:

  • If you are pregnant or breast-feeding.
  • If you feel you will be unable to stop drinking alcohol for the duration of your treatment.
  • If you have any problems with the way your liver works.
  • If you have a rare inherited blood disorder called porphyria.
  • If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.

How to take metronidazole

  • Before you start this treatment, read the manufacturer’s printed information leaflet from inside your pack. The manufacturer’s leaflet will give you more information about metronidazole and a full list of side-effects which you may experience from taking it.
  • Take the tablets or liquid medicine exactly as your doctor or dentist tells you to. The dose you are given will depend upon what type of infection you have, and how severe the infection is.
  • As a guide, a typical dose for an adult would be 400 mg two or three times a day, but your dose may be more or less than this. Doses for children depend upon the child’s age and weight. Your doctor will tell you what dose is right for you (or your child), and this will also be printed on the label of the pack to remind you.
  • Space your doses evenly throughout the day, and keep taking the medicine until the course is finished, unless you are told to stop by your doctor. Your symptoms may return if you stop taking metronidazole before the end of the course prescribed for you.
  • Most courses of metronidazole last for around 7 days, but some may be as short as 3 days and some as long as 14 days. For certain infections you may be given a single, larger dose of metronidazole, usually five 400 mg tablets (2 g) to take at once.
  • Take each of your doses with a snack or just after eating a meal. Swallow the tablets whole (that is, without chewing or crushing them) with a full glass of water.
  • If you forget to take a dose, take it as soon as you remember and try to space your remaining doses evenly throughout the rest of the day. Do not take two doses together to make up for a forgotten dose.

If you have been given metronidazole suppositories

  1. Remove the suppository from its wrapping.
  2. Using your finger, gently push the suppository into your back passage (rectum) as far as is comfortable. Many people find that inserting a suppository is easier if they squat or bend forward.
  3. Remain still for a few moments to help you to hold the suppository in place.
  4. Wash your hands.

Getting the most from your treatment

  • Important: do not drink alcohol while you are on metronidazole and for 48 hours after finishing your course of treatment. This is because drinking alcohol with metronidazole is likely to make you feel very sick and cause other unpleasant effects, such as the sensation of having a ‘thumping heart’ (palpitations), hot flushes and headache.
  • While you are taking metronidazole your urine may look a darker colour than normal. On its own this is nothing to worry about. However, if you also experience tummy (abdominal) pain, or if you feel sick (nausea) or feel generally unwell, you should let your doctor know.
  • If you buy any medicines, check with a pharmacist that they are safe to take with metronidazole. Some cough and cold preparations contain alcohol and should not be taken with metronidazole.
  • If you need to take metronidazole for longer than ten days, your doctor may want you to have some tests. Make sure you keep any appointments that your doctor gives to you.

Can metronidazole cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the ones associated with metronidazole. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Metronidazole side-effects What can I do if I experience this?
Feeling sick (nausea) or being sick (vomiting) Stick to simple foods. Make sure you take your doses after a meal or a snack
Changes in the way things taste, furred tongue, sore mouth Ask your pharmacist to recommend a suitable mouthwash
Lack of appetite This should soon pass, but in the meantime choose food that you usually enjoy

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store metronidazole

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Metronidazole is a synthetic nitroimidazole compound used with increasing frequency in small animal practice. It is commonly prescribed in the treatment of inflammatory bowel disease, gastritis associated with helicobacter, giardiasis and empirical treatment of diarhea.
Metronidazole has also been used successfully to alter intestinal flora in dogs with hepatic encephalopathy and exocrine pancreatic insufficiency. Use of this antibacterial has been advocated in the treatment of osteomyelitis and periodontal diseases. The mechanism of action for these effects are a matter of controversy. It is believed that the drug disrupts DNA and nucleic acid synthesis in bacteria. Its antiprotozoal activity is not adequately explained.
Evans et al in the J Vet Intern Med recently described its uses, toxicities and treatment of neurologic signs that may occur as an untoward side effect.
Metronidazole has excellent bioavailability with peak serum levels in the canine one hour after oral intake. This rather lipophilic antibiotic is distributed to most body tissues and fluids, including bone, abscesses, the central nervous system (CNS) and seminal fluid.
There is extensive metabolism in the liver before renal and fecal excretion. The elimination half-life in the dog varies from three to 13 hours.
Adverse effects in dogs and cats include neurologic disorders, lethargy, weakness, neutropenia, hepatotoxicity, hematuria, anorexia, nausea, vomiting and diarrhea.
Neurotoxic effects include encephalopathy, cerebellovestibular signs and periopheral neuropathy.
Neurotoxicity following prolonged therapy is most often related to cumulative dose and duration of treatment.
Most canines who develop neurologic signs secondary to metronidazole administration have received weeks to months of therapy, but toxicity after short-term therapy at relatively low dosages (
In general, higher dosages may produce signs in a shorter time period than moderate to low dosages.
Reversible CNS dysfunction may produce signs including ataxia, recumbency, opisthotonus, positional ystagmus, muscle spasms and occassionally seizures. Cerebrospinal fluid analysis may reveal mildly elevated protein levels.
In humans, a predominantly sensory polyneuropathy may follow large, cumulative doses. Nerve conduction studies suggest sensory axonal degeneration with low-amplitude or absent sensory potentials and minimal, if any, involvement of motor fibers. Sural nerve biopsies of human patients with sensory polyneuropathy, including teased fiber studies and electron microscopy, demonstrated primary axonal pathology with degeneration of both myelinated and unmyelinated fibers. Ahmeda et al in the journal, Neurology (45, 588) reported that magnetic resonance imaging in a single human case with encephalopathy and ataxia showed reversible T2-weighted hyperintensities in the cerebellum, supatentorial white matter and corpus collosum.
The exact mechanism of metronidazole neurotoxicity is unknown.
Source: Pierre Bichsel, Ronald Lyman (2004): Metronidazole: Uses, toxicity and management of neurologic sequllae. In: DVM Newsmagazine Aug 1, 2004; www.dvmnewsmagazine.com/dvm/
Tell a friend | | Send this article

Metronidazole

Generic Name: metronidazole (me troe NI da zole)
Brand Names: Flagyl, Metrogel

Medically reviewed by Kaci Durbin, MD Last updated on Dec 26, 2018.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Tips
  • Interactions
  • More

What is metronidazole?

Metronidazole is an antibiotic that fights bacteria.

Metronidazole is used to treat bacterial infections of the vagina, stomach or intestines, liver, skin, joints, brain, heart, and respiratory tract. Metrogel (topical metronidazole) is also used to treat rosacea, a skin condition. Vaginal metronidazole gel is also used to treat bacterial infections of the vagina.

Metronidazole will not treat a vaginal yeast infection.

Important information

You should not use metronidazole if you are allergic to it, or if you have taken disulfiram (Antabuse) within the past 2 weeks.

Do not drink alcohol or consume foods or medicines that contain propylene glycol while you are taking metronidazole and for at least 1 day after you stop taking it. You may have unpleasant side effects such as fast heartbeats, warmth or redness under your skin, tingly feeling, nausea, and vomiting.

Seizures and other nervous system abnormalities have been reported in patients treated with metronidazole. You should stop metronidazole immediately for any neurological symptoms such as seizures, headaches, visual changes, weakness, numbness, or tingling.

This medicine will not treat a viral infection such as the common cold or flu.

In animal studies (mice and rats), this medicine caused certain types of cancers or tumors. It is not known whether these effects would occur in people using this medicine. Ask your doctor about your risk.

Before taking this medicine

You should not take metronidazole if you are allergic to it, or if you have taken disulfiram (Antabuse) within the past 2 weeks.

Using metronidazole during the first trimester of pregnancy could harm the unborn baby. Tell your doctor if you are pregnant or if you become pregnant while using this medicine.

To make sure metronidazole is safe for you, tell your doctor if you have ever had:

  • liver or kidney disease;

  • nervous system disease;

  • Cockayne syndrome (a rare genetic disorder);

  • a stomach or intestinal disease such as Crohn’s disease;

  • a blood cell disorder such as anemia (lack of red blood cells) or low white blood cell (WBC) counts;

  • a fungal infection anywhere in your body; or

  • a nerve disorder.

In animal studies, metronidazole caused certain types of tumors, some of which were cancerous. However, very high doses are used in animal studies. It is not known whether these effects would occur in people using regular doses. Ask your doctor about your risk.

Metronidazole can pass into breast milk. It is not known whether metronidazole can harm a nursing baby. Let your doctor know if you are breastfeeding prior to taking metronidazole.

Do not give this medicine to a child without medical advice.

How should I take metronidazole?

Take metronidazole exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Shake the oral suspension (liquid) well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

If you are treating a vaginal infection, your sexual partner may also need to take metronidazole (even if no symptoms are present) or you could become reinfected.

Metronidazole is usually given for up to 10 days in a row. You may need to repeat this dosage several weeks later.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Metronidazole will not treat a viral infection such as the flu or a common cold.

Metronidazole can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using this medicine.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, dizziness, loss of balance or coordination, numbness and tingling, or seizures (convulsions).

What should I avoid while taking metronidazole?

Do not drink alcohol or consume food or medicines that contain propylene glycol while you are taking metronidazole. You may have unpleasant side effects such as headaches, stomach cramps, nausea, vomiting, and flushing (warmth, redness, or tingly feeling).

Avoid alcohol or propylene glycol for at least 3 days after you stop taking this medicine. Check the labels of any medicines or food products you use to make sure they do not contain alcohol or propylene glycol

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Metronidazole side effects

Get emergency medical help if you have signs of an allergic reaction to metronidazole: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • diarrhea;

  • painful or difficult urination;

  • trouble sleeping, depression, irritability;

  • headache, dizziness, weakness;

  • a light-headed feeling (like you might pass out); or

  • blisters or ulcers in your mouth, red or swollen gums, trouble swallowing.

Stop taking the medicine and call your doctor right away if you have neurologic side effects (more likely to occur while taking metronidazole long term):

  • numbness, tingling, or burning pain in your hands or feet;

  • vision problems, pain behind your eyes, seeing flashes of light;

  • muscle weakness, problems with coordination;

  • trouble speaking or understanding what is said to you;

  • a seizure; or

  • fever, neck stiffness, and increased sensitivity to light.

Metronidazole can cause life-threatening liver problems in people with Cockayne syndrome. If you have this condition, stop taking metronidazole and contact your doctor if you have signs of liver failure – nausea, stomach pain (upper right side), dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

Side effects may be more likely in older adults.

Common metronidazole side effects may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect metronidazole?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • busulfan;

  • lithium; or

  • a blood thinner – warfarin, Coumadin, Jantoven.

  • phenytoin or phenobarbital

This list is not complete. Other drugs may interact with metronidazole, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use metronidazole only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 12.02.

Related questions

  • What if you had sex while using metronidazole vaginal gel?
  • How long does it take metronidazole to leave your system?

Medical Disclaimer

More about metronidazole

  • Side Effects
  • During Pregnancy or Breastfeeding
  • Dosage Information
  • Patient Tips
  • Drug Images
  • Drug Interactions
  • Compare Alternatives
  • Support Group
  • Pricing & Coupons
  • 1924 Reviews
  • Drug class: amebicides
  • FDA Alerts (3)

Consumer resources

  • Metronidazole Tablets and Capsules
  • Metronidazole Injection
  • Metronidazole Intravenous (Advanced Reading)
  • Metronidazole Oral, Intravenous (Advanced Reading)

Other brands: Flagyl, Flagyl IV, Flagyl ER

Professional resources

  • Metronidazole (AHFS Monograph)
  • … +6 more

Related treatment guides

  • Bacterial Infection
  • Amebiasis
  • Aspiration Pneumonia
  • Bacteremia
  • … +29 more

Snorting Tramadol

Home Tramadol Addiction Snorting Tramadol

Some people abuse tramadol by snorting the crushed tablets. This may be done by those seeking a rapid initial burst of euphoria by bypassing the steady release of medication that would otherwise result from its intended oral administration. This can result in a relatively rapid delivery of this drug to the brain but can also cause serious side effects.

What Is Tramadol?

Sold under a variety of commercial names—including ConZip, Ultram, and Ultram ER—this analgesic medication is prescribed to manage moderate to moderately severe pain. Tramadol is a synthetic opioid agonist that interacts with certain opioid receptors within the brain—modifying sensations of physical pain and discomfort. It is often prescribed for people with nerve damage, arthritis, or other painful chronic conditions.

Tramadol is sold in immediate-release and extended-release tablets, and it is meant to be taken orally. The extended-release version is intended to control symptoms for a longer period of time and is prescribed to adults who need around-the-clock pain control.

When tramadol is abused for recreational purposes, it can create a near-immediate sense of pleasure and happiness that’s often been compared to a morphine high. But like almost all opiate derivatives, this man-made opioid agonist can be addictive, and snorting the drug increases the risk of dependence.1

How do you know if you or a loved one may be addicted? Find out here.

What Happens When You Snort Tramadol?

When tramadol is taken orally as prescribed by a doctor, the drug is a generally safe alternative to other pain medications. Tramadol has more powerful painkiller properties than non-steroidal anti-inflammatory medications, and it was designed with the intention of providing a less addictive alternative to the stronger opioid analgesics.2,3

Crushing the medication, however, is unsafe. People who misuse tramadol may crush multiple tablets in order to snort the drug and get a euphoric high. While some side effects of snorting tramadol may be shorter-term and less harmful than others, other side effects—such as seizures and overdose—can be much riskier and even lethal.

How Tramadol Enters Your System

When tramadol is ingested orally, it is first processed through the liver before its effects are felt throughout your body. When tramadol is snorted, however, the drug dodges this intended “first-pass” process of liver metabolism. Instead, the mucous membranes of your nasal passages absorb the drug and delivers it across the blood-brain barrier directly to your brain.

How Tramadol Works in the Brain

Tramadol is a synthetic opioid, meaning that its chemical makeup has been man-made, rather than having been developed directly from opium poppy plant derivatives (“opiates”). Nonetheless, it works in the brain very similarly to natural opiates, as it attaches to opioid receptors and alters signaling throughout the body’s pain pathways.4 As a result, you perceive less pain in your body when there is tramadol in your system.

Tramadol is a somewhat unusual opioid analgesic in that it also increases the availability of norepinephrine and serotonin in your brain.

Tramadol is a somewhat unusual opioid analgesic in that it also increases the availability of norepinephrine and serotonin in your brain. The drug’s actions on these neurotransmitters may serve to bolster its pain-relieving capabilities, but is thought to also provide a mild antidepressant effect—elevating good feelings throughout the body.5

How Quickly You Feel Tramadol’s Effects

Orally administered tramadol pills (immediate release) are processed through the liver, and drug levels peak in the body in about 2 hours. Since snorting tramadol skips this liver metabolism process—delivering the drug directly to the neural circulation—the effects of tramadol are experienced in less than 10 minutes. Furthermore, animal studies have shown that the maximum bloodstream concentration of tramadol is 20 times higher when it is snorted then when it is taken orally, and snorting tramadol makes the drugs 500% more available to the body.6 Thus, snorting tramadol greatly intensifies both its desired and dangerous effects.

What Are the Side Effects of Snorting Tramadol?

When tramadol powder is snorted, the medication can cause severe irritation of the mucous lining of the nose. Some users report a painful burning sensation. In addition to causing discomfort and pain, snorting tramadol increases the risk of taking too much of this medication.1

Snorting tramadol can have serious consequences, such as:7

  • Agitation.
  • Panic.
  • Shaking and tremors.
  • Nausea and vomiting.
  • Diarrhea.
  • Dizziness.
  • Weakness.
  • Overdose.
  • Seizures.

When you snort tramadol while you’re drinking or taking other drugs that suppress breathing and heart rate (such as opioid pain relievers like methadone or opiates like heroin), the risk of central nervous system depression increases—as does the risk of accidental death.

Tramadol and Serotonin Syndrome

A 2010 study of tramadol overdose published in Clinical Toxicology indicates that 1.2 percent of all poisoning episodes in 2006 to 2007 were related to tramadol.7 Taking too much of this drug can result in what’s known as serotonin syndrome—a severe drug reaction that can occur when you take medications that alter the brain’s production of the neurotransmitter serotonin. Dangerous side effects of serotonin syndrome may include:7

  • Seizures.
  • Accelerated heart rate.
  • Elevated blood pressure.
  • Elevated body temperature.
  • Delusions and hallucinations.
  • Loss of motor coordination.

Getting Treatment for Tramadol Addiction

If you feel that your tramadol abuse has taken over your life, you may have a physical or psychological dependence on this drug. Getting help for tramadol addiction may require intensive, professional substance abuse treatment, potentially one that specifically promotes recovery from tramadol addiction or other form of prescription drug abuse. Treatment strategies for tramadol abuse include:

  • Enrollment in a residential treatment program.
  • Individual therapy or counseling utilizing behavioral modification techniques.
  • Group and family counseling.
  • Participation in a 12-step addiction program.
  • Stress management techniques to prevent relapse.

Types of Treatment Programs

Treatment program types can vary quite a bit, depending on what you’re looking for in a program. Most treatment programs will involve a period of detox—where the body gets rid of any residual substance of abuse—followed by some combination of individual, group therapy, and ongoing maintenance recovery.

  • Luxury rehab centers provide residential rehabilitation treatment alongside a wide variety of plush, resort-like amenities to make your experience more comfortable.
  • Executive rehabs also provide residential rehabilitation with many of the same luxurious amenities as luxury rehab. Executive rehab, however, also focuses on providing busy professionals with the resources and structure to maintain active involvement in the workplace throughout the recovery process.
  • Standard or traditional rehab facilities also provide the same top-notch rehabilitation treatment as do luxury or executive programs—only without the extra amenities or high price tag.

Sources

About the Editor

Kindra Sclar, M.A.

Kindra Sclar is a Senior Web Content Editor for American Addiction Centers. Before joining the company, she worked for more than 8 years as a print and web editor for several print and online publishers. Kindra has worked on content…

If you have abnormal vaginal discharge, the most likely cause is an infection called bacterial vaginosis, or BV. You can’t catch it from sex, but having BV makes you more likely to get other sexually-transmitted diseases (STDs). It can also cause some other complications if you are pregnant or about to have gynecologic surgery.

Luckily, BV is easily treated with simple antibiotics. In some women, the infection comes back, and they have to take antibiotics for longer to get rid of the infection completely.

We’ll run through the best treatments for BV here—and whether you need treatment at all.

How do I know I have BV?

Many women don’t know that they have BV. That’s ok. One-third of women get better with no treatment at all.

You might have BV if you have watery, milky-colored fluid coming from your vagina, which smells very strong, especially after sex. An itchy or burning feeling down below could be another sign of BV.

Who needs treatment for BV?

If you have symptoms, you need treatment. Simple.

If you are pregnant and have symptoms of BV, you also need treatment, and treatment is safe.

If you are about to have gynecologic surgery, such as a hysterectomy, or an abortion, you will be checked for BV. If you test positive, you need to be treated–whether you have symptoms or not. Getting treated will lower your risk of getting complications after your surgery.

Don’t miss out on savings! Get the best ways to save on your prescriptions delivered to your inbox. By signing up, I agree to GoodRx’s terms of service and privacy policy.

What is the best treatment for BV?

These are the 3 best treatments for BV:

  • Metronidazole (Flagyl) 500 mg pills twice a day for 7 days
  • 0.75% metronidazole vaginal gel once a day for 5 days
  • 2% clindamycin vaginal cream once a day for 5 days

These treatments have been around a while, and are proven to work: 80% of women treated for BV using one of these methods are clear of the infection one month after treatment.

What treatment is best for me?

This depends on your preference (pills or cream) and the side effects you might get.

Pills usually give more side effects than creams, and for metronidazole pills, these might include a headache, nausea, or stomach pain. Both metronidazole pills and creams can give you a metallic taste in your mouth.

There is a risk of C. diff (Clostridioides difficile) diarrhea with both metronidazole and clindamycin.

Precautions

If you are taking metronidazole (Flagyl), drinking alcohol will make you violently ill. We do not recommend it at all (and if you try it, you won’t either). Wait one day after your treatment ends before you start drinking alcohol again.

If you are using clindamycin vaginally, you’ll need to be careful using latex condoms for protection. Clindamycin cream can weaken condoms to the point that they break.

My BV symptoms came back. What now?

Unfortunately, this is pretty common:

  • 30% of BV comes back within 3 months.
  • 50% of BV come back within 12 months.

Doctors aren’t really sure why this happens, but it’s probably related to the antibiotics wiping out the healthy bacteria in your vagina, which protect you from unhealthy bacteria that cause diseases such as BV or yeast infections. (This is why we don’t recommend antibiotic treatment for BV if you don’t have symptoms.)

If your BV comes back and you have symptoms, you will be treated with a longer course of antibiotics, and usually with a different antibiotic than the first time. After that, you can take a longer preventative treatment for 4 to 6 months to prevent it from coming back again.

Does my partner need treatment if I had BV?

If you have sex with a man, he does not need treatment. Good to know: You’ll have a lower chance of getting recurrent BV if your male partner regularly uses a condom during sex with you, or if you abstain from sex altogether.

If you have sex with a woman, then you should tell your partner. There is a 25% to 50% likelihood they will also have BV, so they should be made aware of the symptoms. If your partner starts getting symptoms, they will need a test and treatment to feel better—just like you did.

Put drug prices & coupons in your pocket! We’ll text you a link to download our free Android or iPhone app Get GoodRx Mobile App Your link is on the way!

We’ve sent a link to download the GoodRx mobile app to your phone.

Something went wrong

We were unable to send a link to your phone.

  • How long does Metronidazole take to work?

    Metronidazole is an antibiotic used to treat a number of infections, including mouth infections (such as dental abscesses), skin infections and bacterial vaginosis (BV). Available only by prescription, it’s a highly effective antibiotic that comes in tablet, liquid, gel, cream and suppository form.

    The time it takes for Metronidazole to work will depend on the reason you have been prescribed it. For bacterial vaginosis (BV), you will normally be prescribed a 7 day course of antibiotics (one tablet, twice a day) and all symptoms should have cleared by the end of this (although you will probably notice an improvement after only a couple of days).

    Even if your symptoms appear to have cleared, you should always take antibiotics are prescribed, and you should always finish the full course. While symptoms may not take the whole course to clear, the infection itself does. Stopping antibiotics early could mean that the infection has not completely cleared and you could notice symptoms return.

    How do I use Metronidazole?

    Metronidazole is a prescription-only medicine, which means that you should only use it as advised by your doctor. Metronidazole is available in a variety of forms, and you may be recommended a certain one based on what you are treating. For BV, you can either take it as a tablet or use it as a vaginal gel. The choice is really down to the preference of the woman.

    Take Metronidazole tablets by swallowing them whole with a glass of water. The tablets tend to begin dissolving in the mouth very quickly, and a number of users complain of a very strong, metallic taste in the mouth. If you are struggling with this, try taking the tablets with a glass of milk (instead of water) to mask the taste.

    Like all medications, Metronidazole comes with a list of potential side effects. While not everyone taking ti will experience these, a vast number of users complain of nausea, stomach pains, bloating and a loss of appetite. If you do notice stomach problems such as these, ensure you are taking the tablets after food, and then eat a little something after taking them too. This can ease the impact on your stomach and therefore reduce side effects.

    What is bacterial vaginosis (BV)?

    Bacterial vaginosis is an infection that occurs when the pH of a woman’s vagina is disrupted. This can be for a number of reasons, as the pH balance of the vagina is pretty delicate, so any slight change can cause upset.

    Common triggers of BV include sex, the IUD contraceptive device, and basic hygiene practices. Very regular sex or sex with a number of different partners can trigger BV because it involves a foreign object in the vagina and semen is very slightly alkaline so it can interfere with the slight acidity of the vagina.

    But while BV can be triggered by sex, it is not a sexually transmitted infection. This is because the infection is caused by an imbalance in a woman’s body, and not by something that is acquired from one person to another. Therefore, men cannot get bacterial vaginosis.

    Other common ways in which bacteria can enter the vagina and cause BV is wearing tight underwear (such as thongs), wiping from back to front or not changing your underwear regularly enough. Equally, “overwashing” can trigger BV too by messing with vagina’s natural balance. Try to avoid using heavily scented soaps or perfumes on your delicate areas and stick to a gentle wash instead.

    What are the symptoms of bacterial vaginosis (BV)?

    A lot of the time, women with BV can be asymptomatic and may not even realise they have the infection. However, if you do notice symptoms then the main one is a vaginal discharge with a strong “fishy” smell. This could be white or grey in colour and is usually of a very watery consistency. If your discharge is thick then it’s more likely to be thrush or another vaginal complaint.

    It’s important to get yourself checked if you notice any significant changes to your intimate health. Most vaginal infections (such as BV) are harmless and easy to treat, but discharge, foul smells or bleeding between sex can be symptoms of more serious issues such as pelvic inflammatory disease (PID) or certain kinds of cancer.

    If you feel nervous or embarrassed about going to see a doctor face to face, then you could first try a self-testing kit from the comfort of your own home. These can diagnose common infections such as Thrush, BV, Chlamydia and Gonorrhoea and can help you to avoid any self-consciousness. However, it’s important to remember that any symptoms that persist after treatment should always be checked by a medical professional.

    Side Effects of Metronidazole

    Metronidazole immediate-release and extended-release tablets and capsules are taken by mouth and are absorbed through the stomach. Extended-release drugs stay active in your body for a longer period of time than immediate-release drugs do.

    The extended-release tablets are used to treat vaginal infections. The immediate-release forms of metronidazole are used to treat bacterial infections that affect many parts of the body as well as parasitic infections in the intestines, liver, and reproductive tract.

    More common side effects

    The most common side effects that can occur while taking metronidazole tablets or capsules include:

    • headache
    • loss of appetite
    • vomiting
    • diarrhea
    • heartburn
    • cramps in your abdomen
    • constipation
    • metallic taste in your mouth
    • yeast infection
    • vaginal discharge

    Serious side effects

    Serious side effects can occur while taking metronidazole tablets or capsules. These are all rare, however.

    Cancer: Metronidazole tablets and capsules have a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). In animal studies, cancer developed after animal subjects were given high doses of metronidazole for a long period. There may be a similar risk for cancer in humans.

    Encephalopathy: In some cases, metronidazole tablets or capsules have caused encephalopathy (abnormal brain function). Symptoms can include:

    • a lack of muscle control for voluntary movements, such as walking or picking up objects
    • dizziness
    • slurred or slow speech that can be hard to understand

    If you have any of these symptoms, call your doctor right away. Encephalopathy symptoms usually go away within days to weeks after stopping metronidazole.

    Seizures: If you have a history of seizures, be sure to tell your doctor before starting metronidazole tablets or capsules. They may prescribe a different drug for you instead. And call your doctor right away if you have a seizure while taking metronidazole.

    Meningitis: Meningitis is an inflammation of the membranes covering your brain and spinal cord. The swelling from meningitis can cause:

    • severe headache
    • fever
    • stiff neck

    These symptoms can occur within hours of taking the drug. Meningitis can be life-threatening if not treated right away. Call your doctor immediately if you have any of these symptoms. The risk of meningitis typically goes away after treatment with metronidazole is stopped.

    Peripheral neuropathy: Peripheral neuropathy is caused by damage to your nerves. Typically, the symptoms occur in your hands and feet. They can include:

    • a “pins and needles” sensation
    • a burning feeling
    • numbness
    • sharp, shooting pains

    Call your doctor right away if you have any of these symptoms. Ongoing nerve damage can lead to muscle weakness, decreased reflexes, or loss of balance and coordination. Peripheral neuropathy may not go away after you stop taking metronidazole.

    Severe allergic reaction: If you’re allergic to metronidazole, you may have symptoms such as:

    • trouble breathing
    • swelling of your tongue or throat
    • hives
    • rash

    Sometimes, allergic reactions can be serious and require medical attention. If you have any of these side effects, stop taking metronidazole right away and call your doctor. If you have trouble breathing, call 911.

    Stevens-Johnson syndrome: Stevens-Johnson syndrome is a rare but serious skin disorder. Symptoms can appear in this order:

    • flu-like symptoms, such as fever and tiredness
    • a painful red rash that spreads and blisters
    • shedding of the top layer of your skin

    Stevens-Johnson syndrome is a medical emergency. If you have flu-like symptoms, call your doctor. 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.

    Neutropenia: Neutropenia is the condition when you have low levels of certain white blood cells, called neutrophils, that help fight off infections. Neutropenia puts you at higher risk of infection. Call your doctor right away if you develop a new infection while taking metronidazole. Neutropenia will likely go away after you stop taking metronidazole tablets or capsules.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *