Metronidazole treats infections caused by anaerobic bacteria and certain parasites — dental abscesses, bacterial vaginosis, some gut and skin infections. Its most famous feature is the alcohol reaction, which is genuinely unpleasant and worth taking seriously.
Dental infections and abscesses, bacterial vaginosis, trichomoniasis, some gut infections including Clostridioides difficile, rosacea (as a gel), infected leg ulcers and pressure sores, and as part of Helicobacter pylori treatment.
Take tablets with or just after food, swallowed whole with water, spaced evenly through the day. Finish the whole course.
A persistent metallic taste is very characteristic and resolves after the course. Furred tongue, nausea and loss of appetite are also common, as is darkened urine, which is harmless.
Report numbness or tingling in the hands or feet — this can occur with prolonged courses and should be assessed. Also report severe or bloody diarrhoea, a rash, or confusion and unsteadiness.
Tell your prescriber if you take warfarin — metronidazole raises the INR significantly — lithium, phenytoin or ciclosporin.
It can be used in pregnancy and breastfeeding where indicated, though high single doses are usually avoided.
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