Metronidazole tablets are an antibiotic used to treat a wide range of infections, including bacterial vaginosis.

Metronidazole is available in several forms:

• tablets
• gel
• cream
• suppositories

Metronidazole is only available with approval from a doctor. At Superdrug Online Doctor, we can approve treatment with metronidazole tablets and gel for bacterial vaginosis.

Metronidazole is a type of antibiotic that works by stopping bacteria or parasites growing. The effect of metronidazole is that it kills whatever is causing an infection, helping your body get rid of it.

How effective is metronidazole?

Metronidazole is very effective at treating bacterial vaginosis, with some studies showing that it has a success rate of over 90%. Other research shows metronidazole is between 65 and 95% effective at treating bacterial vaginosis.

Although metronidazole helps most people overcome bacterial vaginosis, it doesn’t cure it permanently. Despite metronidazole’s effectiveness, many women find the infection returns within a year. If your infection does come back, you can request treatment again to help you recover.

Always take metronidazole tablets exactly as your doctor advises. They will tell you how long you will need to take them for and what dose is right for you.

When taking metronidazole tablets:

• swallow the tablets whole with a glass of water
• you must not crush or chew the tablets
• take them with or just after a meal
• avoid alcohol for the duration of your course and for 48 hours after to avoid side effects

When to take metronidazole tablets

Ideally, you should take metronidazole tablets with or just after a meal. You’ll usually need to take your doses 8 hours apart.

How often to take metronidazole tablets

You will either need to take metronidazole twice a day for 7 days, or take your tablets just once, depending on the course of treatment you’ve requested. You can choose which course to request, but our doctors may recommend a different course if they think it’s right for you. The single-dose course works faster, but it’s more likely you could get a repeat infection.

Your doctor will either prescribe a single-dose course of 2g of metronidazole, in which you will need to take 5 x 400mg tablets at the same time, or a course of 1 400mg metronidazole tablet twice a day for up to 7 days. Your doctor will explain to you how to take your metronidazole.

How long do you need to take metronidazole tablets for?

The usual dose lasts for 7 days. Your doctor will tell you how long and how often you will need to take metronidazole tablets. You can also get a single-dose course, which you only take once.

The usual dose for bacterial vaginosis is one metronidazole 400mg tablet twice a day for 7 days. An alternative dose is a 1-day course of metronidazole tablets at a dose of 2000mg (2g), where you take 5 x 400mg tablets at the same time. Your doctor will advise you of the dose you have been prescribed.

You will need a doctor’s approval for metronidazole tablets for the treatment of bacterial vaginosis. You can request metronidazole tablets online from trusted services like Superdrug Online Doctor, or you may be able to get a prescription on the NHS.

Can I buy metronidazole tablets online?

Yes, metronidazole tablets can be requested through Superdrug Online Doctor. Simply:

1. Complete a brief questionnaire about your health and lifestyle.
2. Order your preferred treatment and provide payment details.
3. One of our doctors will review your request and your medical questionnaire answers.
4. If approved, your treatment will be sent to your address in discreet and plain packaging.
5. If our doctors think metronidazole is not right for you, then they will contact you via your account with other suitable treatment options.

Can I buy metronidazole tablets over the counter?

No, it isn’t possible to buy metronidazole over the counter because you need a doctor's approval to get it in either tablet or gel form.

Can I get metronidazole on the NHS?

Yes, you may be able to get metronidazole tablets on the NHS but you will need to make an appointment with your GP to get a prescription.

The NHS will use the same prescribing criteria our doctors use to check whether treatment is right for you.

Like all medications, metronidazole can cause side effects, but not everyone will get them.

Common metronidazole effects include:

• feeling or being sick
• diarrhoea
• metallic taste in your mouth
• furry tongue, which is often a sign of oral thrush, causing a creamy white coating or patches on your tongue, which may wipe away easily, but can leave a painful, red, or bleeding surface underneath

Very rare side effects include:

• confusion
• hallucinations
• seizures
• sleepiness
• dizziness
• headache
• blurred or double vision
• dark coloured pee
• muscle or joint pain

Other metronidazole side effects are:

• numbness, tingling or weakness in the arms or legs
• loss of appetite
• fever
• eye pain
• hearing loss
• ringing in the ears
• skin rash

You should stop taking metronidazole tablets and call 999 or go to A&E straight away if you experience any of the following:

• swollen hands, feet, lips, or throat
• difficulty breathing
• itchy skin rash (hives) or nettle rash (urticaria)
• skin rashes that occur with blistering, peeling, or bleeding around the eyes, mouth, nose, and genitals
• stiff neck, headache, hallucinations, speech issues, and confusion

You should also let your doctor know if you experience:

• unexpected infections, mouth ulcers, bruising, bleeding gums, or extreme tiredness
• yellowing of the skin and eyes (jaundice)
• severe stomach pain (pancreatitis)

You can find a full list of metronidazole side effects in the patient information leaflet enclosed in the medication packet.

How long do metronidazole side effects last?

Often, metronidazole side effects don’t last long. Most people will notice side effects within 30 minutes of taking metronidazole 400mg tablets and they can last several hours. You may experience side effects with each dose you take.

If you are experiencing side effects for prolonged periods and they are beginning to affect your daily life, speak with your doctor.

What to do if you get metronidazole side effects

Taking metronidazole with food can help reduce the chance of some side effects.

If you experience metronidazole side effects and are struggling to tolerate them, speak to your doctor for advice. They may recommend a different dose or an alternative medication.

You can also report any side effects you experience while taking metronidazole tablets, even if they aren’t listed in the patient leaflet, to the Yellow Card Scheme.

Do not take metronidazole tablets if you are allergic to any of the ingredients listed in the medication.

Before taking metronidazole tablets you should let your doctor know if you:

• have or have ever had a liver problem
• have a disease that affects your nervous system
• are receiving kidney dialysis
• are taking any prescribed, over the counter, or herbal remedies

You should let your doctor know if you are taking any of the following medications:

• anticoagulants to thin the blood, such as warfarin or aspirin
• lithium
• epilepsy medications like phenytoin, primidone, or phenobarbitone
• busulfan for leukaemia
• 5 fluorouracil for cancer
• ciclosporin
• disulfiram

Metronidazole and pregnancy

If you are pregnant, think you might be, or are thinking about becoming pregnant, you should tell your doctor. Metronidazole tablets should only be taken during pregnancy if necessary.

Metronidazole shouldn’t be used if you are breastfeeding because small amounts of the medication may pass into the mother’s milk.

Metronidazole and alcohol

Do not drink alcohol while you are taking metronidazole tablets because it can cause some unpleasant side effects including feeling and being sick. While taking metronidazole tablets, you should avoid alcohol for the duration of the course and for 48 hours after.

At Superdrug Online Doctor, we offer a range of alternative bacterial vaginosis treatments. They are:

• Zidoval
• Dalacin Cream
• Fluomizin

Zidoval is a prescription-only antibacterial gel which contains the active ingredient, metronidazole. Instead of tablets, metronidazole gel is applied inside the vagina to fight the infection. It cures 91% of bacterial vaginosis cases and may be more suitable if you are worried about systemic side effects, like feeling or being sick, that can happen with oral metronidazole tablets.

Dalacin is a cream that is applied inside the vagina. It contains the active ingredient clindamycin and works by stopping the growth of the bacteria responsible for causing bacterial vaginosis. It clears bacterial vaginosis in 85.5% of people and is suitable if you cannot take metronidazole. Dalacin Cream is available to buy with a prescription.

Fluomizin is another antiseptic antimicrobial tablet that is inserted into the vagina using an applicator. It can effectively clear bacterial vaginosis in more than 80% of people in 6 days. Fluomizin contains the active ingredient dequalinium chloride and is usually recommended as an alternative to clindamycin cream when clindamycin cream is unsuitable or ineffective.

Does Metronidazole interfere with contraception?

Metronidazole tablets do not stop any type of contraception from working, but if you are sick or have diarrhoea while taking metronidazole, you may not be protected against pregnancy if you use the contraceptive pill. Speak to a healthcare professional if you have any concerns about taking contraceptives at the same time as Metronidazole, they should be able to advise the best course of action best suited to your personal health needs

Can I use metronidazole gel while on my period?

You should avoid using metronidazole gel while on your period, because your period may make the treatment less effective.

How soon can I have sex after taking metronidazole?

You should avoid having sex while you are using metronidazole gel, but you can still have sex if you are taking metronidazole tablets. However, some people prefer to wait until they have finished their course because even though BV is not a sexually transmitted infection, sex can trigger it. Speak to your doctor if you need more advice.

Can metronidazole tablets treat UTIs?

No, metronidazole tablets are not usually used to treat UTIs. That’s because metronidazole does not target the bacteria responsible for UTIs. If you think you might have a UTI, explore our cystitis service.

Can you take paracetamol with metronidazole tablets?

Yes, there are no known interactions between metronidazole and paracetamol, so it is usually safe to take paracetamol while taking metronidazole for bacterial vaginosis. If you are unsure, speak to your doctor or pharmacist for more advice.

Can you take ibuprofen with metronidazole?

Yes, it is generally safe to take ibuprofen with metronidazole, as there are no known interactions between the medications. If you are unsure, speak to your doctor or pharmacist for more advice.

Can metronidazole cause thrush?

Yes, metronidazole can cause thrush. It is more common if you use metronidazole vaginal gel, and it happens because it also kills the normal, harmless bacteria that protect you against thrush. If you think you may have thrush after using metronidazole, speak to a doctor, pharmacist, or use our thrush treatment service.

Does metronidazole make you tired?

Yes, side effects such as sleepiness, drowsiness, or fatigue are possible with metronidazole. You should avoid driving or operating machinery until you know how the medication affects you.