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

Your doctor will either prescribe a single dose course of 2g of metronidazole or you will need to take metronidazole tablets twice a day for up to 7 days.

How long do you need to take metronidazole tablets for?

The usual dose lasts for 5 to 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 you only take once.

The usual dose for bacterial vaginosis is one metronidazole 400mg tablet twice a day. An alternative dose is a 1 day course of metronidazole tablets equivalent to 2000mg (2g). Your doctor will advise which dose you have been prescribed.

You will need doctor’s approval for metronidazole tablets for 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:

• complete a brief questionnaire about your health and lifestyle
• order your preferred treatment and make payment
• one of our doctors will review your order and your medical questionnaire answers
• if approved, your order will be sent to your address in discrete and plain packaging
• if our doctors decide 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

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 risk 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: 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.
• Dalacin Cream: 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. Dalacin Cream is available to buy with a prescription.
• Fluomizin: Fluomizin is another antiseptic antimicrobial tablet that is inserted into the vagina using an applicator. Fluomizin is usually recommended as an alternative to clindamycin cream if 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