Metronidazole Warnings and Precautions

If you have liver disease or epilepsy, you should let your healthcare provider know before starting metronidazole. Warnings and precautions for the drug should also be discussed with your healthcare provider, as it is important to know about the potential side effects, such as seizures, nerve problems, and other problems. The full risks of using metronidazole during pregnancy or breastfeeding are currently unknown.

What Should I Tell My Healthcare Provider Before Taking Metronidazole?

Prior to taking metronidazole (Flagyl®, MetroCream®, MetroGel®, MetroGel-Vaginal®, MetroLotion®, Noritate®, Vandazole®), tell your healthcare provider if you have:
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Make sure to tell your healthcare provider about any other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Metronidazole Warnings and Precautions

Precautions and warnings to be aware of prior to taking metronidazole include the following:
  • It is a standard recommendation to avoid alcohol while taking metronidazole, although recent research suggests that the medication might not actually interact significantly with alcohol (see Alcohol and Metronidazole for more information).
  • Metronidazole can cause seizures. Let your healthcare provider know immediately if you have a seizure while taking this drug.
  • Metronidazole can cause nerve problems, especially in the hands and feet. Let your healthcare provider know immediately if you develop numbness, paralysis, or any unusual sensations in your hands or feet.
  • If you have liver disease, your body may not metabolize this medication as well as it should. As a result, your healthcare provider will probably recommend a lower metronidazole dosage.
  • Metronidazole can worsen a pre-existing yeast infection (such as thrush or a vaginal yeast infection). These yeast infections usually require treatment with an antifungal medication.
  • Studies in rats and mice suggest that metronidazole may increase the risk of certain cancers. However, similar problems have not been seen in humans.
  • Overuse of antibiotics increases the risk of developing antibiotic-resistant bacteria. Your healthcare provider should prescribe such drugs only when necessary, and only to treat bacterial or parasitic infections. Antibiotics are not effective for treating viral infections, such as the common cold or the flu.
  • It is very important to take metronidazole exactly as prescribed. Skipping doses or stopping treatment too early (even if you feel better) can lead to bacterial resistance.
  • Metronidazole can interact with other medications (see Metronidazole Drug Interactions).
  • Metronidazole is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of using this drug when pregnant (see Metronidazole and Pregnancy for more information). Currently, it is not recommended that women in their first trimester take metronidazole to treat trichomoniasis (a sexually transmitted infection) or bacterial vaginosis.
  • This medication passes through breast milk. Therefore, if you are breastfeeding or plan to start, talk with your healthcare provider before using metronidazole (see Metronidazole and Breastfeeding for more information).
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