Metronidazole

Common side effects include:

• Nausea, vomiting, loss of appetite, having a metallic or unpleasant taste in your mouth
• Take Metronidazole with or after food.
• Headache
• May take pain relief medications.
• Dry skin, redness or itching, skin irritation (for Metronidazole gel only)
• Use the gel a little less often or stop using it until the irritation settles down. If the irritation is severe or worsens, stop using the medication and seek medical advice
  
• Darkening of urine, which is a harmless side effect on its own
  

Very rarely, Metronidazole may cause severe side-effects that are generally reversible once the medication is stopped. Stop this medication and seek medical advice immediately if you develop any of these symptoms below.

Liver injury with symptoms such as:

• Dark-coloured or tea-coloured urine with accompanied symptoms as below
  
• Pale stools
• Severe abdominal pain, nausea and vomiting
• Loss of appetite
• Yellowing of the skin and eyes
  
  Neurological disturbances such as:
• Confusion, hallucinations
• Disturbances in sight and movements, light sensitivity
• Numbness
• Stiff neck, tremors, convulsions, uncontrolled muscle and eye movements

The symptoms of a drug allergy include one or more of the following. If you experience any of these symptoms, you should stop your medicine immediately and see your doctor.

• Swollen face/eyes/lips/tongue        
• Difficulty in breathing
• Skin rashes over your whole body

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication.
• You are pregnant, planning to become pregnant, or breastfeeding. Metronidazole crosses the placenta and may carry risk to the fetus, especially in the first trimester. Metronidazole can be present in significant amounts in the breast milk. It may still be used safely in pregnancy and breastfeeding. Risks and benefits regarding the use of Metronidazole during breastfeeding and pregnancy should be discussed with your doctor.
• You have taken Disulfiram within the past two weeks.
• You are taking any other medications, including supplements, traditional medications and herbal remedies.
• You have liver disease, kidney disease or disease of the nervous system.

​Avoid consuming alcohol during the course of antibiotics and for three days after completion of antibiotics. Drinking alcohol with Metronidazole causes an unpleasant reaction which may present with nausea, vomiting, abdominal pain, palpitations (fast heart rate), hot flushes, headaches.

Oral Metronidazole

• Metronidazole may be taken with or after food.
• Complete the course of antibiotics as prescribed by your doctor. Incomplete treatment may cause infections to happen again.
• Do check with your healthcare professional before stopping your medication.
  
   
  Metronidazole/Nystatin vaginal pessary
• Place one vaginal pessary deep into your vagina. Do this at bedtime. You may wear a sanitary pad to prevent the medicine from getting onto your clothing. Do not use tampons.
• The medication may come with an applicator specially designed to be used with the vaginal pessary.
• Wash and dry your hands before administering the pessary.
• Pull back the applicator plunger about 2.5cm.
• Remove the pessary from its plastic wrapping. Insert the pessary into the cup at the end of the applicator.
• Lie on your back with your knees drawn up towards your chest. Insert the applicator into your vagina as far as it will comfortably go.
• Be sure the applicator is in the correct position in your vagina before you push the plunger.
• Push the plunger fully to place the pessary in your vagina.
• Remove the applicator. Wash with soap and warm water. Rinse thoroughly and dry. 
  
   
  Topical Metronidazole (gel)
• Wash and dry your hands before and after using the medicine.
• Clean and dry the area that you will be applying Metronidazole on. Apply a thin layer of the medicine.
• Topical Metronidazole is usually applied 1 to 2 times a day. Follow your doctor's instructions.
• Avoid your eyes, nose, mouth and lips when you apply Metronidazole on your skin. Wash with water if the medicine gets into any of these areas. Avoid applying onto broken or irritated skin as it can worsen the skin condition.

If you forget to take a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and go back to your usual timing. Do not take two doses at the same time to make up for the missed dose.

​Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin.