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Flagyl - Metronidazole


About Flagyl (metronidazole)

Metronidazole, also known as Flagyl, is an Antibiotic utilized in the treatment of IBD and SIBO.

Metronidazole acts as an Anti - Bacterial Antibiotic and an Anti - Protozoal Medication.
Metronidazole is effective against Anaerobic Bacterial Strains.
Metronidazole is also prescribed for Trichomonas vaginalis or Entamoeba histolytica infections.

Metronidazole is found after dosing in multiple areas of the body including: brain and spinal fluid, breast milk, and Abscesses and can be effective for disease treatment in these areas. It is especially beneficial for treatment of Perianal disease.[1]


Metronidazole should not be used in patients that have a history of hypersensitivity to Metronidazole (Flagyl) or other Nitroimidazole - based products.

Metronidazole should not be used during the first trimester of pregnancy. Metronidazole is secreted in breast milk and does cross the placenta in pregnancy. See also Pregnancy Categories for Drugs

Do not skip doses and make sure to take all prescribed doses even if you are feeling better.

Metronidazole treatment can cause a Yeast Infection / Candidasis to become worse. Additional treatment for the Yeast infection may be required.

Patients with Liver Disease may not metabolize Metronidazole effectively. Levels of Metronidazole in these patients should be monitored to ensure they do not get too high.

Alcohol and Metronidazole (Flagyl)

Alcohol should be avoided during Metronidazole therapy and for a minimum of one day after therapy is stopped. Alcohol when mixed with Metronidazole can cause Abdominal Cramping, Nausea / Vomiting, Headache and/or Flushing of the Skin.

Alcoholic patients on disulfiram within the previous two weeks of metronidazole therapy may have a psychotic response. Metronidazole therapy is not suggested for these patients.

Possible Nervous System Effects

Sometimes Metronidazole can result in Siezures (Convulsions), Peripheral Neuropathy, or other Nervous System effects. In these cases Metronidazole therapy should be stopped immediately. *Always consult your physician before making changes to your medication regimen.

Laboratory Results and Metronidazole

Metronidazole therapy can slightly lower numbers of Leukocytes or White Blood Cells in Blood Tests.

Prothrombin Time may be increased in patients on certain Anticoagulant (Blood Thinner) Type Medications.

Metronidazole can interfere with certain Blood Test Results by interfering with the chemistry of the lab test. These tests include: Aspartate Aminotransferase (AST), Serum Glutamic Oxaloacetic Transaminase (SGOT), Alanine Transaminase (ALT), Serum Glutamic Pyruvic Transaminase (SGPT), Lactate Dehydrogenase (LDH), Triglyceride (TG) levels, and Hexokinase Glucose.

Metronidazole Drug Interactions

Cimetidine can increase Metronidazole levels in patients that take both medications.

Certain "Blood Thinner" Type medications (Warfarin / Coumarin Anticoagulants) may work better during Metronidazole treatment. This can be dangerous if blood clotting ability is reduced too much.

Patients taking Lithium may see an increase in Lithium levels after Metronidazole therapy is started. These patients should be monitored for Lithium toxicity.

Phenobarbital can cause Metronidazole levels in the body to be lower than in patients not taking Phenobarbital.

In patients taking both Phenytoin and Metronidazole, levels of Phenytoin and/or Metronidazole can be reduced in the body.

Adverse Reactions

Abdominal Cramping
Cancer (*Increased Cancer rates in Crohn's Disease Patients)
Convulsions / Siezures
Dizziness / Vertigo
Dry Mouth
Joint Pain
Leukopenia / Neutropenia / Low White Blood Cells
Metallic Taste in the Mouth
Neuropathy (Optic or Peripheral Nerves)
Painful Urination
Stevens - Johnson Syndrome
Thrombocytopenia / Low Platelet Counts
Toxic Epidermyl Necrolysis
Urinating Often


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