Flagyl Gel: Uses, Side Effects, Precautions, FAQs, More

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Vaginal bacterial infections are common in women and can be pretty uncomfortable and come with various symptoms. According to a survey, 3 in 4 women are likely to experience a vaginal bacterial infection (like bacterial vaginosis) at some point. Fortunately, there are various treatment options for bacterial vagina infections. Some treatments are administered orally, used as suppositories, or topically applied. One of the popular treatments for bacterial infections in the vagina is metronidazole antibiotic gel, also known as flagyl gel. This article discusses flagyl gel, its uses, interactions, and more.

What is Flagyl gel?

Metronidazole gel is an antibiotic that explicitly combats infections such as bacterial vaginosis caused by bacteria in the vagina.

This medication does not work for viral or vaginal yeast infections. Its mechanism of action is suitable specifically for treating infections caused by bacteria in the vagina.

Metronidazole topical gel works by halting the growth of bacteria and disrupting their reproduction in the vagina. Healthcare professionals would typically recommend this medication to women above 12 years.

It is crucial to read and follow the instructions on the label of the gel to use this medication safely.

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How flagyl gel works

Metronidazole gel is in a class of drugs called nitroimidazole antimicrobials. This medication is usually recommended to treat vaginal infections caused by bacteria.

This antibiotic works by stopping the growth and reproduction of infectious bacteria in the vagina, thus eliminating the infection.

How to use flagyl vaginal gel

Flagyl vaginal gel is a reliable treatment option for bacterial vagina infections and is relatively easy to use. The gel comes with an applicator to help you correctly use it.

You must read the label instructions and follow them accordingly.

Typical procedures for use include the following:

Put the gel in the applicator to the level indicated as instructed

Lie on your back, draw your knees upwards, and spread them apart.

Gently place the applicator into your vagina and push the plunger to deliver the medication.

Remove the applicator and put it away correctly. If the applicator can be reused, wash it with soap and warm water.

Ensure to wash your hands immediately to avoid spreading the infection.

Precautions and warnings

Before using Flagyl antibiotic gel, you must inform your doctor if the following applies to you:

You must inform your doctor if you’ve previously had a blood disease or central nervous condition (brain or spinal cord issues).

Inform your doctor if you’re pregnant, planning to become pregnant, or breastfeeding.

Inform your doctor if you become pregnant while using flagyl gel.

If you’re allergic to secnidazole (Solosec), tinidazole (Tindamax), metronidazole, any of the ingredients in the medication, or other drugs, you must inform your doctor before using Flagyl vaginal gel.

If you’re taking disulfiram (Antabuse), your healthcare expert may ask you to avoid metronidazole.

Also, if you’re taking vitamins, supplements, prescription or OTC or herbal medications, you must inform your doctor before using Flagyl antibiotic gel.

Inform your doctor if you’re using blood thinners such as lithium and warfarin.

Avoid alcohol and products with alcohol or propylene glycol while using this gel and for a minimum of 3 days after your final dose.

Mixing alcohol with flagyl vaginal gel may trigger adverse reactions such as stomach cramps, headache, sweating, nausea, vomiting, and flushing.

Side effects of Flagyl vagina gel

Like every medication, metronidazole vaginal gel can cause some side effects. The side effects of this antibiotic are typically mild and easy to handle. However, inform your doctor if the following symptoms become severe or don’t go away:

  • Headache
  • Vomiting
  • Diarrhea
  • Loss of appetite
  • Unusual metallic taste in the mouth
  • Stomach cramps and discomfort

Some severe side effects include the following:

  • Seizures
  • Rash
  • Hives
  • Itching
  • Unusual vagina discharge, itching, or irritation
  • Blistering or peeling of skin
  • Burning or tingling in your feet and hands
  • Numbness or pain in hour hands and feet

Call your doctor if you notice any of these symptoms.

Pros and cons of using Flagyl antibiotic gel

There are advantages and disadvantages to consider when using metronidazole vaginal gel for bacterial infections like bacterial vaginosis.

Some of the advantages include:

It can be used with or without food

This medication effectively treats bacterial infections in the vagina

Flagyl antibiotic gel is available as a cheaper, generic option

Some of the disadvantages include the following:

Stay away from alcohol to avoid the risk of getting a severe reaction called disulfiram reaction.

It can trigger an unusual metallic taste in your mouth, which can be unpleasant.

It can also cause headaches, cramps, and nausea.

This medication also heightens the risk of bleeding in people using blood thinners like warfarin and lithium.

Severe health risks of using metronidazole gel

This medication can cause some severe health risks, especially for certain groups of people. If you’re concerned about the risks, you should consult your doctor about alternative medications.


Based on animal studies, metronidazole vaginal gel increases the risk of cancer. You must use this medication as instructed. Do not use longer than what your doctor prescribed.

Brain problems or seizures

Some patients can have challenges with normal brain function or get seizures when taking flagyl vaginal gel. Although rare, a condition that causes brain damage (encephalopathy) and inflammation of the linings of the brain (aseptic meningitis) has been reported using metronidazole.

Sometimes, these conditions are reported hours after using this medication. It can take days or weeks to stop, but these conditions improve once the drug is discontinued.

Symptoms include inability to speak, uncontrolled body movements, shaking, dizziness, and difficulty walking straight.

Nerve damage

Although rare, metronidazole can cause nerve damage. Symptoms of this condition include numbness, tingling, intolerance to heat or cold, and a burning sensation.

These symptoms can become permanent if not properly attended to once noticed. Inform your healthcare provider if you notice any symptoms.

Low blood cell count

This medication can reduce white blood cells. Inform your healthcare provider if you have a low blood cell count history. Suppose you do.

Your doctor must monitor you closely with labs before and after you use metronidazole.

Fungal infections

Using metronidazole vaginal gel can cause new fungal infections to occur. This is quite common with antibiotics. Antibiotics can cause fungal infections like yeast overgrowth infections or thrush.

This medication can also heighten the symptoms of an existing fungal infection. Some of the symptoms include the following:

  • Thick, white vagina discharge
  • Itching
  • Redness or soreness
  • Pain while eating or swallowing
  • White patches in your mouth

Flagyl vaginal gel dosage forms

Metronidazole gel is an effective antibiotic that treats bacterial vagina infections. The recommended dosage for this medication varies depending on your infection type.

You must follow the instructions and complete your course on time, even if you feel better.

Interactions between Metronidazole vaginal gel and other medications

Flagyl may have contraindications with other medications and supplements. Inform your healthcare provider of all your drugs and supplements, including vitamins, herbal or dietary supplements, or prescribed and OTC medications. In addition, inform your doctor if you have allergies to avoid allergic reactions.

The following in the list below are some of the possible drug interactions of metronidazole. This list is not exhaustive.

  • Amprenavir
  • Bepridil
  • Cisapride
  • Disulfiram
  • Dronabinol
  • Dronedarone
  • Mesoridazine
  • Pimozide
  • Saquinavir
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Read also: Metronidazole for Dental Infection

Frequently Asked Questions

Metronidazole and Antabuse share similar effects when used with alcohol. Antabuse is a medication that treats alcoholism by heightening the patient’s sensitivity to alcohol consumption. This can result in you feeling sick after drinking a small amount of alcohol.

Flagyl vagina gel is explicitly made to be inserted into the vagina, where it can eliminate infectious bacteria by stopping their growth. This medication usually has an applicator to help you correctly use the gel. The applicator enables you to insert the medicated gel into your vagina.

Always keep medications out of the reach of children. Store your flagyl vagina gel at room temperature between 15- and 30-degrees C. Dispose of any unused medicine after its expiry date. Do not put your medication in the freezer.

The content on Doctor Alexa’s blog is reviewed by Advanced practice registered nurses or pharmacist and is intended for educational purposes only. This information should not be relied upon as professional medical counsel. Be sure to always consult with your physician about the dangers and benefits of any medication, treatment or procedure.

You shouldn’t wait to see the doctor for simple health needs.