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Overview: Vaginal metronidazole gel is inserted into the vagina to treat an infection called bacterial vaginosis. It works by killing certain types of bacteria. The most common side effect is a vaginal yeast infection. Contact your health care provider if you have vaginal irritation or signs of a yeast infection, such as thick, white discharge and itchiness. Avoid alcohol during treatment and for a short time after using vaginal metronidazole. Combining alcohol with metronidazole can cause nausea, vomiting, flushing, and other reactions.

Uses

What is vaginal metronidazole used for?

Vaginal metronidazole is an antibiotic that is commonly used for an infection called bacterial vaginosis that is caused by certain bacteria.

Vaginal metronidazole may not be the right medicine for the infection listed above, depending on which germs are causing the infection. Bacteria in some locations may be resistant to vaginal metronidazole, which will make it not work as well.

Vaginal metronidazole may also be used for other conditions as determined by your health care provider.

Metronidazole is also available for use on the skin. See Metronidazole topical for more information.

Metronidazole is also available for use by mouth or injection. See Metronidazole for more information.

How does vaginal metronidazole work (mechanism of action)?

Vaginal metronidazole kills certain types of bacteria by damaging the DNA.

How is vaginal metronidazole supplied (dosage forms)?

Brands and other names

  • Nuvessa
  • Vandazole

Dosage forms and strengths

  • 1.3% vaginal gel  
  • 0.75% vaginal gel

How should I store vaginal metronidazole?

Vaginal metronidazole should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C  and 30 C), for shorter periods of time, such as when transporting it. Do not freeze.

Side Effects

What are the most common side effects of vaginal metronidazole?

The most common side effects of vaginal metronidazole are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Headache
  • Itching around the vagina 
  • Stomach pain
  • Nausea
  • Painful or heavy periods
  • Sore throat 
  • Rash
  • Diarrhea
  • Breast pain (Vandazole)

Vaginal Yeast Infection. A vaginal yeast infection may happen during or after treatment withvaginal metronidazole. Vaginal metronidazole does not treat yeast infections. Contact your health care provider if you have signs of a vaginal yeast infection, such as vaginal discharge, itching, or discomfort. You may need treatment with an antifungal drug.

There may be other side effects of vaginal metronidazole that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of vaginal metronidazole?

While less common, the most serious side effects of vaginal metronidazole are described below, along with what to do if they happen.

Severe Allergic Reactions. Vaginal metronidazole can cause allergic reactions, which can be serious. Stop using vaginal metronidazole and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or a general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Nervous System Problems. Use of other forms of metronidazole taken by mouth or given by injection has caused nervous system problems. Stop using vaginal metronidazole if you have any of the following symptoms and call your health care provider.

  • Seizures
  • Numbness, tingling, or pain in the hands or feet, also called peripheral neuropathy
  • Confusion, problems thinking, or behavior changes

Warnings & Precautions

Who should not use vaginal metronidazole?

Allergies to Ingredients. People who are allergic to any of the following should not use vaginal metronidazole.

  • Metronidazole
  • Nuvessa
  • Vandazole
  • Parabens
  • Any other medicine known as a nitroimidazole derivative
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific metronidazole vaginal products they stock.

Drug Interactions. Vaginal metronidazole should not be used while you are using certain other medicines. Before using vaginal metronidazole, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Alcohol. Potentially serious side effects can occur if vaginal metronidazole is used with either foods or drinks that contain alcohol. Do not drink alcohol or consume foods that contain a type of alcohol called propylene glycol while using vaginal metronidazole. See the Interactions section for more details.

What should I know about vaginal metronidazole before using it?

Do not use vaginal metronidazole unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share vaginal metronidazole with other people, even if they have the same condition as you. It may harm them.

Keep vaginal metronidazole out of the reach of children.

Do not have sex or use vaginal products like tampons or douches when using vaginal metronidazole.

Vaginal metronidazole is only for use in the vagina. If vaginal metronidazole gets in your eyes, splash your eyes with cool water and call your health care provider.

What should I tell my health care provider before using vaginal metronidazole?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if vaginal metronidazole is right for you.

In particular, make sure that you discuss any of the following.

Nervous System Problems. Tell your health care provider if you have any nervous system diseases like seizures or a condition called peripheral neuropathy before using vaginal metronidazole. 

Other Medicines and Supplements. Vaginal metronidazole may interact with other medicines and supplements. Before using vaginal metronidazole, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section below for more details.

Pregnancy. It is not known if or how vaginal metronidazole could affect pregnancy or harm a fetus Tell your health care provider if you are or plan to become pregnant. Your health care provider will let you know if you should use vaginal metronidazole while you are pregnant or trying to get pregnant.

Breastfeeding. Vaginal metronidazole may pass into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. You may choose to pump your breast milk and discard it while using vaginal metronidazole and for 2 days after your last dose. During this time, you may feed your baby previously stored breast milk or infant formula. 

Interactions

Does vaginal metronidazole interact with foods or drinks?

Do not eat or drink anything that contains alcohol or propylene glycol while using vaginal metronidazole and for at least 1 day after stopping Nuvessa or 3 days after stopping Vandazole. 

Does vaginal metronidazole interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. 

In particular, make sure that you discuss if you are using any of the following before using vaginal metronidazole. 

  • Warfarin (Coumadin, Jantoven), which is a blood thinner
  • Disulfiram (Antabuse) within the past 2 weeks, which is a medicine commonly used to treat alcohol use disorder
  • Lithium, which is a medicine used to treat certain mental health conditions 

This may not be a complete list of medicines that can interact with vaginal metronidazole. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much vaginal metronidazole?

If you or someone else has used too much vaginal metronidazole, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of vaginal metronidazole?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses. 

It is important to complete your prescribed course of vaginal metronidazole even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to vaginal metronidazole or other similar medicines.