Metronidazole gel

Metronidazole vaginal gel is a prescription-only antibiotic medication. The active ingredient, metronidazole, is used to treat a number of infections, such as rosacea, mouth infections, and bacterial vaginosis (BV).

Metronidazole gel for BV works by stopping the growth of harmful bacteria that cause the infection. As the gel is applied inside the vagina, it reduces the number of bacteria at the site of the infection. Your body can then restore its natural balance of bacteria.

How long does metronidazole gel take to work?

When used correctly, you may start to notice an improvement in your BV symptoms within 2 to 3 days. You’ll still need to finish the whole treatment course, or the infection could come back.

How effective is metronidazole gel?

Metronidazole gel can be just as effective as oral antibiotics when treating BV, with 87 to 91% of people treated successfully.

Zidoval vaginal gel should be used once a day, for 5 days in a row. It is advisable to use it before going to sleep. One dose of 5g should be inserted into the vagina with the applicator.

Before using metronidazole gel, you should make sure you wash your hands thoroughly with soap and water. Once you have opened the tube of gel, you should:

1. Put the open end of an applicator onto the end of the tube.
2. Gently and slowly squeeze the tube from the bottom to fill the applicator.
3. Take the applicator off the tube and place the cap back onto the tube.
4. Lie on your back, before bending and parting your knees.
5. Get hold of the filled applicator by its barrel, before inserting the applicator gently into your vagina. Do this as far as it will go without causing discomfort.
6. Push the plunger down slowly into the applicator. This will release the gel into your vagina.
7. Continue to press down until the plunger comes to a stop. This means that you have released the full amount of gel.
8. Remove the applicator from your vagina and put it in the bin immediately.
9. Use a fresh applicator each night and repeat this process for 5 nights in a row or until your doctor says so.

It’s best to avoid having sex when using Zidoval gel, and it’s not recommended to use it if you’re on your period.

You should not drink alcohol while using metronidazole as it may cause severe side effects, including:

• feeling or being sick (nausea or vomiting)
• stomach cramps
• headaches
• flushing
• a rapid or irregular heartbeat

If you do not feel better after a full course of treatment, talk to your doctor as you may need alternative treatment.

What if I miss a dose?

If you miss a dose, you should not take a double dose but apply the gel when you next go to sleep. When using metronidazole gel, it is important to follow the instructions provided in your patient information leaflet.

Metronidazole gel does not normally cause side effects, but some people may experience:

• nausea and vomiting
• diarrhoea
• a metallic taste in the mouth or a furry tongue
• dizziness and headaches
• dry skin
• itchy or irritated skin
• stomach cramps

Some uncommon side effects of metronidazole gel include:

• fatigue
• unusual feelings in fingers and toes
• muscle cramps
• depression
• metallic taste in the mouth

In rare cases, there may be some serious side effects, such as:

• a serious allergic reaction, which can cause difficulty breathing, swelling in the face, rash, and loss of consciousness – you or someone else should call 999 straight away
• numbness, tingling, or burning in your hands or feet – speak to a doctor straight away or call 999 in an emergency

How long do metronidazole gel side effects last?

Side effects of metronidazole gel usually clear up within a few days once you have stopped using the medication. If side effects do not go away or get worse, you should speak with your doctor straight away.

What to do if you get metronidazole gel side effects

If you do get side effects when using metronidazole gel, most can be easily treated at home. If you get nausea, vomiting, dizziness or headaches, you can help to ease them by:

• staying hydrated
• getting plenty of rest
• eating bland foods
• taking over-the-counter pain medications such as paracetamol or ibuprofen
• getting fresh air
• avoiding alcohol while using the medication, and for 2 days after

These can also help with diarrhoea and stomach cramps. If you are experiencing skin dryness or irritation, it may help to use moisturisers or antihistamines.

Metronidazole gel may not be suitable for everyone. Before you start using metronidazole gel, you should tell your doctor if you:

• are allergic to metronidazole
• are pregnant or breastfeeding
• are under the age of 18
• do not think you will be able to stop drinking alcohol for the duration of the treatment

Medical conditions

It’s important to talk to your doctor about any medical conditions you have before you use metronidazole. You should let your doctor know if you have or have ever had:

• liver disease
• kidney disease, or you’re on dialysis
• a central nervous system condition, or a blood disease
• a stomach or intestinal disease, such as Crohn's disease
• a heart rhythm disorder

Medication interactions

Metronidazole gel may interact with some medications and become less effective, so it is important to let your doctor know if you are currently taking, have recently taken, or may take any medications, especially:

• lithium, used to treat depression
• warfarin, used to treat blood clots
• ciclosporin, used to treat autoimmune diseases
• fluorouracil or busulfan, used in some cancer treatments
• phenytoin, used to treat epilepsy

There are no known interactions with taking herbal remedies with metronidazole, but you should still let your doctor know.

There are a number of places to buy metronidazole gel, but as it is prescription-only, you will need a doctor’s approval to get it. You can request metronidazole gel from trusted online services or sometimes from the NHS.

Can I buy metronidazole gel online?

Yes, you can buy Zidoval vaginal cream from Asda Online Doctor. To buy it, you will first need to complete a short online health assessment for one of our doctors to review. You will then:

1. Place your order.
2. If approved, your order will be prescribed, dispatched, and sent to your home address in discreet packaging, or you can choose to collect it from your local Asda Pharmacy 4 hours after a doctor’s approval.
3. If your order is not approved, one of our doctors will contact you through your account with alternative treatment options.

Getting Zidoval from Asda Online Doctor is an easy and convenient way to treat your BV symptoms, without needing to get a doctor’s appointment or find time to have a face-to-face appointment. You can also message a doctor for free if you have any other questions while taking your BV treatment.

Can I buy metronidazole gel over the counter?

No, you can not buy metronidazole gel over the counter as it is a prescription-only medication.

Can I get metronidazole gel on the NHS?

Yes, you can usually get a prescription for metronidazole gel on the NHS, but you will need to make an appointment with your doctor. You can also get treatment for BV from a sexual health clinic.

There are some alternative BV treatments available if metronidazole gel is not for you, including:

Metronidazole tablets, which are taken by mouth and contain the same active ingredient as Zidoval. Most commonly prescribed as one 400mg tablet twice a day for 7 days. This may be a suitable alternative if you cannot use the gel, such as if you are on your period.

Dalacin cream, which is a 2% cream containing the antibiotic clindamycin. It is applied the same way as the gel, by using an applicator to insert the cream into the vagina. It may be a suitable alternative if you cannot use metronidazole.

Fluomizin, which is a vaginal tablet containing the antiseptic dequalinium chloride. It can be a useful alternative if you cannot use antibiotics such as metronidazole or clindamycin. One tablet is inserted into the vagina every day for 6 days.