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Flagyl suppositories

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Flagyl suppositories (Contd)

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain

Unpleasant taste

Sensation of a furry tongue

Inflamed and sore mouth

Loss of appetite

Itchy rash (urticaria)

Severe swelling of lips, face or tongue (angioedema)

Drowsiness

Dizziness

Headache

Shaky movements and unsteady walk (ataxia)

Skin rashes

Pain in the muscles or joints

Darkening of the urine

Visual disturbances

Confusion

Liver disorders

Disorder of the peripheral nerves called peripheral neuropathy, that causes weakness and numbness (on prolonged or intensive therapy)

Decrease in the number of white blood cells in the blood (leucopenia)

Seizures

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to ensure that the combination is safe.

You should avoid alcohol while using this antibiotic, and for at least 48 hours after finishing the course, as this can cause unpleasant symptoms such as hot flushes, abdominal cramps, nausea, vomiting, headache and palpitations.

Metronidazole may enhance the anti-blood-clotting effect of anticoagulant medicines such as warfarin and nicoumalone, and this may increase the risk of bleeding. If you are taking an anticoagulant medicine your blood clotting time (INR) should be monitored during treatment with a course of metronidazole, and your doctor may need to reduce your anticoagulant dose.

Metronidazole may increase the blood levels of the following medicines:

ciclosporin (people taking ciclosporin may need their ciclosporin blood level and kidney function monitored while taking a course of metronidazole)

fluorouracil (also known as 5-FU, this is an anticancer medicine; its side effects are increased by metronidazole, but not its anti-cancer effects)

lithium (people taking lithium should have their lithium blood level and kidney function monitored while taking a course of metronidazole)

phenytoin.

Barbiturates, such as the antiepileptic medicine phenobarbital, decrease the blood level of metronidazole and may make it less effective at treating infection. Your doctor may prescribe you a larger than normal dose of metronidazole if you are taking a barbiturate.

If metronidazole is taken by people taking disulfiram there may be a risk of confusion and psychotic symptoms such as paranoia and hallucinations. This combination should be avoided where possible or closely monitored if essential.

If you are taking a combined oral contraceptive pill or are using contraceptive patches, there may be a very low risk that this antibiotic may make it less effective at preventing pregnancy. Although the risk of this is very low, the personal and ethical consequences of an unwanted pregnancy can be very serious. For this reason, the Family Planning Association recommends that women using a combined contraceptive pill or patch should use an extra method of contraception (eg condoms) while taking a short course of broad-spectrum antibiotic, and for seven days after finishing the antibiotic course. If these seven days run beyond the end of a pill packet, a new packet should be started without a break (in the case of ED pills the inactive tablets should be omitted). If the seven days run beyond the 3 weeks of a patch cycle, a new cycle should be started immediately without a patch-free break.

Other medicines containing the same active ingredient

Oral and rectal brands of metronidazole:

Flagyl S	Flagyl tablets	Metrolyl suppositories
Norzol

Metronidazole capsules, suspension and injection are also available without a brand name, ie as the generic medicine.

Brands of metronidazole that are applied to the skin:

Anabact	Metrogel	Metrosa
Metrotop	Rozex	Zyomet

Brands of metronidazole for application to the vagina:

Zidoval

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