Flagyl, Flagyl ER, Flagyl IV RTU, Flagyl 375, Metizol, Metric 21, Metro I.V., MetroGel, MetroGel Vaginal, MetroLotion, Noritate, Protostat
antiinfective; antitrichomonal; amebicide; antibiotic
Pregnancy Category: B


Assessment & Drug Effects

  • Discontinue therapy immediately if symptoms of CNS toxicity (see Appendix F) develop. Monitor especially for seizures and peripheral neuropathy (e.g., numbness and paresthesia of extremities).
  • Lab tests: Obtain total and differential WBC counts before, during, and after therapy, especially if a second course is necessary.
  • Monitor for S&S of sodium retention, especially in patients on corticosteroid therapy or with a history of CHF.
  • Monitor patients on lithium for elevated lithium levels.
  • Report appearance of candidiasis or its becoming more prominent with therapy to physician promptly.
  • Repeat feces examinations, usually up to 3 mo, to ensure that amebae have been eliminated.

Patient & Family Education

  • Adhere closely to the established regimen without schedule interruption or changing the dose.
  • Refrain from intercourse during therapy for trichomoniasis unless male partner wears a condom to prevent reinfection.
  • Have sexual partners receive concurrent treatment. Asymptomatic trichomoniasis in the male is a frequent source of reinfection of the female.
  • Do not drink alcohol during therapy; may induce a disulfiram-type reaction (see Appendix F). Avoid alcohol or alcohol-containing medications for at least 48 h after treatment is completed.
  • Urine may appear dark or reddish brown (especially with higher than recommended doses). This appears to have no clinical significance.
  • Report symptoms of candidal overgrowth: Furry tongue, color changes of tongue, glossitis, stomatitis; vaginitis, curd-like, milky vaginal discharge; proctitis. Treatment with a candidacidal agent may be indicated.
  • Do not breast feed while taking this drug.

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