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Formulation : Vaginal gel
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Indications

Nidagel (metronidazole) is indicated for the treatment of bacterial vaginosis, which is a common vaginal infection caused by an imbalance of bacteria in the vagina.

Metronidazole, the active ingredient in Nidagel, belongs to the class of medicines known as antibiotics. It works by killing the bacteria or preventing their growth.

Use and Dosage

Read the Patient Information Leaflet if available from your pharmacist before you start taking metronidazole and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor. To prevent stomach upset, take this medication with food or a full glass of water or milk.

If you are using the suspension form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

The dosage is based on your medical condition and response to treatment. In children, the dose is also based on weight.

For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.

Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

Tell your doctor if your condition lasts or gets worse.

Side Effects

Get emergency medical help if you have signs of an allergic reaction to metronidazole (hives, itching, warmth, or tingling; fever, joint pain; dry mouth, dry vagina; stuffy nose, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Metronidazole may cause serious side effects including:

  • Nervous system problems include brain disorder (encephalopathy), inflammation of the brain and spinal cord membranes (aseptic meningitis), numbness or tingling in the hands or feet (peripheral neuropathy), and seizures (convulsions). Tell your healthcare provider right away if you have any nervous system problems while taking metronidazole
  • Worsening yeast infection (candidiasis) symptoms in people with a known yeast infection or a yeast infection they were not aware of
  • Low white blood cell count (leukopenia) in people with a history of blood problems. This can affect how well the body fights infection

The most common side effects of metronidazole include

  • Diarrhea
  • Nausea
  • Headache
  • Pain in the upper abdomen and abdominal cramping
  • Vomiting
  • Weight loss
  • Constipation

Other side effects of metronidazole may include allergic reactions: such as itching, hives (urticaria), flushing of the skin, red skin rash that can be widespread, blisters and separation of skin layers, nasal congestion, dryness of the mouth and vagina, and fever.

Abnormal heart rhythms (QT prolongation) may also occur. Metronidazole can cause life-threatening liver problems in people with Cockayne syndrome. If you have this condition, stop taking this medicine and contact your doctor if you have signs of liver failure–nausea, stomach pain (upper right side), dark urine, clay-colored stools, or jaundice (yellowing of the skin or eyes).

These are not all the possible side effects of metronidazole. 

Cautions

  • Before taking metronidazole, tell your doctor or pharmacist if you are allergic to it; or to other antibiotics (such as tinidazole); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
  • Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, certain blood disorders (low blood cell counts), and a certain rare genetic disorder (Cockayne syndrome).
  • Avoid alcoholic beverages and products containing propylene glycol while taking this medication and for at least 3 days after finishing this medicine because severe stomach upset/cramps, nausea, vomiting, headache, and flushing may occur.
  • This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana (cannabis).
  • Metronidazole may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your healthcare professional that you are using metronidazole before having any immunizations/vaccinations.
  • Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
  • During pregnancy, this medication should be used only when needed. Discuss the risks and benefits with your doctor.
  • This medication passes into breast milk. If you are prescribed the single-dose treatment, your doctor may direct you to stop breastfeeding for a short time after the dose. Consult your doctor before breast-feeding.

Forms and Strengths

Nidagel is available in the following forms and strengths:

  • Nidagel Vaginal gel:
    • 0.75%

FAQ

What happens if I miss a dose?

Take the medicine as soon as you can but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention.

Overdose symptoms may include nausea, vomiting, numbness, tingling, or problems with balance or muscle movement.

What other drugs will affect metronidazole?

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.

Resources:

  1. https://www.medbroadcast.com/drug/getdrug/nidagel
  2. https://www.drugs.com/metronidazole.html#side-effects
  3. https://www.webmd.com/drugs/2/drug-6426/metronidazole-oral/details
  4. https://medlineplus.gov/druginfo/meds/a689011.html

Additional information

Formulation:

Vaginal gel