Metronidazole
Metronidazole, sold under the brand name Flagyl among others, is an antibiotic and antiprotozoal medication. It is used either alone or with other antibiotics to treat pelvic inflammatory disease, endocarditis, and bacterial vaginosis. It is effective for dracunculiasis, giardiasis, trichomoniasis, and amebiasis. It is an option for a first episode of mild-to-moderate Clostridioides difficile colitis if vancomycin or fidaxomicin is unavailable. Metronidazole is available orally (by mouth), as a cream or gel, and by slow intravenous infusion (injection into a vein).
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| AHFS/Drugs.com | Monograph |
| MedlinePlus | a689011 |
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| Routes of administration | By mouth, topical, rectal, intravenous, vaginal |
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| Bioavailability | 80% (by mouth), 60–80% (rectal), 20–25% (vaginal) |
| Protein binding | 20% |
| Metabolism | Liver |
| Metabolites | Hydroxymetronidazole |
| Elimination half-life | 8 hours |
| Excretion | Urine (77%), faeces (14%) |
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| ECHA InfoCard | 100.006.489 |
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| Formula | C6H9N3O3 |
| Molar mass | 171.156 g·mol−1 |
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| Melting point | 159 to 163 °C (318 to 325 °F) |
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Common side effects include nausea, a metallic taste, loss of appetite, and headaches. Occasionally seizures or allergies to the medication may occur. Some state that metronidazole should not be used in early pregnancy, while others state doses for trichomoniasis are safe. Metronidazole is generally considered compatible with breastfeeding.
Metronidazole began to be commercially used in 1960 in France. It is on the World Health Organization's List of Essential Medicines. It is available in most areas of the world. In 2020, it was the 222nd most commonly prescribed medication in the United States, with more than 2 million prescriptions.