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Flagyl (Metronidazole) Buyer and Patient Handbook in South Africa

What is Flagyl?

Flagyl (Metronidazole) is an antibacterial and antiprotozoal medication belonging to the nitroimidazole class, used primarily to treat bacterial infections and certain parasites. It is indicated for conditions such as bacterial vaginosis, Trichomoniasis, amoebic dysentery, and intra-abdominal infections. The product is approved by the FDA, EMA, and South Africa’s Medicines Control Council (MCC) and is supplied as oral tablets (200 mg and 400 mg).

Who Should Use Flagyl?

• Adults diagnosed with anaerobic bacterial or protozoal infections.
• Patients with bacterial vaginosis, trichomoniasis, or amoebic liver abscesses.
• Individuals requiring pre-operative prophylaxis for colorectal surgery.

How Does It Work?

Flagyl interferes with the DNA of susceptible microorganisms. Once inside the microbial cell, it is reduced to active metabolites that disrupt DNA synthesis, leading to bacterial death. Think of it as a wrench that jams the engine of a car, preventing it from running. The drug has no significant abuse potential, but patients should avoid alcohol during therapy because of a disulfiram-like reaction.

Why Choose Flagyl?

• Proven efficacy: Decades of clinical data support its reliability against anaerobic infections.
• Broad spectrum: Works on both bacteria and certain protozoa, reducing the need for multiple drugs.
• Cost-effective: Generic metronidazole tablets are widely available and affordable in South Africa. Off-label uses exist (e.g., Acne, Rosacea) but should be discussed with a healthcare professional.

Dosage, Administration, Lifestyle and Dietary Recommendations

Recommended Dosage

• 200 mg tablet: 1-2 tablets twice daily, depending on infection severity.
• 400 mg tablet: 1 tablet twice daily for most indications.

How to Take

1. Swallow the tablet whole with a glass of water.
2. Take with food or a light snack to minimise stomach upset.
3. Do not crush or chew unless directed by a pharmacist.

Missed Dose

• Take the missed dose as soon as you remember unless it is within 12 hours of the next scheduled dose.
• Skip the missed dose if the next dose is due soon; do not double-dose.

Overdose

• Seek emergency medical care immediately.
• Common signs include nausea, vomiting, abdominal Pain, and dizziness.

Special Populations

• Elderly: Start with the lower dose; monitor renal function.
• Children (≥ 2 months): Dose is weight-based; consult a paediatrician.
• Renal or hepatic impairment: Dose adjustment may be required; physician oversight essential.

Lifestyle & Diet

• Alcohol: Avoid during treatment and for 48 hours after the last dose to prevent severe flushing, nausea, and rapid heartbeat.
• Grapefruit: No significant interaction, but maintain a balanced diet.

Precautions and Warnings

• Do not use if you have a known hypersensitivity to metronidazole or other nitroimidazoles.
• Caution in patients with severe liver disease, as metabolism may be impaired.
• Flagyl may cause a temporary metallic taste; this is harmless.

Drug Interactions

Potential Side Effects

Common Side Effects

• Nausea
• Metallic taste
• Headache
• Diarrhoea

Less Common Side Effects

• Dark urine (harmless)
• Skin rash
• Peripheral Neuropathy (rare)

Serious Side Effects

• Seizures
• Severe allergic reaction (hives, swelling, difficulty breathing) - seek urgent medical help
• Liver inflammation - monitor liver function tests if symptoms persist

Who Should Avoid This Medication?

• Individuals with a documented allergy to metronidazole or other nitroimidazoles.
• Patients receiving disulfiram therapy.
• Pregnant women in the first trimester unless benefits outweigh risks (consult a healthcare provider).

Storage Instructions

• Keep tablets in their original container, tightly closed.
• Store at room temperature (15-30 °C); protect from moisture and direct sunlight.
• Keep out of reach of children.

Flagyl Alternatives

Frequently Asked Questions

How long does treatment usually last?

Typical courses range from 5 to 10 days, depending on the infection. Some conditions, like bacterial vaginosis, may require a 7-day regimen, while intra-abdominal infections often need 10 days.

Can I drink coffee while taking Flagyl?

Yes, moderate coffee consumption does not affect the drug’s efficacy. However, avoid alcohol throughout the treatment period.

What should I do if I experience a metallic taste?

The taste is a known, harmless side effect. You can rinse your mouth with water or chew sugar-free gum to alleviate it.

Is Flagyl safe for breastfeeding mothers?

Metronidazole is excreted in breast milk in small amounts. Discuss benefits and risks with a healthcare professional; short courses are generally considered acceptable.

Why am I feeling dizzy after taking Flagyl?

Dizziness can occur as a mild central nervous system effect. If it persists or worsens, contact a medical practitioner.

Can Flagyl be used to treat acne?

Off-label use for acne has been reported, but it is not a first-line therapy. Consult a dermatologist before using it for this purpose.

What happens if I miss a dose?

Take the missed dose as soon as you remember, unless it is close to the next scheduled dose. Do not double-dose.

Are there any foods I should avoid?

Aside from alcohol, no specific foods need to be avoided. Maintaining a balanced diet supports recovery.

How quickly will I feel better?

Symptoms often improve within 48-72 hours, but complete eradication of the infection may take the full course. Continue the medication even if you feel better.

Can I take Flagyl with other antibiotics?

Concurrent use is possible, but interactions may occur (e.g., with warfarin). Always inform your pharmacist or doctor about all current medications.

Glossary

• Anaerobic bacteria: Microorganisms that thrive without oxygen; often responsible for deep-tissue infections.
• Protozoa: Single-celled parasites such as Trichomonas vaginalis that cause infections.
• Nitroimidazole: Class of drugs that damage microbial DNA after reduction inside the cell.

Disclaimer

The information provided here is for educational purposes only and does not replace professional medical advice. Off-label uses are discussed for awareness; any such use must be consulted with a qualified healthcare provider. Our online pharmacy platform offers convenient access to medications, but the final decision to use Flagyl rests with the patient and their healthcare professional. Always seek professional guidance before starting or changing any medication regimen.