METRONIDAZOLE ___insert / applicatorful in the vagina It is important that you keep your doctor ____times a day for ___days appointments and come for your  Other NAMES : Flagyl laboratory tests so that your progress What should you do if you FORGET a dose? can be followed. WHY is this drug prescribed? If you miss a dose of metronidazole, take it as What other PRECAUTIONS should you Metronidazole is a drug used to treat soon as possible. However, if it is time for your follow while using this drug? infections caused by parasites (amoeba) next dose, do not double the dose, just carry on and anaerobe bacteria. It can be given to with your regular schedule. Before starting metronidazole, please treat diarrhea caused by Entamoeba inform your doctor if you have a history of histolytica , Giardia lamblia , or Clostridium Why should you not forget to take this drug? problems with your liver, blood or nervous difficile . It can also be used to treat vaginal system (convulsions). Also, inform your infections or various types of bacterial If you miss doses of metronidazole, the infection doctor if you are allergic to metronidazole. infections. will continue and possibly worsen. Therefore, it is You should NOT use metronidazole if you extremely important that you take metronidazole have a known allergy to this drug. HOW should this drug be taken? for the entire duration of the treatment. You should NOT drink any alcohol while Metronidazole is available as 250 mg tablets What ADVERSE EFFECTS can this drug you are taking metronidazole and for at and 500 mg capsules. It is also available as cause? What should you do about them? least 24 hours after the end of the vaginal creams and inserts as well as a treatment. Drinking alcohol will give you cream to apply on the skin. If needed, Adverse effects seen on occasion with flushing. This is characterized by hot metronidazole can also be given metronidazole are nausea, vomiting, upset flashes, redness of the face and chest, intravenously (by the veins). stomach, loss of appetite, dry mouth, and nausea, headaches and a general feeling of

metallic taste. Metronidazole can also cause being unwell. The recommended dose of metronidazole headache, dizziness, drowsiness, and will vary depending on the type of infection confusion. Rarely it can cause hallucinations, As this drug may cause some people to that is being treated. convulsions and a tingling or numbness become dizzy, drowsy or less alert than

feeling in the hands, legs and feet (peripheral normal, you should NOT drive, use Metronidazole can be taken with or without neuropathy) . If these effects appear and are machinery or do anything else that could be food. You should NOT take any alcohol bothersome, call your doctor or pharmacist. dangerous if you are dizzy or are not alert. during your treatment and for at least 24 hours following the end of the treatment. Rarely, an allergic reaction with a skin rash, Metronidazole can interfere with other

hives and fever may occur. Please consult a drugs. Inform your doctor and pharmacist Your dosage is: doctor immediately if this happens. of all prescribed and non-prescribed drugs

you are taking. As well, you should inform 250 mg tablet Metronidazole may cause decreases in white them of natural products you are taking. If 500 mg capsule blood cells (needed to help fight infection) as you wish to start a new drug or natural

well as increases in liver enzymes (sign of liver product, please consult with your ___tablets or capsules (_____mg) by mouth damage). Blood tests should be done regularly pharmacist before doing so. ___times a day for _____ days to check if there are any changes in these

values. Also, your doctor will check your In particular, you should NOT take or pancreas function. Please inform your doctor if metronidazole if you are taking disulfiram

you develop symptoms such as fever, chills, (Antabuse ). 500 mg vaginal insert sore throat, fatigue, yellow skin and eyes, severe vaginal cream (applicator included) abdominal pain and vomiting. Also, inform your doctor and pharmacist if you How should this drug be STORED? are taking the following drugs: Metronidazole should be stored in a cool - 5-fluorouracil ° (15-25 C) dry place, protected from light and - lithium (Carbolith , Lithane , well out of the reach of children. Ensure that Duralith ) the drug has not expired by checking the - phenobarbital expiry date (“EXP”) shown on the outside of - phenytoin (Dilantin ) the package. - warfarin (Coumadin ) METRONIDAZOLE Do not store in your bathroom or kitchen, as Metronidazole should NOT be used during heat and moisture may cause the drug to be pregnancy, especially during the first less active. trimester. Please inform your doctor if you are pregnant. The potential benefits will If you have any questions or concerns need to be compared to the potential risks about this drug or if you are experiencing for the baby. You should NOT breastfeed adverse effects, please discuss them while taking metronidazole. with your pharmacist, doctor or nurse.

When you have diarrhea, it is crucial to Write questions or concerns down to MEDICATION always drink appropriate amounts of fluids ensure they are addressed. in order to avoid dehydration. If you have minor diarrhea (less than 4 stools daily) The following pharmacist is available to drinking caffeine-free soft drinks, juices or answer questions: FACT SHEET sport rehydration drinks can be sufficient. If the diarrhea is more severe, specially Pharmacist: ______formulated rehydration drinks should be taken. Telephone: ______

These products can be obtained in pharmacies (for example, Pedialyte® or

Gastrolyte®). These drinks contain sugar as well as other substances that you may lose in high amounts because of the diarrhea (sodium, potassium). Your pharmacist can tell you how much of these drinks you need to take to avoid dehydration.

You should consult a doctor if you have Reference: Product Monograph Flagyl  one or more symptoms associated with dehydration. These are dry mouth, (metronidazole); Laval, Qc, Canada: Sanofi Aventis Pharma ., 2007. Prepared by the Ontario HIV excessive thirst, wrinkled skin, little or no Pharmacy Professional Specialty Group, 2003. urination, dizziness and lightheadedness. Reviewed 2009.

Additional medication fact sheets and updates may be found at: www.hivclinic.ca