Precautions and Warnings With Metronidazole Vaginal Gel

There have been reports of women developing seizures or nerve problems while using metronidazole vaginal gel. Other precautions for safely using this product include warnings of potential drug interactions or allergic reactions. Also, women who have a history of anemia, low white blood cells, or other low blood cell counts may not be able to use this vaginal gel.

What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to using metronidazole vaginal gel (MetroGel-Vaginal®) if you:
  • Have any allergies, including to medications, foods, dyes, or preservatives
  • Have a history of low blood cell counts
  • Have liver disease, such as hepatitis, liver failure, or cirrhosis
  • Are pregnant or thinking of becoming pregnant
  • Are breastfeeding.
You should also tell your healthcare provider about all other medications you are taking, including prescription and nonprescription medicines, vitamins, and herbal supplements.

Specific Metronidazole Vaginal Gel Precautions and Warnings

Some warnings and precautions to be aware of prior to using this medication include the following:
  • Metronidazole vaginal gel is for vaginal use only. Do not swallow it, and make sure to keep it out of the eyes. If you accidentally get some of the gel in your eyes, flush your eyes with large amounts of cool tap water.
  • In rare cases, some people have had seizures or developed peripheral neuropathy due to oral or intravenous (IV) metronidazole, the active ingredient in metronidazole vaginal gel. Thus, such problems are at least theoretically possible with metronidazole vaginal gel. Signs of peripheral neuropathy typically include unusual sensations, such as burning, tingling, or pricking in the extremities (the hands, lower legs, and feet). Let your healthcare provider know if you develop any such problems.
  • Make sure your healthcare provider knows if you have (or have ever had) low blood cell counts, such as low white blood cells, low platelets, or anemia. Although it is probably quite unlikely, it is possible that metronidazole vaginal gel could make such problems worse.
  • Although metronidazole vaginal gel is applied vaginally, some of the medication is absorbed into the bloodstream. If you have liver disease, your body will clear the medication from the bloodstream more slowly, perhaps leading to increased levels of the drug.
  • Do not have sex while you are being treated with metronidazole vaginal gel.
  • Be aware that up to 10 percent of women develop vaginal yeast infections during or immediately after treatment with metronidazole vaginal gel. Such infections need to be treated, as this drug is not effective against yeast infections.
  • The active ingredient in metronidazole vaginal gel passes through breast milk. Therefore, if you are breastfeeding a child or plan to start, check with your healthcare provider (or your child's healthcare provider) before beginning treatment (see MetroGel-Vaginal and Breastfeeding).
  • Metronidazole vaginal gel is a pregnancy Category B medication, which means that it is probably safe for use during pregnancy, although the full risks are currently unknown (see MetroGel-Vaginal and Pregnancy for more information).

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Last reviewed by: Kristi Monson, PharmD
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