Flagyl ER (metronidazole extended-release) is a prescription antimicrobial medication designed to provide sustained, effective therapy for a range of serious bacterial and parasitic infections. Its advanced extended-release formulation ensures consistent drug levels in the bloodstream, enhancing therapeutic efficacy while potentially reducing dosing frequency. This medication is specifically indicated for the treatment of bacterial vaginosis in adult women and is valued in clinical practice for its reliable pharmacokinetic profile and targeted antibacterial action.

Features

• Contains 750 mg metronidazole per tablet in an extended-release formulation
• Designed for once-daily dosing, improving patient adherence
• Bioequivalent to immediate-release metronidazole with optimized absorption
• Film-coated tablet for easier swallowing
• Manufactured under strict pharmaceutical quality standards
• Available in 30-count prescription bottles

Benefits

• Provides sustained therapeutic drug levels over 24 hours
• Reduces dosing frequency compared to immediate-release formulations
• Effectively eliminates susceptible anaerobic bacteria and parasites
• Helps restore normal vaginal flora in cases of bacterial vaginosis
• Minimizes peak-trough fluctuations in plasma concentrations
• Supported by extensive clinical evidence of efficacy and safety

Common use

Flagyl ER is primarily prescribed for the treatment of bacterial vaginosis in non-pregnant adult women. It may also be used off-label for other anaerobic bacterial infections when extended-release metronidazole therapy is deemed appropriate by healthcare providers. The medication targets susceptible strains of anaerobic bacteria, including Bacteroides species, Fusobacterium species, and Clostridium species, making it valuable in managing various infections where these pathogens are implicated.

Dosage and direction

The recommended dosage for bacterial vaginosis is one 750 mg tablet taken orally once daily for seven consecutive days. Tablets should be swallowed whole with a full glass of water and must not be crushed, chewed, or split. Administration with food may help minimize gastrointestinal discomfort. Treatment should be completed in full as prescribed, even if symptoms improve before finishing the course. Dosage adjustments may be necessary for patients with hepatic impairment, as determined by a healthcare provider.

Precautions

Patients should be advised to avoid alcohol consumption during treatment and for at least 72 hours after completing therapy due to the risk of a disulfiram-like reaction. Use with caution in patients with central nervous system disorders, as metronidazole has been associated with neurological side effects. Regular monitoring of blood counts is recommended during prolonged therapy. Patients should be informed that this medication may cause dizziness or lightheadedness, requiring caution when operating machinery or driving.

Contraindications

Flagyl ER is contraindicated in patients with known hypersensitivity to metronidazole, other nitroimidazole derivatives, or any component of the formulation. It should not be used during the first trimester of pregnancy unless clearly needed and benefits outweigh risks. Concomitant use with disulfiram is contraindicated due to increased risk of psychotic reactions. Administration with alcohol or alcohol-containing medications is strictly prohibited.

Possible side effect

Common adverse reactions include nausea (approximately 12%), headache (10%), metallic taste (9%), and diarrhea (5%). Less frequently reported effects include dizziness, dry mouth, abdominal discomfort, and constipation. Serious but rare side effects may include peripheral neuropathy, seizures, encephalopathy, and aseptic meningitis. Hematological abnormalities such as leukopenia and neutropenia have been reported with prolonged use. Allergic reactions including urticaria, Stevens-Johnson syndrome, and anaphylaxis may occur in susceptible individuals.

Drug interaction

Metronidazole may potentiate the anticoagulant effect of warfarin, requiring close monitoring of prothrombin time. Concurrent administration with lithium may increase lithium serum concentrations and risk of toxicity. Cimetidine may prolong metronidazole half-life and increase plasma concentrations. Phenytoin and phenobarbital may decrease metronidazole efficacy through enhanced metabolism. Concomitant use with busulfan may increase busulfan toxicity risk.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed administration. Healthcare providers should be consulted if multiple doses are missed or if uncertainty exists about proper dosing.

Overdose

Symptoms of overdose may include nausea, vomiting, ataxia, and neurological disturbances including seizures. There is no specific antidote for metronidazole overdose. Management should include supportive care with gastric lavage if presented early, symptomatic treatment, and monitoring of vital signs. Hemodialysis may accelerate elimination of metronidazole and metabolites. Patients experiencing suspected overdose should seek immediate medical attention.

Storage

Store at controlled room temperature between 20°C to 25°C (68°F to 77°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Do not store in bathroom cabinets where humidity levels may fluctuate. Keep out of reach of children and pets. Properly dispose of any expired or unused medication according to local regulations.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Flagyl ER is available by prescription only and should be used under appropriate medical supervision. Patients should consult their healthcare provider for diagnosis and treatment recommendations. The prescribing physician should be informed of all medical conditions and concurrent medications before starting therapy.

Reviews

Clinical studies demonstrate Flagyl ER’s efficacy in treating bacterial vaginosis, with complete resolution rates comparable to immediate-release formulations. Healthcare providers report good patient tolerance of the extended-release formulation and appreciate the simplified dosing regimen. Some patients note improved gastrointestinal tolerance compared to immediate-release products. The extended-release characteristics are particularly valued in maintaining consistent therapeutic levels throughout the treatment period.