Skip to main content

Metronidazole topical Disease Interactions

There are 4 disease interactions with metronidazole topical.

Moderate

Topical metronidazole (applies to metronidazole topical) alcoholism

Moderate Potential Hazard, Low plausibility.

Metronidazole may be systemically absorbed when applied to the skin or mucosal membranes. A disulfiram-like reaction has been reported in patients who consume alcohol during treatment with oral metronidazole. Symptoms include nausea, vomiting, flushing, sweating, headache, abdominal cramps, and hypotension. Therapy with topical metronidazole should be administered cautiously in patients who might be prone to acute alcohol intake. Patients should be instructed to avoid alcohol-containing products during therapy and for at least 48 hours after the last dose.

References

  1. Giannini AJ, DeFrance DT "Metronidazole and alcohol: potential for combinative abuse." J Toxicol Clin Toxicol 20 (1983): 509-15
  2. Alexander I "Alcohol-antabuse syndrome in patients receiving metronidazole during gynaecological treatment." Br J Clin Pract 39 (1985): 292-3
  3. Harries DP, Teale KF, Sunderland G "Metronidazole and alcohol: potential problems." Scott Med J 35 (1990): 179-80
  4. "Product Information. MetroGel-Vaginal (metroNIDAZOLE topical)." Curatek Pharmaceuticals Ltd (2022):
View all 4 references
Moderate

Topical metronidazole (applies to metronidazole topical) blood dyscrasias

Moderate Potential Hazard, Low plausibility. Applicable conditions: Bone Marrow Depression/Low Blood Counts, History - Blood Dyscrasias

Metronidazole may be systemically absorbed when applied to the skin or mucosal membranes. The use of metronidazole has rarely been associated with hematologic adverse effects such as mild, transient leukopenia, thrombocytopenia, and bone marrow aplasia. The manufacturers recommend that therapy with metronidazole be administered cautiously in patients with evidence of or a history of blood dyscrasias.

References

  1. Smith JA "Neutropenia associated with metronidazole therapy." Can Med Assoc J 123 (1980): 202
  2. White CM, Price JJ, Hunt KM "Bone marrow aplasia associated with metronidazole." Br Med J 280 (1980): 647
  3. "Product Information. MetroGel (metroNIDAZOLE topical)." Galderma Laboratories Inc (2022):
Moderate

Topical metronidazole (applies to metronidazole topical) liver disease

Moderate Potential Hazard, Low plausibility.

Metronidazole may be systemically absorbed when applied to the skin or mucosal membranes. Once absorbed, metronidazole is extensively metabolized by the liver to both pharmacologically active and inactive compounds. The plasma clearance of metronidazole may be decreased and the half-life prolonged in patients with impaired hepatic function. Therapy with topical metronidazole should be administered cautiously in patients with liver disease.

References

  1. Lau AH, Evans R, Chang CW, Seligsohn R "Pharmacokinetics of metronidazole in patients with alcoholic liver disease." Antimicrob Agents Chemother 31 (1987): 1662-4
  2. Jensen JC, Gugler R "Single- and multiple-dose metronidazole kinetics." Clin Pharmacol Ther 34 (1983): 481-7
  3. Farrell G, Baird-Lambert J, Cvejic M, Buchanan N "Disposition and metabolism of metronidazole in patients with liver failure." Hepatology 4 (1984): 772-6
  4. Loft S, Dossing M, Poulsen HE, et al. "Influence of dose and route of administration on disposition of metronidazole and its major metabolites." Eur J Clin Pharmacol 30 (1986): 467-73
  5. Loft S, Sonne J, Dossing M, Andreasen PB "Metronidazole pharmacokinetics in patients with hepatic encephalopathy." Scand J Gastroenterol 22 (1987): 117-23
  6. "Product Information. MetroGel-Vaginal (metroNIDAZOLE topical)." Curatek Pharmaceuticals Ltd (2022):
View all 6 references
Moderate

Topical metronidazole (applies to metronidazole topical) neurologic toxicity

Moderate Potential Hazard, Low plausibility. Applicable conditions: CNS Disorder, Peripheral Neuropathy

Metronidazole may be systemically absorbed when applied to the skin or mucosal membranes. The use of oral and intravenous metronidazole has been associated with the development of nervous system toxicity including convulsive seizures and dose-related peripheral neuropathy, the latter characterized primarily by numbness or paresthesia of an extremity. Persistent peripheral neuropathy has been reported in some patients treated for prolonged periods. Other neurologic adverse effects include vertigo, incoordination, ataxia, confusion, agitation, hallucinations, and depression. Therapy with topical metronidazole should be administered cautiously in patients with or predisposed to seizures or other nervous system abnormalities. Metronidazole therapy should be discontinued promptly if neurologic disturbances occur.

References

  1. Kusumi RK, Plouffe JF, Wyatt RH, Fass RJ "Central nervous sytem toxicity associated with metronidazole therapy." Ann Intern Med 93 (1980): 59-60
  2. Schentag JJ, Ziemniak JA, Greco JM, Rainstein M, Buckley RJ "Mental confusion in a patient treated with metronidazole: a concentration-related effect." Pharmacotherapy 2 (1982): 384-7
  3. Alvarez RS, Richardson DA, Bent AE, Ostergard DR "Central nervous system toxicity related to prolonged metronidazole therapy." Am J Obstet Gynecol 145 (1983): 640-1
  4. Wienbren M, Perinpanayagam RM, Camba L, Lee CA "Convulsions and encephalopathy in a patient with leukaemia after treatment with metronidazole." J Clin Pathol 38 (1985): 1076
  5. Duffy LF, Daum F, Fisher SE, et al. "Peripheral neuropathy in Crohn's disease patients treated with metronidazole." Gastroenterology 88 (1985): 681-4
  6. Boyce EG, Cookson ET, Bond WS "Persistent metronidazole-induced peripheral neuropathy." DICP 24 (1990): 19-21
  7. Stahlberg D, Barany F, Einarsson K, Ursing B, Elmquist D, Persson A "Neurophysiologic studies of patients with Crohn's disease on long-term treatment with metronidazole." Scand J Gastroenterol 26 (1991): 219-24
  8. Learned-Coughlin S "Peripheral neuropathy induced by metronidazole." Ann Pharmacother 28 (1994): 536
  9. Ahmed A, Laes DJ, Bressler EL "Reversible magnetic resonance imaging findings in metronidazole-induced encephalopathy." Neurology 45 (1995): 588-9
  10. "Product Information. MetroGel-Vaginal (metroNIDAZOLE topical)." Curatek Pharmaceuticals Ltd (2022):
  11. Schreiber W, Spernal J "Metronidazole-induced psychotic disorder." Am J Psychiatry 154 (1997): 1170-1
View all 11 references

Metronidazole topical drug interactions

There are 8 drug interactions with metronidazole topical.

Metronidazole topical alcohol/food interactions

There is 1 alcohol/food interaction with metronidazole topical.


Report options

Share by QR Code
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.