Metronidazole Topical Side Effects

Medically reviewed by Drugs.com. Last updated on Feb 11, 2024.

For healthcare professionals

Applies to metronidazole topical: topical cream, topical gel, topical kit, topical lotion, vaginal gel.

Local adverse events

• Very common (10% or more): Dryness (up to 28.5%), scaling (up to 24.6%), itching (up to 16.3%), pruritus (up to 15.8%), stinging (up to 11%), stinging/burning (up to 10.3%)
• Common (1% to 10%): Burning, local allergic reaction
• Frequency not reported: Condition aggravated (rosacea or acne), transient redness, irritation
• Postmarketing reports: Application site reaction, local irritation^[Ref]

Local cutaneous signs/symptoms of irritation that were worse than baseline included dryness (25.4% [mild: 17.1%; moderate: 7.7%; severe: 0.6%]), scaling (24.6% [mild: 16.2%; moderate: 7.9%; severe: 0.6%]), pruritus (15.8% [mild: 9.7%; moderate: 5%; severe: 1.1%]), and stinging/burning (10.3% [mild: 7.2%; moderate: 1.3%; severe: 1.8%]).^[Ref]

Genitourinary

• Very common (10% or more): Vaginal discharge (up to 12%)
• Common (1% to 10%): Candida cervicitis/vaginitis, yeast infection, dysmenorrhea, metrorrhagia, vulvovaginal candidiasis, vulvovaginal pruritus, urinary tract infection (UTI), vaginal itching/irritation/burning/numbness, vulva/vaginal irritative symptoms, pelvic discomfort
• Uncommon (0.1% to 1%): Vaginal mycosis, urine discoloration, UTI symptoms, vulva edema, menstrual discomfort/irregularities, vaginal spotting/bleeding
• Frequency not reported: Breast enlargement, dysuria, female lactation, labial edema, menorrhagia, salpingitis, urinary frequency, vulvovaginal disorder, vulvovaginal discomfort, itching (vaginal and perianal), vulvar burning, vulvar lesions, uterine/menstrual/vaginal cramping, darkened urine
• Postmarketing reports: Leukorrhea, vaginitis, vulvar disorder, genital pruritus

Oral or parenteral formulations:

• Frequency not reported: Yeast infection, darkened urine, vaginal discharge, vaginal itching, overgrowth of Candida in vagina, dyspareunia, proctitis, dysuria, cystitis, polyuria, incontinence, sense of pelvic pressure, vulva/vaginal irritative symptoms, itching (vaginal and perianal), vulvar burning, vulvar lesions, vaginal burning, pelvic discomfort, uterine/menstrual/vaginal cramping^[Ref]

Other

• Very common (10% or more): Fungal infection (up to 12%)
• Common (1% to 10%): Infection, breast pain, unspecified cramping, abscess, accidental injury
• Uncommon (0.1% to 1%): Fatigue
• Frequency not reported: Mucous membrane disorder, pain, thirst, surgical/medical procedure
• Postmarketing reports: Swelling face, facial edema, treatment failure (worsening of rosacea)

Oral or parenteral formulations:

• Frequency not reported: Fatigue, weakness^[Ref]

Respiratory

• Very common (10% or more): Influenza (up to 11%)
• Common (1% to 10%): Pharyngitis, bronchitis, nasopharyngitis, sinusitis, rhinitis, upper respiratory tract infection, nasal congestion
• Frequency not reported: Asthma^[Ref]

Gastrointestinal

• Common (1% to 10%): Abdominal pain, nausea, diarrhea/loose stools, gastritis, tooth disorder, gastrointestinal discomfort, abdominal cramps, vomiting, unpleasant taste/unusual feeling on tongue
• Uncommon (0.1% to 1%): Constipation, dry mouth, abdominal bloating/noises
• Frequency not reported: Dyspepsia, flatulence, gingivitis, abdominal cramping, abdominal bloating/gas
• Postmarketing reports: Abdominal pain, diarrhea, nausea

Oral or parenteral formulations:

• Frequency not reported: Nausea, unpleasant taste/feeling on tongue, diarrhea, constipation, abdominal cramping, abdominal discomfort, vomiting, epigastric distress, "furry" tongue, glossitis, stomatitis, pancreatitis, gastrointestinal discomfort, gastrointestinal disturbance^[Ref]

Nervous system

• Common (1% to 10%): Headache, dizziness, unpleasant taste, hypertonia
• Uncommon (0.1% to 1%): Metallic taste, dysgeusia/unusual taste, paresthesia, hypoesthesia
• Frequency not reported: Ataxia, drowsiness
• Postmarketing reports: Peripheral neuropathy, taste perversion, dizziness, headache, paresthesia, metallic taste, tingling/numbness of extremities

Oral or parenteral formulations:

• Frequency not reported: Unpleasant taste, dizziness, headache, convulsive seizures, encephalopathy, aseptic meningitis, peripheral neuropathy (characterized mainly by numbness/paresthesia of an extremity), syncope, vertigo, incoordination, ataxia, confusion, dysarthria, unpleasant metallic taste, taste of alcoholic beverages modified^[Ref]

Cardiovascular

• Common (1% to 10%): Hypertension

Oral or parenteral formulations:

• Frequency not reported: Flattening of T-wave in ECG tracings^[Ref]

Dermatologic

• Common (1% to 10%): Pruritus, rash, contact dermatitis, dry skin, skin discomfort (burning, pain of skin/stinging), erythema/transient skin erythema, worsening of rosacea, skin irritation, psoriasis, seborrhea, skin infection, sunburn, urticaria
• Frequency not reported: Acne, sweating, generalized itching/rash, severe flare of comedonal acne, rosacea aggravated
• Postmarketing reports: Hyperpigmentation, pigmentation disorder, hypertrichosis, rash, urticaria, contact dermatitis, skin exfoliation, erythema, pruritus, burning, dryness, tightness, discomfort, rash, zoster lesion, pustules on the nose, vesicular bullous eruption

Oral or parenteral formulations:

• Frequency not reported: Urticaria, angioedema^[Ref]

Metabolic

• Common (1% to 10%): Decreased appetite
• Frequency not reported: Anorexia, hypomagnesemia

Oral or parenteral formulations:

• Frequency not reported: Decreased appetite, anorexia^[Ref]

Musculoskeletal

• Common (1% to 10%): Bursitis, myalgia, osteoporosis
• Uncommon (0.1% to 1%): Back pain, cramp^[Ref]

Hematologic

• Common (1% to 10%): Increased/decreased WBC counts

Oral or parenteral formulations:

• Frequency not reported: Reversible neutropenia, reversible thrombocytopenia

Ocular

• Common (1% to 10%): Conjunctivitis
• Frequency not reported: Eye irritation (watering/tearing)
• Postmarketing reports: Eyelid edema, watery eyes

Oral or parenteral formulations:

• Frequency not reported: Optic neuropathy^[Ref]

Oncologic

• Common (1% to 10%): Skin carcinoma
• Uncommon (0.1% to 1%): Basal cell carcinoma
• Frequency not reported: Skin cancer^[Ref]

Endocrine

• Common (1% to 10%): Hypothyroidism

Hypersensitivity

• Postmarketing reports: Allergic reaction

Oral or parenteral formulations:

• Frequency not reported: Allergic reaction, hypersensitivity reactions (including urticaria, erythematous rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, flushing, nasal congestion, dryness of mouth/vagina/vulva, fever, pruritus, fleeting joint pains), anaphylaxis

Psychiatric

• Uncommon (0.1% to 1%): Depression, difficulty sleeping, irritability
• Frequency not reported: Insomnia

Oral or parenteral formulations:

• Frequency not reported: Trouble sleeping, irritability, depression, insomnia, decreased libido^[Ref]

Hepatic

• Frequency not reported: Abnormal liver function test^[Ref]

Renal

• Frequency not reported: Pyelonephritis^[Ref]

Further information

Metronidazole topical side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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