Drug interactions with Flagyl (Metronidazole)

Are drug interactions possible with Metronidazole?

Drug interactions are mutual or irreciprocal actions of the medicines when used together. They can occur when the medicines are mixed together or used one after the other. Some drugs may alter the actions of other drugs, increase the risk of adverse reactions.1

So, to avoid all possible Metronidazole interactions it is necessary to keep the track of all other medicines you use at the same period. This includes the prescription and non-prescription drugs, herbal products, vitamins, minerals and dietary products.

The list of the medical products, you are using, should be discussed with the doctor who prescribes you Metronidazole. Sometimes, there is a need for dose change or avoidance of certain medicines and your doctor can notify you about it.

2It is important to remember to tell your doctor if you are going to start using any other medicine product during the treatment with Metronidazole. Consult your doctor and do not mix drugs until approved.

Flagyl (Metronidazole) may interact with:

1) Severe interactions of Metronidazole: the medicines should not be mixed or used together. Metronidazole must not be used with Disulfiram, Tinidazole ethyl, alcohol, any medicine containing alcohol.

Disulfiram should not be used for 2 weeks before and during treatment with Flagyl. Serious drug interactions may happen.

Flagyl should not be used with alcohol in any form. Serious health consequences related to liver condition may occur. The use of alcohol should be avoided before the treatment with Metronidazole and during 1-2 days after the treatment is stopped.3

If you know that the medical product you use or any other product contains alcohol, do not use consume it with Metronidazole. To this relates the following: cough and cold syrups, herbal tinctures and other alcohol containing drugs.

Special notification is made towards usage of products containing propylene glycol, lopinavir or ritonavir oral solution, warfarin, busulfan, cimetidine, fluorouracil, lithium, mebendazole, live bacterial vaccines, phenobarbital, phenytoin. These products should not be used during the treatment with Metronidazole.

4Alcohol with Flagyl therapy may cause abdominal cramps, nausea, vomiting, headaches, and flushing.

Special care should be made in patients who abuse alcohol. Such patients using Disulfiran and Metronidazole simultaneously are at high risk for having psychotic side effects.

2) Serious drug interactions of Metronidazole:

The following medications may seriously interact with Metronidazole and cause very harmful health effects: Mebendazole, Busulfan, Tinidazole, anticoagulants, Fluorouracil.

Metronidazole can increase the anticoagulant effect of warfarin and other oral coumarin anticoagulants. The result of this interaction is a prolongation of prothrombin time. During Metronidazole therapy, the use of anticoagulants should be evaded.

3) Moderate drug interactions of Metronidazole:5

The medications like barbiturates, phenytoin, phenobarbital, lithium taken with Metronidazole may increase the elimination of the last one from the body, decrease its plasma level and make ineffective. These medicines should be avoided as they have influence on the effectiveness of Metronidazole.

Any medication which decreases the enzyme liver activity should not be used together with Metronidazole. Such medicines as lithium can become more toxic if used with Metronidazole.

The simultaneous administration of certain drugs with Metronidazole is not advised or may be even harmful for health. It is wise to notify your doctor about all the medicines you are using.

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