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Flagyl Vaginal Cream

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Metronidazole

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Flagyl Vaginal Cream (metronidazole) is a prescription antibiotic medication used to treat certain vaginal infections caused by susceptible bacteria and microorganisms.

Flagyl Vaginal Cream contains metronidazole 10%, an active ingredient belonging to a class of medications called nitroimidazole antibiotics.

Metronidazole works by damaging the genetic material of certain bacteria and protozoa, preventing them from surviving and multiplying.

Flagyl Vaginal Cream is applied directly inside the vagina, allowing the medication to act on microorganisms responsible for the infection.

In Canada, Flagyl 10% Vaginal Cream is indicated for treating bacterial vaginosis and trichomonal infections in women. 

Treatment of Bacterial Vaginosis

Flagyl Vaginal Cream is used to treat bacterial vaginosis (BV), a common vaginal condition that develops when the natural balance of bacteria inside the vagina changes.

A healthy vagina normally contains beneficial bacteria, particularly Lactobacillus species. These bacteria help maintain a slightly acidic vaginal environment that limits the growth of certain harmful microorganisms.

Bacterial vaginosis develops when beneficial bacteria decrease and other bacteria, including anaerobic bacteria, grow in excessive amounts.

Anaerobic bacteria can survive and multiply in environments with little or no oxygen.

This bacterial imbalance may lead to changes in vaginal discharge, unpleasant odor, and irritation.

Flagyl Vaginal Cream helps control the overgrowth of susceptible bacteria, allowing the vaginal environment to recover.

The medication may help relieve the following symptoms:

  • Unusual Vaginal Discharge: Bacterial vaginosis may cause thin, watery, white, or grey vaginal discharge. Treating the bacterial imbalance can help reduce abnormal discharge.
  • Unpleasant Vaginal Odor: A strong, fish-like smell is a common symptom of bacterial vaginosis. The odor may become more noticeable after sexual intercourse or during menstruation.
  • Vaginal Irritation: Some women experience mild irritation or discomfort caused by changes in the vaginal environment.
  • Vaginal Burning: Bacterial vaginosis may occasionally cause burning sensations or discomfort during urination.
  • Changes in Vaginal pH: BV often causes vaginal pH to rise above its usual acidic range. Effective antibiotic treatment helps reduce the bacteria associated with this imbalance.

Not everyone with bacterial vaginosis experiences noticeable symptoms. Some women may have the condition without realizing it.

Flagyl Vaginal Cream treats the bacteria associated with BV, but it does not guarantee that the condition will never return.

Bacterial vaginosis can recur, particularly when the vaginal bacterial balance becomes disrupted again.

Your healthcare provider will determine whether Flagyl Vaginal Cream is appropriate based on your symptoms, medical history, and the results of any necessary examinations or laboratory tests. 

How Does Flagyl Vaginal Cream Work?

Flagyl Vaginal Cream contains metronidazole, an antibiotic belonging to the nitroimidazole class.

Metronidazole works by entering susceptible bacteria and interfering with essential processes that allow them to survive and multiply.

The medication is particularly effective against certain anaerobic bacteria associated with bacterial vaginosis.

Damages Bacterial DNA

Bacteria need healthy DNA to maintain their normal functions, reproduce, and survive.

When metronidazole enters susceptible anaerobic bacteria, chemical processes inside these microorganisms convert it into active compounds.

These compounds interact with bacterial DNA, causing damage that interferes with normal cellular activities.

As a result, susceptible bacteria lose their ability to survive.

Reduces the Growth of Harmful Vaginal Bacteria

Bacterial vaginosis involves an increase in certain bacteria that disrupt the vagina’s normal environment.

These may include Gardnerella vaginalis, Mobiluncus species, and other anaerobic bacteria.

Metronidazole helps eliminate susceptible organisms associated with the infection.

As the number of these bacteria decreases, symptoms such as abnormal discharge and unpleasant odor may gradually improve.

Helps Restore the Vaginal Bacterial Balance

A healthy vaginal environment contains beneficial bacteria that help maintain normal acidity.

When harmful bacteria become more abundant, this balance can change, leading to bacterial vaginosis.

Flagyl Vaginal Cream reduces susceptible bacteria associated with BV, which may allow beneficial vaginal bacteria to become more established again.

However, metronidazole does not directly replace beneficial bacteria or guarantee that BV will not return.

Provides Treatment Directly Inside the Vagina

Flagyl Vaginal Cream is administered inside the vagina using an applicator.

This allows metronidazole to come into direct contact with the affected vaginal tissues and microorganisms.

Although treatment is local, some metronidazole may still enter the bloodstream.

The vaginal cream should not be swallowed or applied to other body areas unless specifically directed by your healthcare provider.

How Long Does Flagyl Vaginal Cream Take to Work?

Flagyl Vaginal Cream begins acting against susceptible microorganisms after administration, but noticeable symptom relief may take several days.

Some women experience a gradual reduction in abnormal vaginal discharge or unpleasant odour during treatment.

The time needed for improvement depends on the severity of the bacterial imbalance, how consistently the medication is used, and whether another vaginal condition is also present.

Continue using Flagyl Vaginal Cream for the complete prescribed treatment period, even if your symptoms improve before you finish the medication.

If your symptoms continue after treatment, become worse, or return shortly afterward, contact your healthcare provider.

Important Information About Flagyl Vaginal Cream

Flagyl Vaginal Cream should only be used for infections that your healthcare provider determines are appropriate for metronidazole treatment.

It does not treat vaginal yeast infections caused by Candida species. It also should not be used as a substitute for the recommended treatment of other sexually transmitted infections.

Avoid vaginal douching during treatment because it may disrupt the natural bacterial environment and increase the likelihood of bacterial vaginosis returning.

The cream’s ingredients may weaken latex condoms and diaphragms, so ask your healthcare provider about suitable protection during treatment.

Tell your healthcare provider if you are pregnant, breastfeeding, allergic to metronidazole, or taking other medications.

Flagyl Vaginal Cream treats bacterial vaginosis by damaging the DNA of susceptible bacteria and reducing their overgrowth inside the vagina. By controlling the underlying bacterial imbalance, the medication helps relieve abnormal discharge, unpleasant odor, and related discomfort.

Flagyl Vaginal Cream is a prescription antibiotic medication used to treat certain vaginal infections, including bacterial vaginosis.

Flagyl contains metronidazole, an antibiotic belonging to a class of medications called nitroimidazoles. It works by damaging the DNA of susceptible bacteria and other microorganisms, preventing them from surviving and multiplying.

Flagyl Vaginal Cream is intended for intravaginal use only, meaning it is applied directly inside the vagina using the applicator supplied with the medication.

The cream delivers metronidazole to the affected area, helping reduce the bacteria responsible for the infection.

Your healthcare provider will determine the correct dosage, application frequency, and treatment duration based on your condition and medical history.

How to Apply Flagyl Vaginal Cream

Follow these steps to apply Flagyl Vaginal Cream safely and correctly:

  1. Wash your hands: Clean your hands thoroughly with soap and water before handling the medication or vaginal applicator.
  2. Prepare the vaginal area: Gently clean the external vaginal area with lukewarm water if necessary, then pat it dry with a clean towel. Avoid using scented soaps, vaginal douches, or harsh cleansing products.
  3. Remove the tube cap: Open the Flagyl Vaginal Cream tube. If the tube is sealed, use the pointed end of the cap to pierce the seal.
  4. Attach the applicator: Screw the open end of the supplied vaginal applicator securely onto the threaded opening of the cream tube.
  5. Fill the applicator: Gently squeeze the tube from the bottom until the red graduation mark on the applicator plunger becomes visible. This indicates that the applicator contains the measured dose.
  6. Remove the applicator: Carefully unscrew the filled applicator from the tube and replace the tube cap.
  7. Get into a comfortable position: Lie on your back with your knees bent and legs slightly apart. This position may make insertion easier.
  8. Insert the applicator: Gently insert the filled applicator into your vagina as far as it comfortably goes. Do not force it if you experience pain or resistance.
  9. Release the medication: Hold the applicator steady and slowly press the plunger until the cream has been released into your vagina.
  10. Remove the applicator: Carefully withdraw the applicator after administering the medication.
  11. Clean the applicator: Wash the reusable applicator with mild soap and warm water. Rinse it thoroughly and allow it to dry before storing.
  12. Wash your hands again: Clean your hands after application to maintain proper hygiene.

Follow the instructions supplied with your specific Flagyl Vaginal Cream product, as applicator designs may vary. 

Recommended Dosage of Flagyl Vaginal Cream

The Canadian prescribing information for Flagyl 10% Vaginal Cream recommends one full applicator containing 500 mg of metronidazole, administered once or twice daily for 10 or 20 consecutive days.

The exact schedule depends on your infection and your healthcare provider’s instructions.

Dosage information Recommended instructions
Medication strength Metronidazole 10% vaginal cream
Amount per application One full applicator (500 mg)
Application frequency Once or twice daily
Treatment duration 10 or 20 consecutive days, as prescribed
Route of administration Intravaginal

Continue the prescribed treatment during menstruation unless your healthcare provider instructs you otherwise.

Do not confuse Flagyl 10% Vaginal Cream with metronidazole 0.75% vaginal gel, which has a different concentration and treatment schedule. 

Important Tips When Using Flagyl Vaginal Cream

Apply the Medication at the Prescribed Time

Flagyl Vaginal Cream may be prescribed once or twice daily, depending on your treatment plan.

If you are instructed to use it once daily, applying the medication at bedtime may be more convenient.

Lying down after application may help reduce leakage and allow the cream to remain in contact with the vaginal tissues.

If you are prescribed two applications daily, follow the morning and evening schedule recommended by your healthcare provider.

Try to apply the medication at approximately the same time each day.

Complete the Full Treatment Course

Continue using Flagyl Vaginal Cream for the entire prescribed treatment period, even if your vaginal discharge, odor, or irritation improves before you finish treatment.

Symptoms may improve before the infection has been fully treated.

Stopping treatment too early may allow the infection to persist or return.

Do not skip applications or shorten your treatment unless your healthcare provider tells you to do so.

If your symptoms continue after completing treatment, contact your healthcare provider for further evaluation.

Avoid Vaginal Douching

Avoid vaginal douching while using Flagyl Vaginal Cream.

Douching can disturb the natural balance of bacteria in the vagina and may contribute to irritation or recurring bacterial vaginosis.

The vagina cleans itself naturally, so internal washing is generally unnecessary.

Gently clean the external genital area with lukewarm water and avoid heavily fragranced feminine hygiene products.

Avoid Sexual Intercourse During Treatment

It is generally recommended to avoid vaginal intercourse during treatment or follow your healthcare provider’s advice about sexual activity.

Sexual activity may increase irritation and interfere with treatment.

The cream also contains ingredients that may weaken latex condoms and diaphragms, reducing their effectiveness.

Ask your healthcare provider about suitable contraception and protection during treatment. 

Avoid Alcohol During Treatment

The Canadian Flagyl product information recommends avoiding alcohol while using the medication and for at least one day after finishing treatment.

Combining alcohol with metronidazole may cause unpleasant symptoms in some people, including nausea, vomiting, stomach cramps, flushing, headache, and a rapid heartbeat.

Although evidence for this interaction is inconsistent, following the manufacturer’s precaution is advisable.

Avoid alcoholic beverages and check with your pharmacist about alcohol-containing medicines during treatment.

Use the Applicator Carefully

Insert the applicator gently to avoid damaging or irritating sensitive vaginal tissues.

If you experience pain, significant resistance, or unusual bleeding during insertion, stop and contact your healthcare provider.

The Canadian product information states that the supplied applicator should not be used after the seventh month of pregnancy.

If you are pregnant or think you may be pregnant, consult your healthcare provider before using Flagyl Vaginal Cream. Your healthcare provider will determine whether treatment and the applicator are appropriate.

What Should I Do If I Miss a Dose?

If you forget to apply Flagyl Vaginal Cream, use the missed dose as soon as you remember, unless it is almost time for your next scheduled application.

If your next application is approaching, skip the missed dose and continue with your regular treatment schedule.

Do not use two doses at the same time to make up for a missed application.

Applying extra cream may increase the risk of side effects without making treatment more effective.

If you miss several applications, contact your healthcare provider or pharmacist for instructions.

How Long Does Flagyl Vaginal Cream Take to Work?

Flagyl Vaginal Cream begins acting against susceptible microorganisms after application, but it may take several days before symptoms improve.

Some women notice a gradual reduction in unusual vaginal discharge, unpleasant odor, and irritation during treatment.

The time needed for improvement depends on the severity of the infection and how consistently you use the medication.

Even if symptoms disappear after a few days, continue treatment for the full prescribed period.

Bacterial vaginosis may return after successful treatment because the vaginal bacterial balance can change again.

If your symptoms do not improve, become worse, or return after treatment, contact your healthcare provider.

How Should I Store Flagyl Vaginal Cream?

Store Flagyl Vaginal Cream at room temperature between 15°C and 30°C (59°F and 86°F).

Keep the medication in its original tube with the cap tightly closed when not in use.

Avoid exposing the cream to excessive heat or moisture.

Store it in a secure location away from children and pets.

Do not use Flagyl Vaginal Cream after its expiration date.

When to Contact Your Healthcare Provider

Contact your healthcare provider if you experience persistent vaginal burning, unusual irritation, worsening discharge, or symptoms that do not improve during treatment.

Some people may experience vaginal dryness, burning, nausea, or stomach discomfort while using metronidazole.

Seek prompt medical advice if you develop a new or worsening rash, numbness, tingling, severe dizziness, or difficulty coordinating your movements.

Seek emergency medical attention immediately if you experience difficulty breathing, swelling of your face or throat, seizures, or a severe blistering skin reaction.

Always use Flagyl Vaginal Cream exactly as prescribed. Applying the correct amount with the supplied applicator, following the recommended treatment schedule, and completing the prescribed course can help treat the infection effectively.

Common Side Effects of Flagyl Vaginal Cream (Metronidazole):

  • Nausea, stomach pain, or diarrhea
  • Headache, dizziness, or loss of balance
  • Vaginal itching or discharge
  • Dry mouth or unpleasant metallic taste
  • Cough, sneezing, runny, or stuffy nose
  • Swollen or sore tongue 

Serious Side Effects of Flagyl Vaginal Cream (Metronidazole):

  • Seizures (convulsions)
  • Fever, chills, body aches, sore throat, or flu symptoms
  • Numbness or tingling in your hands or feet
  • White patches or sores inside your mouth or on your lips
  • Pain or burning when you urinate
  • Diarrhea 

Flagyl Vaginal Cream (Metronidazole) is available in the following forms and strength:

Flagyl Vaginal Cream: Cream

  • 10%

Metronidazole: Cream

  • 10%

Before using Flagyl Vaginal Cream, tell your healthcare provider about any existing medical conditions, allergies, and medications you are taking.

Flagyl Vaginal Cream is a prescription antibiotic used to treat certain vaginal infections, including bacterial vaginosis. It contains metronidazole, which belongs to a class of medications called nitroimidazole antibiotics.

Although Flagyl Vaginal Cream is applied directly inside the vagina, some metronidazole may enter your bloodstream. This means certain side effects and drug interactions associated with oral metronidazole may also occur.

People with liver disease, neurological disorders, blood disorders, or allergies to metronidazole may require additional precautions.

Always follow your healthcare provider’s instructions and use the medication for the prescribed treatment period. 

Allergic Reactions and Hypersensitivity

Do not use Flagyl Vaginal Cream if you are allergic to metronidazole, other nitroimidazole antibiotics such as tinidazole, or any ingredient in the cream.

Some people may experience an allergic reaction after using metronidazole.

Possible symptoms include:

  • Skin Rash: Red, itchy, or inflamed patches may develop.
  • Hives: Raised, itchy bumps may appear on your skin.
  • Swelling: Your face, lips, tongue, or throat may become swollen.
  • Breathing Difficulties: You may experience wheezing, chest tightness, or shortness of breath.
  • Dizziness: Severe allergic reactions may cause lightheadedness or fainting.

Some allergic reactions can become serious and require immediate medical treatment.

Stop using Flagyl Vaginal Cream and contact your healthcare provider if you develop a new rash, unusual swelling, or persistent itching.

Seek emergency medical attention immediately if you experience difficulty breathing, swelling of your tongue or throat, or other symptoms of a severe allergic reaction.

Severe Skin Reactions

Metronidazole has been associated with rare but serious skin reactions.

These include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and drug reaction with eosinophilia and systemic symptoms (DRESS).

These conditions can cause widespread skin inflammation and may affect other parts of the body.

Warning signs include:

  • Widespread Rash: A rash that spreads rapidly across your body.
  • Skin Blistering: Painful blisters or peeling skin.
  • Mouth Sores: Painful sores inside your mouth or on your lips.
  • Fever: A high temperature accompanied by a rash.
  • Facial Swelling: Unusual swelling, sometimes accompanied by swollen lymph nodes.

Stop using Flagyl Vaginal Cream and seek medical attention immediately if you develop a new skin rash, blisters, peeling skin, or sores involving your mouth or eyes.

Serious skin reactions require prompt medical evaluation. 

Liver Disease and Liver Problems

Tell your healthcare provider if you have liver disease before using Flagyl Vaginal Cream.

The liver plays an important role in breaking down metronidazole and removing it from your body.

If your liver is not functioning normally, metronidazole may remain in your bloodstream longer than expected.

This may increase medication exposure and the risk of side effects.

People with severe liver disease may require additional monitoring or a different treatment plan.

Possible symptoms of liver problems include:

  • Yellowing of the Skin or Eyes: Also called jaundice.
  • Dark Urine: Urine may become unusually dark.
  • Abdominal Pain: Particularly pain in the upper right side of your abdomen.
  • Persistent Nausea: Ongoing stomach discomfort or vomiting.
  • Unusual Fatigue: Feeling significantly weaker or more tired than normal.

In rare cases, serious liver injury has occurred with metronidazole.

People with a rare inherited condition called Cockayne syndrome may be at particularly high risk of severe liver damage from systemic metronidazole.

Tell your healthcare provider if you have Cockayne syndrome or a history of serious liver problems.

Contact your healthcare provider immediately if you develop jaundice, persistent abdominal pain, or other symptoms suggesting liver injury. 

Neurological Disorders and Nerve Damage

Flagyl Vaginal Cream should not be used in people with certain active neurological disorders, according to the Canadian prescribing information.

Metronidazole may cause neurological side effects, including peripheral neuropathy, dizziness, poor coordination, and, rarely, seizures.

Peripheral neuropathy occurs when nerves outside the brain and spinal cord become damaged.

Possible symptoms include:

  • Numbness: Reduced sensation in your hands or feet.
  • Tingling: A pins-and-needles sensation.
  • Burning Pain: Unusual burning or sharp nerve pain.
  • Poor Coordination: Difficulty walking or maintaining balance.
  • Dizziness: Feeling unusually lightheaded or unsteady.
  • Seizures: Sudden episodes of abnormal electrical activity in the brain.

These effects are uncommon, but the risk may increase with prolonged treatment or excessive medication exposure.

Tell your healthcare provider if you have epilepsy, peripheral neuropathy, or another neurological condition.

Stop using Flagyl Vaginal Cream and seek immediate medical advice if you develop numbness, tingling, poor coordination, or other unusual neurological symptoms.

Seek emergency medical attention if you experience a seizure, severe confusion, or significant difficulty walking.

Blood Disorders and Low White Blood Cell Count

Tell your healthcare provider if you have a history of blood disorders before using Flagyl Vaginal Cream.

Metronidazole has occasionally been associated with changes in blood cell counts, including reduced numbers of white blood cells.

White blood cells help your immune system fight infections.

A low white blood cell count may make it harder for your body to respond to certain infections.

Possible symptoms include:

  • Unexplained Fever: A persistent or unusually high temperature.
  • Sore Throat: Particularly when accompanied by fever.
  • Mouth Ulcers: Painful sores inside your mouth.
  • Frequent Infections: Developing infections more often than usual.
  • Unusual Weakness: Feeling significantly tired or unwell.

The Canadian Flagyl product monograph lists a history of certain blood disorders as a contraindication.

Your healthcare provider may recommend blood tests if you have relevant medical conditions or require prolonged treatment.

Contact your healthcare provider if you develop unexplained fever, persistent sore throat, or signs of infection.

Alcohol Consumption

The Canadian Flagyl prescribing information recommends avoiding alcohol while using metronidazole and for at least one day after completing treatment.

Some people may experience unpleasant symptoms when alcohol is consumed during metronidazole treatment.

These symptoms may include:

  • Nausea and Vomiting: Feeling sick or vomiting.
  • Stomach Cramps: Abdominal pain or discomfort.
  • Facial Flushing: Sudden warmth or redness of the face.
  • Headache: Unusual or persistent head discomfort.
  • Rapid Heartbeat: Feeling that your heart is racing or pounding.

This reaction is sometimes described as a disulfiram-like reaction.

Although clinical evidence for this interaction is inconsistent, the manufacturer continues to recommend avoiding alcohol during treatment.

Check whether any medicines you use contain alcohol, and ask your pharmacist if you are unsure.

Avoid alcoholic beverages during treatment and for at least 24 hours after your final dose, following the Canadian product instructions. 

Pregnancy and Breastfeeding

Tell your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding before using Flagyl Vaginal Cream.

Metronidazole can enter the bloodstream after vaginal application, although the amount absorbed may differ from oral treatment.

Metronidazole can cross the placenta and reach the developing baby.

The Canadian Flagyl product monograph advises avoiding the medication during pregnancy, particularly during the first trimester, unless your healthcare provider determines that treatment is necessary.

However, metronidazole has been studied during pregnancy, and available human evidence has not established an increased risk of major birth defects with recommended treatment.

Your healthcare provider will consider the type of vaginal infection, the risks of leaving it untreated, and the most appropriate treatment for your stage of pregnancy.

If you are breastfeeding, tell your healthcare provider before starting treatment.

Metronidazole can pass into breast milk. The amount that reaches breast milk after using this specific vaginal cream is less clearly established.

The Canadian product information advises avoiding Flagyl during breastfeeding.

Your healthcare provider can recommend a suitable treatment or discuss whether temporary changes to breastfeeding are necessary.

Do not stop breastfeeding or begin treatment without discussing your options with your healthcare provider.

Vaginal Irritation and Discomfort

Flagyl Vaginal Cream may cause local irritation in some people.

Although the medication is intended to treat vaginal infections, certain individuals may experience discomfort after application.

Possible symptoms include:

  • Vaginal Burning: A burning or stinging sensation.
  • Itching: Increased irritation around the vaginal opening.
  • Vaginal Dryness: Reduced moisture or discomfort.
  • Redness: Irritation affecting the surrounding tissues.
  • Unusual Discharge: Changes in vaginal discharge during treatment.

Mild irritation may occur, but persistent or worsening symptoms should be evaluated.

Do not use additional cream to relieve irritation unless your healthcare provider instructs you to do so.

Contact your healthcare provider if you experience severe burning, increasing pain, unusual bleeding, or worsening vaginal discomfort.

Vaginal Yeast Infections

Metronidazole treats certain bacterial and protozoal infections, but it does not treat vaginal yeast infections caused by Candida species.

Antibiotic treatment may sometimes change the normal balance of microorganisms in the vagina.

This can allow yeast to grow more easily in some individuals.

Symptoms of a vaginal yeast infection may include:

  • Persistent vaginal itching.
  • Thick, white vaginal discharge.
  • Redness or swelling around the vaginal opening.
  • Burning or irritation during urination.
  • Discomfort during sexual activity.

If you develop these symptoms during or after Flagyl treatment, contact your healthcare provider.

Your healthcare provider may recommend testing to determine whether you have a yeast infection or another condition.

Do not use antifungal medication or additional vaginal treatments without confirming that they are appropriate.

Sexual Intercourse and Contraceptive Products

Avoid vaginal intercourse during treatment or follow your healthcare provider’s recommendations about sexual activity.

Sexual intercourse may increase irritation and discomfort while your vaginal tissues are recovering.

Flagyl Vaginal Cream also contains ingredients that may weaken latex condoms and diaphragms.

This may reduce their effectiveness in preventing pregnancy or sexually transmitted infections.

Ask your healthcare provider about suitable protection during treatment.

If you are receiving treatment for trichomoniasis, sexual partners generally need evaluation and treatment to prevent reinfection.

Vaginal metronidazole is not the preferred treatment for trichomoniasis under current clinical guidelines. Oral treatment is generally recommended because vaginal therapy does not reliably treat infection outside the vagina.

Drug Interactions

Flagyl Vaginal Cream may interact with certain medications, even though it is administered locally.

Some metronidazole can enter your bloodstream after vaginal application.

Important potential interactions include:

  • Warfarin: Metronidazole may increase warfarin’s blood-thinning effects and raise the risk of bleeding.
  • Lithium: Metronidazole may increase lithium levels, potentially causing toxicity.
  • Disulfiram: Combining these medications may cause confusion or other serious reactions.
  • Phenytoin and Phenobarbital: These medications may affect metronidazole levels or require additional monitoring.
  • Cyclosporine: Metronidazole may increase cyclosporine levels in the bloodstream.
  • Busulfan: Combining these medications may increase the risk of serious busulfan toxicity.
  • Heart Rhythm Medications: Certain medications that prolong the QT interval may increase the risk of abnormal heart rhythms when combined with metronidazole.

Not everyone will experience a significant interaction.

However, your healthcare provider should review your medication list before recommending treatment.

Tell your healthcare provider or pharmacist about all prescription medications, over-the-counter drugs, vitamins, herbal supplements, and other vaginal products you use.

Do not start, stop, or change another medication without medical advice. 

Use in Children and Older Adults

The safety and effectiveness of Flagyl 10% Vaginal Cream have not been adequately established in children and adolescents younger than 18 years.

The Canadian product monograph does not establish an approved pediatric indication or standard pediatric dosage.

Older adults may also require additional consideration because kidney function, liver function, and the use of other medications can affect treatment safety.

Your healthcare provider will determine whether Flagyl Vaginal Cream is appropriate based on your age, medical condition, and treatment needs.

Do not give this medication to another person, even if they have similar symptoms.

Avoid Unnecessary or Prolonged Use

Flagyl Vaginal Cream should only be used to treat infections that are known or strongly suspected to involve microorganisms susceptible to metronidazole.

Unnecessary antibiotic use can contribute to antimicrobial resistance.

This occurs when microorganisms develop the ability to survive medications that previously controlled them.

Use Flagyl Vaginal Cream for the exact duration prescribed by your healthcare provider.

Do not apply more cream than recommended or continue treatment longer than instructed.

If symptoms persist after completing treatment, contact your healthcare provider rather than starting another course on your own.

When to Contact Your Healthcare Provider

Contact your healthcare provider if your vaginal discharge, odour, itching, or irritation does not improve during treatment or returns after completing the prescribed course.

You should also seek medical advice if you develop persistent nausea, unusual vaginal bleeding, a new rash, or symptoms suggesting a yeast infection.

Stop using Flagyl Vaginal Cream and seek immediate medical advice if you experience numbness, tingling, poor coordination, or symptoms suggesting liver injury.

Seek emergency medical attention immediately if you experience difficulty breathing, swelling of your face or throat, seizures, severe confusion, or a widespread blistering skin reaction.

Flagyl Vaginal Cream can treat certain vaginal infections, but it should be used carefully in people with allergies, liver problems, neurological conditions, or potential drug interactions. Following the prescribed treatment schedule and reporting unusual symptoms can help reduce the risk of serious side effects.

How Often Should I Use Flagyl Vaginal Cream?

The recommended application frequency depends on the type of vaginal infection and your healthcare provider’s instructions. For Canadian Flagyl 10% Vaginal Cream, the manufacturer’s recommended dosage is one full applicator containing 500 mg of metronidazole, administered once or twice daily for 10 or 20 consecutive days. Your healthcare provider will determine which treatment schedule is appropriate for you. Try to use the medication at approximately the same time each day to maintain a consistent treatment routine. Do not increase your application frequency or shorten the treatment period without medical advice. Flagyl 10% Vaginal Cream should not be confused with metronidazole 0.75% vaginal gel, which has different dosing instructions. 

How Long Does Flagyl Vaginal Cream Take to Work?

Flagyl Vaginal Cream begins acting against susceptible bacteria after application, but noticeable improvements in vaginal symptoms may take several days. Some women may notice that unusual vaginal discharge, unpleasant odor, or irritation begins to improve during the first few days of treatment. However, the time needed for improvement depends on the severity of the infection, the microorganisms involved, and your response to treatment. Even if your symptoms disappear before you finish treatment, continue using the medication for the prescribed period unless your healthcare provider tells you to stop. If your symptoms do not improve, become worse, or return after treatment, contact your healthcare provider.

Can I Have Sexual Intercourse While Using Flagyl Vaginal Cream?

It is generally recommended to avoid vaginal intercourse during treatment or follow your healthcare provider’s advice about sexual activity. Sexual intercourse may increase vaginal irritation and discomfort while the infection is being treated. In addition, ingredients in some vaginal creams may affect the reliability of certain barrier contraceptives, including latex condoms and diaphragms. Ask your healthcare provider or pharmacist whether your specific product is compatible with latex contraceptives and whether alternative protection is needed. If you are being treated for trichomoniasis, both you and your sexual partner may need treatment to prevent reinfection. Current treatment guidelines generally recommend oral metronidazole rather than vaginal metronidazole for this infection.

Can I Use Flagyl Vaginal Cream During My Period?

Yes, the Canadian prescribing information for Flagyl 10% Vaginal Cream allows treatment to continue during menstruation. You should generally follow your prescribed treatment schedule even if your menstrual period begins before the medication course is complete. Continuing treatment as directed helps ensure that you receive the prescribed amount of antibiotic. Use sanitary pads if needed during treatment. Avoid using tampons to absorb medication leakage because they may remove some of the vaginal cream. If you experience unusually heavy bleeding, severe pelvic discomfort, or other concerning symptoms, contact your healthcare provider.

Can I Drink Alcohol While Using Flagyl Vaginal Cream?

The Canadian manufacturer recommends avoiding alcohol while using Flagyl Vaginal Cream and for at least 24 hours after completing treatment. Although the medication is applied directly inside the vagina, some metronidazole may enter your bloodstream. Some people may experience unpleasant symptoms when alcohol is consumed during metronidazole treatment, including nausea, vomiting, stomach cramps, flushing, headache, or a rapid heartbeat. However, clinical evidence for a direct alcohol-metronidazole reaction is inconsistent. Following the manufacturer’s alcohol precaution is a reasonable approach. If you take medications containing alcohol or are unsure whether a product is safe to use, ask your healthcare provider or pharmacist. 

Can Flagyl Vaginal Cream Treat a Yeast Infection?

No, Flagyl Vaginal Cream is not intended to treat vaginal yeast infections. Flagyl contains metronidazole, an antibiotic that works against certain bacteria and protozoa. Vaginal yeast infections are usually caused by an overgrowth of Candida fungi. These infections require antifungal treatment rather than metronidazole. Symptoms of a yeast infection may include vaginal itching, redness, burning, and thick, white discharge. Bacterial vaginosis, on the other hand, commonly causes thin, white, or grey discharge and a noticeable fish-like odor. Because these conditions can have overlapping symptoms, it is important to identify the cause before starting treatment. If you develop new itching, thick discharge, or worsening irritation while using Flagyl Vaginal Cream, contact your healthcare provider. Antibiotic treatment may sometimes contribute to changes in vaginal microorganisms that allow yeast to grow.

Is Flagyl Vaginal Cream Safe During Pregnancy or Breastfeeding?

If you are pregnant, planning to become pregnant, or breastfeeding, consult your healthcare provider before using Flagyl Vaginal Cream. Metronidazole can enter the bloodstream after vaginal application, although the amount absorbed may differ from oral treatment. Available research on metronidazole during pregnancy has not established an increased risk of major birth defects with recommended treatment. However, the safety of the specific Flagyl 10% Vaginal Cream formulation must also be considered. Your healthcare provider will assess whether treatment is necessary and whether another medication would be more appropriate. If you are breastfeeding, metronidazole may pass into breast milk. Your healthcare provider will consider the amount of medication absorbed, your baby’s health, and available treatment options. Do not use Flagyl Vaginal Cream during pregnancy or breastfeeding without medical advice.

What Should I Do If I Miss a Dose of Flagyl Vaginal Cream?

If you miss a dose of Flagyl Vaginal Cream, skip the missed application and return to your regular dosing schedule, as directed in the Canadian product monograph. Do not use two doses at the same time or apply extra cream to make up for a missed dose. Using more medication than prescribed may increase the risk of side effects without improving treatment effectiveness. If you miss several applications or are unsure how to continue your treatment, contact your healthcare provider or pharmacist. 

How Should I Store Flagyl Vaginal Cream?

Store Flagyl Vaginal Cream according to the temperature and storage instructions on the medication packaging. Keep the tube tightly closed when not in use and protect it from excessive heat and moisture. Avoid leaving the medication in direct sunlight, a hot vehicle, or other locations exposed to extreme temperatures. Keep Flagyl Vaginal Cream out of the reach of children and pets. Do not use the medication after its expiration date or if the cream has changed noticeably in appearance or consistency. If you are unsure whether your medication has been stored properly, ask your pharmacist for advice.

Can Bacterial Vaginosis Return After Using Flagyl Vaginal Cream?

Yes, bacterial vaginosis can return even after successful antibiotic treatment. Bacterial vaginosis develops when the normal balance of bacteria inside the vagina changes. Although metronidazole helps reduce susceptible bacteria, it does not guarantee that the vaginal bacterial environment will remain balanced permanently. Some women experience repeated episodes of bacterial vaginosis. Factors associated with BV recurrence include vaginal douching, changes in vaginal bacterial communities, and certain sexual practices. Avoid vaginal douching because it may disrupt the normal balance of bacteria. If your symptoms return after completing treatment, contact your healthcare provider rather than using leftover medication. Your healthcare provider may recommend another examination, additional testing, or a different treatment plan to manage recurrent bacterial vaginosis.

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Additional Information Book
Generic name:

Metronidazole

Formulation:

Cream

Strength(s):

10%

Quantities Available:

60g, 120g

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Our online Canadian Pharmacy is known for high standards of quality, safety, and efficiency when it comes to medications.

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How to Order

How much Flagyl Vaginal Cream can I order at once from a Canadian pharmacy?

When ordering Flagyl Vaginal Cream (metronidazole) from a Canadian pharmacy, you can typically purchase up to a 90-day supply at one time, which is common for prescription medications to ensure adequate management of chronic conditions without frequent refills.

Here’s what you need to know:

Dosage and Quantity: Flagyl Vaginal Cream is commonly prescribed in a dosage of one applicatorful (5 grams of cream containing 37.5 mg of metronidazole) applied once or twice daily. For a 90-day supply, you would order between 450 grams (90 days x 1 applicatorful per day) and (90 days x 2 applicatorfuls per day) 900 grams of Flagyl Vaginal Cream, depending on the prescribed frequency of application.

Do you sell metronidazole?

No, we do not sell metronidazole directly on our website. However, you can still enjoy low prices on Flagyl Vaginal Cream, which contains metronidazole as an active ingredient. To purchase Flagyl Vaginal Cream, you will need a valid prescription from your healthcare provider. We require this prescription to dispense the medication safely and appropriately. You can submit your prescription by mailing it to us, faxing it, or uploading it through your online account.

Do you offer shipping of Flagyl Vaginal Cream (metronidazole) to the United States?

Yes, we ship Flagyl Vaginal Cream (metronidazole) to both the United States and Puerto Rico.

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Online Pharmacies Canada has provided information from third parties intended to increase awareness and does not contain all the information about Flagyl Vaginal Cream (Metronidazole). Talk to your doctor or other qualified medical practitioners for medical attention or advice, or if you have any concerns about Flagyl Vaginal Cream (Metronidazole).