Metronidazole vaginal gel for bacterial vaginosis (Zidoval)

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Metronidazole vaginal gel is used to treat bacterial vaginosis.

Use one applicatorful at bedtime.

A usual course of treatment lasts for five nights.

Type of medicineAn antibacterial gel
Used forTreatment of bacterial vaginosis
Also calledZidoval®
Available asGel to use in the vagina

Bacterial vaginosis is a common condition. It is a bacterial infection of the vagina and is caused by an overgrowth of normal bacteria. The main symptom is a vaginal discharge, often with a noticeable fishy smell. The infection may clear without treatment, or it can be treated with an antibacterial gel such as metronidazole. Metronidazole vaginal gel is applied into the vagina using an applicator.

Metronidazole is also available as a cream/gel to be used on the skin, and as tablets/medicine to take by mouth. There are two separate information leaflets available which provide more information about this, called Metronidazole skin gel and cream and Metronidazole for infection.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using metronidazole vaginal gel it is important that your doctor knows:

  • If you are pregnant or breast-feeding. (Although metronidazole is not known to be harmful to a baby, it is still important that you tell your doctor if you are expecting or breast-feeding a baby.)
  • If you have ever had an allergic reaction to a medicine or to a skin preparation.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. The manufacturer's leaflet will give you more information about metronidazole, and it will also explain how to use the gel and applicator.
  • Use metronidazole vaginal gel exactly as your doctor tells you to. It is for use in the vagina only.
  • Use one applicatorful (approximately 5 grams) of gel in the vagina at bedtime. A usual course of treatment lasts for five consecutive days.
  • If you forget to use the gel, use it as soon as you remember. If you do not remember until the following day, use the gel as normal on your next dose (that is, do not 'double-up' the amount you use). Use the gel for the correct number of days in total.

How to fill the applicator and use the gel

  1. Remove the cap from the tube of gel.
  2. Attach one of the disposable applicators to the tube (the applicator will screw on to the tube).
  3. Squeeze the tube of gel gently to fill the applicator. When the plunger on the applicator stops moving, the applicator is full.
  4. Unscrew the applicator from the tube, and replace the cap on to the tube.
  5. Gently insert the applicator into your vagina (it may help to lie on your back with your knees bent to do this). Insert the applicator as far as it is comfortable.
  6. Gently push on the plunger of the applicator to empty the gel into your vagina. Then remove the applicator and throw it away (it can be wrapped in toilet paper and disposed of in a waste bin).
  7. Wash your hands afterwards.
  • It is not recommended that metronidazole vaginal gel is used during a monthly period. If you are having your period, ask your doctor when you should start the treatment.
  • Even if you feel your infection has cleared up, keep using the gel until the course is finished (unless you are told to stop by your doctor). This is to prevent the infection from coming back.
  • Sexual intercourse during treatment for a vaginal infection is not recommended.
  • Some women develop thrush (redness and itching around the vagina) after a course of an antibacterial. If you think you have thrush, speak with your doctor or pharmacist for advice.
  • Drinking alcohol while you are on a course of metronidazole can make you feel dizzy or sick. This is less likely to happen when using metronidazole vaginal gel than with other forms of metronidazole (tablets, for example), but if it does happen, it is best not to drink alcohol.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with metronidazole when used in the vagina. You will find a full list in the manufacturer's information leaflet supplied with your gel. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common metronidazole vaginal gel side-effects (these affect less than 1 in 10 women)
What can I do if I experience this?
Irritation and itchingThis should improve as your infection is treated
HeadacheIf troublesome, ask your pharmacist to recommend a suitable painkiller
Feeling dizzyTake care when driving or using tools or machines
Stomach upset or discomfortStick to simple meals - avoid rich or spicy foods
Unusual taste, lack of appetiteThis will soon pass

If you experience any other symptoms which you think may be due to the gel, speak with your doctor or pharmacist.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never use more than the prescribed dose. If you suspect that you or someone else might have swallowed some of this gel by accident, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

If you buy any medicines, check with a pharmacist that they are suitable to take with your other medicines.

If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are using.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine, ask your pharmacist.

Further reading & references

  • Manufacturer's PIL, Zidoval®; Meda Pharmaceuticals, The electronic Medicines Compendium. Dated June 2012.
  • British National Formulary; 66th Edition (September 2013) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.

Original Author:
Helen Allen
Current Version:
Peer Reviewer:
Prof Cathy Jackson
Document ID:
28824 (v1)
Last Checked:
Next Review:
The Information Standard - certified member

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