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Flagyl (metronidazole, metronidazole) 200 mg, may be taken with or without food.

Flagyl in the presence of sexual stimulation. Film-coated.

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Metronidazole
Clinical data
Pronunciation/ m ɛ t r ə ˈ n aɪ d ə z oʊ l /
Trade namesFlagyl, Metro, others
AHFS/Drugs.comMonograph
License dataUS   FDA: Metronidazole
Pregnancy categoryAU: B2 US: B (No risk in non-human studies)
Routes of administrationby mouth, topical, rectal, IV, vaginal
ATC codeA01AB17 ( WHO ) D06BX01 ( WHO ), G01AF01 ( WHO ), J01XD01 ( WHO ), P01AB01 ( WHO ), QP51AA01 ( WHO )
Legal status
Legal statusAU: S4 (Prescription only) CA : ℞-only UK: POM (Prescription only) US: ℞-only
Pharmacokinetic data
Bioavailability80% (by mouth), 60–80% (rectal), 20–25% (vaginal) [1] [2]
Protein binding20% [1] [2]
MetabolismHepatic [1] [2]
Elimination half-life8 hours [1] [2]
ExcretionUrine (77%), faeces (14%) [1] [2]

There are currently no studies in humans to suggest that use of metronidazole by the father would negatively affect the sperm or increase the risk for birth defects. Be sure to talk to your healthcare provider about all of your breastfeeding questions. Gray MS, et al.

Blood and milk concentrations of metronidazole in mothers and infants. Vaginal use of metronidazole may result in more absorption of the medication into your body.

These infants did not have the same anomalies; one had hydrocephalus, the other had an unspecified GI anomaly. A Danish population-based retrospective cohort study found no association with congenital anomalies OR, 0. Centers for Disease Control and Prevention Selected References:

Antibiotics and pregnancy: What's safe?

Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having is flagyl safe during pregnancy observed.

The majority of studies did not show an increased risk for congenital anomalies or other adverse fetal outcomes. Heisterberg L, Branebjerg PE. Obstet Gynecol

Use is not recommended unless clearly needed; according to some authorities, use is not recommended in the first trimester AU TGA pregnancy category: However, most studies show that metronidazole does not increase risks for a pregnancy.

Ann Intern Med Koss CA, et al. Antimicrob Agents Chemother 56 9:

What is metronidazole? What if the father of the baby takes metronidazole? Vaginal use of metronidazole may result in more absorption of the medication into your body. This drug flagyl while pregnant the placenta and rapidly enters fetal circulation.

While it is widely recognized that symptomatic BV and T. Genotoxicity and carcinogenicity of metronidazole.

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Obstet Gynecol Finegold SM. Rosa FW, et al.

Passmore CM, et al. If very little medication is in your blood, very little is expected to be able to affect a pregnancy. Although studies have not shown metronidazole to be carcinogenic in humans 2it has been documented as a bacterial mutagen and carcinogen in animals 14

Is metronidazole teratogenic? The majority of studies did not show an increased risk for congenital anomalies or other adverse fetal outcomes. Interactions Metronidazole Pregnancy Warnings Animal studies have failed to reveal evidence of impaired fertility nor flagyl while pregnant harm at higher doses. Currently there is no evidence to suggest that metronidazole places a pregnancy at risk at any stage.

It is unlikely. Selected References: Each of these limitations would lead to a bias toward the null.

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Flagyl while pregnant

Metronidazole Pregnancy and Breastfeeding Warnings

Metronidazole that is used on skin topical preparations is minimally absorbed and not likely to result in significant levels in your blood. Burtin P, et al. Heisterberg L, Branebjerg PE.

Is metronidazole teratogenic? A population based case-control teratologic study of oral metronidazole. Use of antibiotics during pregnancy and risk of spontaneous abortion.

In addition to these studies, meta-analyses have evaluated first trimester metronidazole treatment. Multiple epidemiologic studies and meta-analyses have not shown an association between metronidazole treatment during pregnancy and congenital anomalies in infants.

Congenital anomalies were also significantly associated with maternal age above 35 years OR, 2. Possible metronidazole teratogenicity and clefting. If very little medication is in your blood, very little is expected to be able to affect a pregnancy.

Two other large studies found no association between metronidazole exposure and congenital anomalies.

Taking flagyl during pregnancy

Koss CA, et al. Gray MS, et al. Can taking metronidazole during early pregnancy increase the risk for miscarriage?

Sheehy O et al. Can I take metronidazole any time during pregnancy? Sexually transmitted diseases treatment guidelines, Curr Drug Saf.

Antibiotics In Pregnancy & Nursing:

If you have questions or concerns about the use of an antibiotic during pregnancy, talk to your health care provider. Selected References: Rosa FW, et al. Obstet Gynecol 82 3:

Br J Vener Dis; Interactions Metronidazole Pregnancy Warnings Animal studies have failed to reveal evidence of impaired fertility nor fetal harm at higher doses. Obstet Gynecol 82 3:

Andrews WW, et al. Safety of metronidazole in pregnancy: Evaluation of Syracuse Healthy Start's program for abnormal flora screening, treatment, and rescreening among pregnant women, Syracuse, New York, —

After a breastfeeding mother has taken metronidazole, the infant may experience loose stools, especially when the drug is given directly into a vein intravenously. Finegold SM.

Ann Intern Med Use of antibiotics during pregnancy and risk of spontaneous abortion. The current data do not support an increased risk for birth defects or other harmful effects on the baby.

Koss CA, et al. Antimicrob Agents Chemother 56 9: Use of antibiotics during pregnancy and risk of spontaneous abortion. J Perinat Med;

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