Flagyl ER (Metronidazole)

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Generic Name: Metronidazole
Brand Names: Flagyl ER
Dosage: 200mg, 400mg
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Metronidazole (Flagyl) is antimicrobial and antibacterial drug.

It is used to treat:

  • protozoal infections: extra-intestinal amebiasis, amebic liver abscess, intestinal amebiasis (amebic dysentery), trichomoniasis;
  • bone and joint infections, infections of the central nervous system (CNS), including meningitis, brain abscess, bacterial endocarditis and pneumonia, empyema and lung abscess, sepsis;
  • abdominal infections (peritonitis, liver abscess);
  • pelvic infection (endometritis, abscess of the fallopian tubes and ovaries, vaginal cuff infection);
  • pseudomembranous colitis;
  • gastritis or duodenal ulcer.

Side effects

Side effects are usually observed at the beginning of the therapy. Keep in mind that elderly and weakened patients have side effects more frequently.

If you feel any of the following side effects, contact your doctor:

  • digestive system: diarrhea, anorexia, nausea, vomiting, intestinal colic, constipation, “metallic” taste in the mouth, dry mouth, glossitis, stomatitis, pancreatitis;
  • nervous system: dizziness, incoordination, ataxia, confusion, irritability, depression, irritability, fatigue, insomnia, headache, convulsions, hallucinations;
  • allergic reactions: urticaria, skin rash, redness of the skin, nasal congestion;
  • genitourinary system: dysuria, cystitis, polyuria, urinary incontinence, candidiasis.

Taking the medication during pregnancy may cause harmful effects to the newborn baby.


Metronidazole is contraindicated for patients with:

  1. hypersensitivity to the drug and its active components;
  2. organic lesions of the central nervous system;
  3. hepatic failure;
  4. period of lactation.

Use caution when driving, operating machinery, or performing other hazardous activities.

How to take

The drug is taken orally with a full glass of water, during or after the meal.

Trichomoniasis: 250 mg two times a day for 10 days or 400 mg twice a day for 5-8 days.

Asymptomatic amoebiasis (detection of cysts): 1-1.5 g for 5-7 days.

Chronic amebiasis: 1.5 g in 3 divided doses for 5-10 days.

Liver abscess: 2.5 g during 3-5 days.

Do not exceed your prescribed dosage.

Drug interactions

Metronidazole enhances the effect of indirect anticoagulants, which leads to increased formation of prothrombin.

The simultaneous use of disulfiram can lead to a variety of neurological symptoms.

It is not recommended to combine the drug with non-depolarizing muscle relaxants.

Sulfonamides enhance the antimicrobial action of Metronidazole.

Missed dose

Take the capsule as soon as you remember. However, dont take the double dose and continue the prescribed dosage.


Symptoms of overdose nausea, vomiting, and ataxia.

Treatment of overdose should be symptomatic, as there is no specific antidote.

In case of severe overdose, contact emergency services immediately (USA/UK – 911 / 112 / 999).


The medicine should be kept in a dry place with temperature no higher than 25C, away from children.

Has a Generic Metronidazole been approved?

Yes. It’s not different from the brand medication.

Other manufacturers include:

  • Manufacturer: ALEMBIC PHARMS LTD
    Approval date: March 13, 2009
    Strength(s): 250MG, 500MG
  • Manufacturer: APPCO PHARMA LLC
    Approval date: September 23, 2015
    Strength(s): 250MG, 500MG
  • Manufacturer: AUROBINDO PHARMA LTD
    Approval date: May 29, 2015
    Strength(s): 250MG, 500MG
  • Manufacturer: FLAMINGO PHARMS
    Approval date: May 16, 2016
    Strength(s): 250MG, 500MG
  • Manufacturer: NOSTRUM LABS INC
    Approval date: July 16, 1986
    Strength(s): 250MG, 500MG
  • Manufacturer: PLIVA
    Approval date: December 6, 1984
    Strength(s): 500MG
  • Manufacturer: STRIDES PHARMA
    Approval date: May 25, 2016
    Strength(s): 250MG, 500MG
  • Manufacturer: TEVA PHARMS USA
    Approval date: November 6, 1984
    Strength(s): 250MG


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