Flagyl ER (metronidazole extended-release) is a prescription antimicrobial medication designed to provide sustained, targeted therapy for specific anaerobic bacterial and protozoal infections. Its advanced formulation allows for once-daily dosing while maintaining therapeutic plasma concentrations, offering both clinical efficacy and improved patient adherence. This extended-release tablet is particularly valuable in treating conditions where consistent drug levels are critical for successful eradication of pathogens.

Features

• Contains 750 mg metronidazole in extended-release formulation
• Designed for once-daily oral administration
• Maintains therapeutic plasma concentrations over 24 hours
• Film-coated tablet for easier swallowing
• Requires prescription and medical supervision

Benefits

• Provides consistent antimicrobial coverage throughout the dosing interval
• Reduces dosing frequency compared to immediate-release formulations
• May improve treatment adherence through simplified dosing schedule
• Effectively targets anaerobic bacteria and certain parasites
• Helps prevent development of secondary infections
• Supports complete eradication of susceptible organisms

Common use

Flagyl ER is primarily indicated for the treatment of bacterial vaginosis in adult women. It may also be prescribed off-label for other anaerobic bacterial infections when extended-release formulation is deemed appropriate by healthcare providers. The medication works by entering microbial cells and interfering with DNA synthesis, leading to cell death in susceptible organisms.

Dosage and direction

The recommended dosage for bacterial vaginosis is one 750 mg tablet taken orally once daily for seven consecutive days. Tablets should be swallowed whole with a full glass of water, without chewing, crushing, or splitting. Administration with food may help minimize gastrointestinal discomfort. Treatment should be completed in full as prescribed, even if symptoms improve before finishing the course.

Precautions

Patients should avoid alcohol consumption during treatment and for at least 72 hours after completing therapy due to risk of disulfiram-like reaction. Use with caution in patients with central nervous system disorders, hepatic impairment, or blood dyscrasias. Regular monitoring of blood counts may be necessary during prolonged therapy. Not recommended during first trimester of pregnancy unless clearly needed.

Contraindications

Hypersensitivity to metronidazole, other nitroimidazole derivatives, or any component of the formulation. Contraindicated in patients with trichomoniasis during first trimester of pregnancy. Should not be used in patients with active organic neurologic disorders. Avoid concurrent use with disulfiram or alcohol-containing medications.

Possible side effect

Common side effects may include nausea, headache, dry mouth, metallic taste, and gastrointestinal discomfort. Less frequently, patients may experience dizziness, darkened urine, or reversible peripheral neuropathy with prolonged use. Serious but rare side effects include seizures, encephalopathy, pancreatitis, and blood dyscrasias. Allergic reactions including Stevens-Johnson syndrome have been reported.

Drug interaction

Significant interactions occur with warfarin (enhanced anticoagulant effect), lithium (increased lithium levels), and disulfiram (psychotic reactions). Concurrent use with alcohol may cause disulfiram-like reaction. May increase levels of phenytoin, phenobarbital, and cyclosporine. Cimetidine may increase metronidazole concentrations.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Maintain regular dosing schedule and contact healthcare provider if multiple doses are missed or if unsure about proper administration.

Overdose

Symptoms may include nausea, vomiting, ataxia, and neurotoxic effects including seizures. There is no specific antidote for metronidazole overdose. Treatment is supportive and symptomatic. Gastric lavage may be beneficial if performed soon after ingestion. Hemodialysis may accelerate elimination. Contact poison control center immediately if overdose is suspected.

Storage

Store at room temperature (20-25°C or 68-77°F) in original container. Protect from light and moisture. Keep tightly closed and out of reach of children. Do not use after expiration date printed on packaging. Properly discard any unused medication after treatment completion.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. Individual response to medication may vary. Proper diagnosis and prescription require medical evaluation by a licensed practitioner.

Reviews

Clinical studies demonstrate Flagyl ER’s efficacy in treating bacterial vaginosis with complete resolution rates comparable to immediate-release formulations while offering improved convenience. Healthcare providers report good patient tolerance and adherence with the extended-release formulation. Patients appreciate the once-daily dosing schedule, though some report persistent metallic taste as a common concern.