Summary
More frequently reported side effects include: cervical candidiasis and vaginitis. Continue reading for a comprehensive list of adverse effects.
Applies to metronidazole topical: topical cream, topical gel/jelly, topical lotion. Other dosage forms:
- vaginal gel/jelly
Serious side effects
Along with its needed effects, metronidazole topical may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking metronidazole topical:
Less common
- Bladder pain
- blistering, burning, crusting, dryness, or flaking of the skin
- bloody or cloudy urine
- blurred vision
- body aches or pain
- chest tightness
- chills
- cough producing mucus
- diarrhea
- difficult, burning, or painful urination
- difficulty breathing
- dizziness
- ear congestion
- fever
- frequent urge to urinate
- general feeling of discomfort or illness
- headache
- itching, scaling, severe redness, soreness, or swelling of the skin
- joint pain
- loss of appetite
- loss of voice
- lower back or side pain
- muscle aches and pains
- nausea
- pounding in the ears
- shivering
- slow or fast heartbeat
- sore throat
- stuffy or runny nose
- sweating
- trouble sleeping
- unusual tiredness or weakness
- vomiting
Incidence not known
- Burning, numbness, tingling, or painful sensations
- unsteadiness or awkwardness
- weakness in the arms, hands, legs, or feet
Other side effects
Some side effects of metronidazole topical may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Rare
- Back pain
For Healthcare Professionals
Applies to metronidazole topical: topical cream, topical gel, topical kit, topical lotion, vaginal gel with applicator.
Local
Very common (10% or more): Dryness (up to 28.5%), scaling (up to 24.6%), itching (up to 16.3%), pruritus (up to 15.8%), stinging (up to 11%), stinging/burning (up to 10.3%)
Common (1% to 10%): Burning, local allergic reaction
Frequency not reported: Condition aggravated (rosacea or acne), transient redness, irritation
Postmarketing reports: Application site reaction, local irritation[Ref]
Local cutaneous signs/symptoms of irritation that were worse than baseline included dryness (25.4% [mild: 17.1%; moderate: 7.7%; severe: 0.6%]), scaling (24.6% [mild: 16.2%; moderate: 7.9%; severe: 0.6%]), pruritus (15.8% [mild: 9.7%; moderate: 5%; severe: 1.1%]), and stinging/burning (10.3% [mild: 7.2%; moderate: 1.3%; severe: 1.8%]).[Ref]
Genitourinary
Very common (10% or more): Vaginal discharge (up to 12%)
Common (1% to 10%): Candida cervicitis/vaginitis, yeast infection, dysmenorrhea, metrorrhagia, vulvovaginal candidiasis, vulvovaginal pruritus, urinary tract infection (UTI), vaginal itching/irritation/burning/numbness, vulva/vaginal irritative symptoms, pelvic discomfort
Uncommon (0.1% to 1%): Vaginal mycosis, urine discoloration, UTI symptoms, vulva edema, menstrual discomfort/irregularities, vaginal spotting/bleeding
Frequency not reported: Breast enlargement, dysuria, female lactation, labial edema, menorrhagia, salpingitis, urinary frequency, vulvovaginal disorder, vulvovaginal discomfort, itching (vaginal and perianal), vulvar burning, vulvar lesions, uterine/menstrual/vaginal cramping, darkened urine
Postmarketing reports: Leukorrhea, vaginitis, vulvar disorder, genital pruritus
Oral or parenteral formulations:
-Frequency not reported: Yeast infection, darkened urine, vaginal discharge, vaginal itching, overgrowth of Candida in vagina, dyspareunia, proctitis, dysuria, cystitis, polyuria, incontinence, sense of pelvic pressure, vulva/vaginal irritative symptoms, itching (vaginal and perianal), vulvar burning, vulvar lesions, vaginal burning, pelvic discomfort, uterine/menstrual/vaginal cramping[Ref]
Other
Very common (10% or more): Fungal infection (up to 12%)
Common (1% to 10%): Infection, breast pain, unspecified cramping, abscess, accidental injury
Uncommon (0.1% to 1%): Fatigue
Frequency not reported: Mucous membrane disorder, pain, thirst, surgical/medical procedure
Postmarketing reports: Swelling face, facial edema, treatment failure (worsening of rosacea)
Oral or parenteral formulations:
-Frequency not reported: Fatigue, weakness[Ref]
Respiratory
Very common (10% or more): Influenza (up to 11%)
Common (1% to 10%): Pharyngitis, bronchitis, nasopharyngitis, sinusitis, rhinitis, upper respiratory tract infection, nasal congestion
Frequency not reported: Asthma[Ref]
Gastrointestinal
Common (1% to 10%): Abdominal pain, nausea, diarrhea/loose stools, gastritis, tooth disorder, gastrointestinal discomfort, abdominal cramps, vomiting, unpleasant taste/unusual feeling on tongue
Uncommon (0.1% to 1%): Constipation, dry mouth, abdominal bloating/noises
Frequency not reported: Dyspepsia, flatulence, gingivitis, abdominal cramping, abdominal bloating/gas
Postmarketing reports: Abdominal pain, diarrhea, nausea
Oral or parenteral formulations:
-Frequency not reported: Nausea, unpleasant taste/feeling on tongue, diarrhea, constipation, abdominal cramping, abdominal discomfort, vomiting, epigastric distress, "furry" tongue, glossitis, stomatitis, pancreatitis, gastrointestinal discomfort, gastrointestinal disturbance[Ref]
Nervous system
Common (1% to 10%): Headache, dizziness, unpleasant taste, hypertonia
Uncommon (0.1% to 1%): Metallic taste, dysgeusia/unusual taste, paresthesia, hypoesthesia
Frequency not reported: Ataxia, drowsiness
Postmarketing reports: Peripheral neuropathy, taste perversion, dizziness, headache, paresthesia, metallic taste, tingling/numbness of extremities
Oral or parenteral formulations:
-Frequency not reported: Unpleasant taste, dizziness, headache, convulsive seizures, encephalopathy, aseptic meningitis, peripheral neuropathy (characterized mainly by numbness/paresthesia of an extremity), syncope, vertigo, incoordination, ataxia, confusion, dysarthria, unpleasant metallic taste, taste of alcoholic beverages modified[Ref]
Cardiovascular
Common (1% to 10%): Hypertension
Oral or parenteral formulations:
-Frequency not reported: Flattening of T-wave in ECG tracings[Ref]
Dermatologic
Common (1% to 10%): Pruritus, rash, contact dermatitis, dry skin, skin discomfort (burning, pain of skin/stinging), erythema/transient skin erythema, worsening of rosacea, skin irritation, psoriasis, seborrhea, skin infection, sunburn, urticaria
Frequency not reported: Acne, sweating, generalized itching/rash, severe flare of comedonal acne, rosacea aggravated
Postmarketing reports: Hyperpigmentation, pigmentation disorder, hypertrichosis, rash, urticaria, contact dermatitis, skin exfoliation, erythema, pruritus, burning, dryness, tightness, discomfort, rash, zoster lesion, pustules on the nose, vesicular bullous eruption
Oral or parenteral formulations:
-Frequency not reported: Urticaria, angioedema[Ref]
Metabolic
Common (1% to 10%): Decreased appetite
Frequency not reported: Anorexia, hypomagnesemia
Oral or parenteral formulations:
-Frequency not reported: Decreased appetite, anorexia[Ref]
Musculoskeletal
Common (1% to 10%): Bursitis, myalgia, osteoporosis
Uncommon (0.1% to 1%): Back pain, cramp[Ref]
Hematologic
Common (1% to 10%): Increased/decreased WBC counts
Oral or parenteral formulations:
-Frequency not reported: Reversible neutropenia, reversible thrombocytopenia
Ocular
Common (1% to 10%): Conjunctivitis
Frequency not reported: Eye irritation (watering/tearing)
Postmarketing reports: Eyelid edema, watery eyes
Oral or parenteral formulations:
-Frequency not reported: Optic neuropathy[Ref]
Oncologic
Common (1% to 10%): Skin carcinoma
Uncommon (0.1% to 1%): Basal cell carcinoma
Frequency not reported: Skin cancer[Ref]
Endocrine
Common (1% to 10%): Hypothyroidism
Hypersensitivity
Postmarketing reports: Allergic reaction
Oral or parenteral formulations:
-Frequency not reported: Allergic reaction, hypersensitivity reactions (including urticaria, erythematous rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, flushing, nasal congestion, dryness of mouth/vagina/vulva, fever, pruritus, fleeting joint pains), anaphylaxis
Psychiatric
Uncommon (0.1% to 1%): Depression, difficulty sleeping, irritability
Frequency not reported: Insomnia
Oral or parenteral formulations:
-Frequency not reported: Trouble sleeping, irritability, depression, insomnia, decreased libido[Ref]
Hepatic
Frequency not reported: Abnormal liver function test[Ref]
Renal
Frequency not reported: Pyelonephritis[Ref]