Flagyl (Metronidazole) medication uses. Flagyl over-the-counter (OTC)

Flagyl (Metronidazole) medication online

What is Metronidazole

Metronidazole is an antimicrobial drug with the intensive antiprotozoal action. WHO puts this medication in the Model List of Essential Medicines. As of today, Metronidazole is one of few ingredients that effectively neutralizes the activity of the anaerobe microflora and protozoa. The common antibiotics show a weak activity to these microorganisms, and therefore the administration of Metronidazole is vital in the medicine.

What is Metronidazole?

The drug significantly enhances the therapeutic activity of penicillin, tetracycline, and cephalosporin agents. The combined antimicrobial therapy is prescribed during the mixed flora. The imbalance of anaerobe, gram-positive and gram-negative microorganisms will appear without Metronidazole.

The mechanism of the action of Metronidazole may be described in several stages:

  • Metronidazole goes to the systemic blood flow and penetrates into the area of the infection;
  • The active ingredients restore the organic compounds (including 5-nitrogroups) inside the cells;
  • 5-nitrogroup of the organic compositions controls the DNA inside the cells of the pathogenic microflora;
  • A complete destruction of the RNA of microorganisms and their death happens under the action of these compositions.
Mechanism of the action of Metronidazole

Metronidazole does not provide a direct action on the pathogenic agents. It just helps the body to synthesize the ingredients that will destroy bacteria naturally. Metronidazole shows a good bioavailability at a rate of 100% during the oral use. It penetrates into more than 90% of tissues and liquids of the body. A small concentration of the ingredient is observed in the breast-milk and afterbirth.

The ingredient seldom induces serious side effects, and the scientists have given a high estimation of the pharmacological safety of Metronidazole in general.           

What is Metronidazole used for?

Metronidazole is widely used in the medical practice during the bacterial infections. It is often prescribed patients who have trichomoniasis diagnosis. The drug is effective at any stage of the disease including during the asymptomatic course. 

Metronidazole used for

Doctors highly recommend to treat both partners during the sexual infections. Even if trichomonas is not detected in a man, he may be a carrier in the latent form. 

Taking the drug, it is necessary to remember about the safety measures. The treatment of trichomoniasis should be accompanied by the sexual abstinence. Do not take alcohol during the treatment. It may enhance the toxic load on the liver, so that the severe side effects will appear.

The indication for the prescription of Metronidazole is also:

  • Anaerobe infections of the internal organs: peritonitis, abscess of the liver, abdomen, internal genital organs, meningitis, abscess of the brain and lungs, bacterial pneumonia, bone tissue infection, septicemia, and others;
  • Gardnerella (bacterial vaginosis);
  • Infections caused by mixed flora;
  • Amebiasis;
  • Giardiasis.  

Metronidazole is used for the prophylaxis of the infectious inflammatory processes during the gynecological surgeries and complicated surgical interventions. It is especially important for patients with HIV and oncology diseases who have a low immune status.

Metronidazole has high rates in the treatment of Helicobacter pylori. The drug is prescribed in the combined therapy (often with Amoxicillin and proton pump inhibitors). Helicobacter pylori is a gram-negative bacterium that has a high sensitivity to Metronidazole. The average treatment period is cut by 2 times during the use of this drug.

Metronidazole may be taken during many specific infectious processes. However, there are certain restrictions that should be examined before the treatment:

  • Do not take the drug during pregnancy, in the first term. Then a doctor may prescribe the drug taking into account a patient’s condition.
  • Breast-feeding mothers are not prescribed the drug. If a need in the use of this antibiotic appears, the breast-feeding is terminated.
  • Children under 6, and patients with epilepsy, leukopenia, high sensitivity to the drug ingredients are contraindicated to take Metronidazole.
  • Patients who are diagnosed a renal or hepatic failure should take the drug with due care.
  • Crohn’s disease is a serious contraindication for the use of Metronidazole. The laboratory tests have detected that these patients may develop the oncological disease of the intestine.  

What kind of bacteria does Metronidazole treat?

The doctors recommend taking Metronidazole only after previous consultation. As the drug inhibits just certain group of bacteria and protozoa, it is desirable to take the microbiological blood test. But most diseases take an urgent therapy, and so Metronidazole is prescribed as soon as possible. The course of the treatment is adjusted after having the test results.

Taking Metronidazole

Metronidazole is effective as to pathogenic microflora:

  • Anaerobic microorganisms: Bacteroides spp. (including the Bacteroides fragilis group, Bacteroides distasonis, Bacteroides vulgatus), Fusobacterium spp.,
  • Gram-negative microorganisms: Helicobacter pylori, Peptostreptococcus spp., Clostridium spp.,
  • Trichomonas vaginalis,
  • Giardia intestinalis,
  • Entamoeba histolytica,
  • Gardnerella vaginalis.

If the disease is caused by the strains that are not vulnerable to the basic active ingredient, the use of Metronidazole is cancelled then.

Bear in mind that the uncontrolled administration of the antibiotics may induce an insusceptibility of some bacteria to the medical products. As a result, the drug will be ineffective during serious diseases.

Metronidazole dosage

  • Metronidazole tablets are taken during or after meals.
  • Do not chew the tablet. Just take it with clear water.

In case of the trichomoniasis, partners are prescribed an individual course by a doctor. There are two types of the therapy.

  • First, one-time use of 8 tablets of Metronidazole 250 mg (a total daily dose is 2 g). This dose is prescribed both partners. The treatment is indicated for patients who cannot follow more complicated scheme of the use.
  • The second option is calculated on the treatment within 7 days. Patients are prescribed Metronidazole 400 mg 2 times a day. The use of the drug more than 7 days is not recommended because a relapse may appear. 

If the effect is absent, it is recommended to take the drug again after 2-week-break.

A doctor controls the image of the blood during the treatment and prescribes a total leukocyte count test.

  • To treat amebiasis, adults take 3 tablets of Metronidazole 250 mg three times a day. The daily dose should not be less than 1,5 g. The course of the treatment takes 5 to 10 days depending on the clinical pattern.
  • In case of the dysentery caused by the acute amebic infection, patients are prescribed 750 mg Metronidazole 3 times a day till the full symptom control. 
  • In case of the purulent inflammation of the liver, 2-3 tablets Metronidazole 250 mg is taken 3 times a day. A duration of the course is 5 to 10 days.
  • The maximal dose must not exceed 4 grams.
  • A duration of the treatment is increased up to 10-14 days during the inflammation of the lungs, joints, and bone tissue. If endocarditis or meningitis, a prolonged course is recommended: 14 to 28 days.

A doctor selects an individual dose for children at the age of 6 to 12 according to the body mass of a child:

  • 35 to 50 mg of Metronidazole a day is prescribed per 1 kg body mass. The dose is divided into 3 times. The treatment takes 7 to 10 days.

If the bacterial infections have the initial stage, the use of Metronidazole gives a good result within a week. 

Prescribing the drug old people, doctor takes into account the speed of the elimination rate of Metronidazole from the blood. The drug is excreted slowly at old age, and therefore it is necessary to select either a lower dose, or to increase the interval between the use of the tablets.

In case of the chronic liver diseases, the dose of Metronidazole should be reduced by 2 times.  

Metronidazole for dental uses (tooth infection)

Metronidazole has a wide pharmacological action. It is actively used in the dental practice to prevent and treat infections. A cause of the inflammatory processes is often as follows in the mouth cavity:

  • Poor hygiene of the mouth cavity;
  • Use of none-sterile dental tools;
  • Absence of the in time caries treatment.
Metronidazole for dental infections

The infection reaches the mucous coat of the gingiva, palate, or cheeks, places having good conditions for the bacteria development.

Metronidazole is used in two cases in the dental practice:

  • Local treatment: the treatment of the symptoms of gingivitis (gingiva inflammation), parodontosis, and periodontics disease. The drug favors the healing of the erosions and ulcerous affections of the mucous membranes in the mouth during the stomatitis. Also the drug effectively helps during the distribution of the cavity infection appeared after the tooth extraction.
  • Systemic treatment: the treatment of the mixed and anaerobe bacterial infections in the mouth cavity (osteo-maxillary osteomyelitis, necrotizing stomatitis, abscesses, alveolitis, etc.).  

The dental infections have one peculiarity. They are quickly manifested and have a severe course. A patient has:

  • Severe inflammatory process;
  • Severe toothache,
  • Uloncus;
  • Bleeding;
  • Destructive changes of the jaw and bones;
  • Ulcers and wounds on the mucous of the tongue, cheeks, gums, palate.

If a doctor has detected that a cause of the tooth infection is anaerobe microflora, Metronidazole therapy is prescribed. The drug has a narrow action, effectively copes with the site of the infection. Moreover, the antibiotics with broad action may not give the positive results.

In case of the severe infectious processes, the drug is prescribed orally or intramuscularly. If the disease has just appeared, Metronidazole soaking therapy may be applied. A tablet is crushed and mixed with the solution of the antiseptic. A cotton ball is damped and put between the sore gum and a cheek (lip). Or it is applied to the place where the inflammatory process is.

The dose of Metronidazole in the treatment of the tooth infection depends on a type of the activator and a spread of the infection. But the treatment usually begins with the minimal dose:

  • 1 Metronidazole tablet 250 mg 3 times a day within 5 days;
  • In case of the complicated type of the dental infection, Metronidazole 400 mg is prescribed 3 times a day.

The action of the drug is based on the antimicrobial effect. Metronidazole does not contain the analgesic ingredients. So if the disease is accompanied with the intensive toothache, it is recommended to add NSAIDS to the therapy. Sometimes, a weak result of the therapy is enhanced by the additional use of the antibiotics with a broad action. 

Metronidazole 200 mg and 400 mg price online

You will find cheap Metronidazole 200 mg and 400 mg from the well-known manufacturers in the online pharmacy. The minimal cost of Metronidazole online is $0,4 per tablet. The maximal cost of Metronidazole online is $0,9 per tablet. This is by ten times cheaper than in the city pharmacies.

Metronidazole 200 mg and 400 mg price online

The online pharmacy sells quality Generic Metronidazole 200 mg and 400 mg. It is supplied from the plant of the manufacturer without any dealers. Therefore, a cost of Metronidazole online does not contain extra fees of the trading dealers.

The customers of the internet pharmacies may buy Generic Metronidazole at the wholesale price of the manufacturers. A cost of Metronidazole online will be by several times lower than in the city pharmacies even with the shipment cost to your country.

Flagyl for BV. Metronidazole for BV dosage

A bacterial vaginosis (BV) is a pathological change of the vaginal flora. Other microorganisms substitute the normal vaginal flora (lactic bacteria) during this disease. These are pathogenic organisms:

  • Bacteroides spp.;
  • Peptostreptococcus spp.;
  • Gardnerella vaginalis;
  • Mycoplasma hominis.
Metronidazole for bacterial vaginosis: dosage

The bacterial vaginosis is often a chronic infectious process that goes without an inflammatory reaction. For example, about 3,1% of the infected men have the clinical symptoms in the form of the balanoposthitis. Most part of men are carriers without intensive symptoms.

The clinical pattern is more intensive in women. The basic manifestations of the disease are as follows: 

  • Profuse discharges from the genital tracts, white or gray color;
  • Bad smell from genitals (especially after the sexual intercourse);
  • The discharges become thicker during the protracted infectious process.

The bacterial vaginosis has one peculiarity. The disease is seldom accompanied with itching, painful sensations during the sexual intercourse, and other symptoms specifically attributed to the sexually-transmitted diseases. The symptoms appear episodically, in about 20% of women. It is usually manifested during periods, or a decrease in immunity.

Most women do not even suspect an infection. Therefore they visit a doctor rather late. The treatment is prescribed after the medical examination. A doctor should determine an amount of the pathogenic flora in the vaginal cells and the infectious invaders. A doctor may prescribe Flagyl before getting the microbiological tests.

Bacterial vaginosis pills: Metronidazole

This drug is active during all activators of the bacterial vaginosis. Both partners have to take Flagyl. Men are often carriers of the infection. If a woman has had the course of the treatment, and a man – not, the infection will reoccur in 99%.

  • Men should take Flagyl in the dose of 400 mg 2 times a day within 7 days;
  • The dose of Metronidazole is higher in women during the treatment of the BV: 400 mg 3 times a day within 7-10 days.
  • There is also an alternative scheme of the treatment for women: one-time use of Metronidazole in the dose of 2 g. In case of this approach, a risk of the side effects grows but the treatment goes faster.

Women must apply Metronidazole gel 0,75% besides the tablets. The gel is used intravaginally within 5 days, for the night. It has a strong local action and helps to restore the flora.        

Metronidazole (Flagyl) for yeast infection

The overwhelming majority of people on the planet (about 80%) are carriers of the various fungi. This is a part of the healthy flora that executes good functions in the body. The fungi like to live around the oil-glands because they need the secretion for the production of the fatty acids.

Yeast infection pills: flagyl (metronidazole)

But there are also the potentially pathogenic fungi such as Candida albicans besides the good fungi. Fungi of this type live on the mucous membranes in the vagina, esophagus, and mouth cavity. The increase of the amount of the pathogenic flora appears as a result of the decrease in the immunity, or a reduction of the good flora (for example, during the use of the antibiotics).

  • Up to 80 million people suffer from the fungal infection every year.
  • About 70% from all number are women.
  • According to the doctors, more than 75% of women have had the yeast infection of the genitals just once in their life.

To treat yeast infections, doctors prescribe patients the antifungal drugs with broad action. This is often Fluconazole. It effectively neutralizes Candida, and is able to completely cure a patient in one session.

Metronidazole (Flagyl) is an antibacterial drug and does not shows the action as to the fungi. Why is it used in the treatment of the yeast infections? 

The matter is that the vaginal flora is rather quickly changed during the yeast infections. The potentially pathogenic microorganisms start actively replicating. 40% of women have the bacterial vaginosis during the yeast infections. We have talked about it before. If the candidiasis is not treated, the bacterial infections appear in 90% of women because of the severe change of the flora. 

Even if you take the antifungal drugs and are able to treat the candidiasis, the bacterial vaginosis stays. Due to this, the symptoms are left, and you do not know a reason. Therefore, a doctor always examines the bacterial and fungal flora during the first examination.

Every pharmaceutical therapy of the yeast infection should include the combined drugs. These are:

  • Flagyl 400 mg 2 times a day + Diflucan 150 mg every 3 days within 7-10 days;
  • Flagyl 400 mg 2 times a day + Monistat 50 mg once a day within 7-10 days.

It is mandatory for a patient to use both tablets, and gel for the intravaginal introduction. Women with yeast infection will quickly restore the normal flora due to the use of Metronidazole.

Fungi does not disappear from the mucous membrane. The medical therapy just helps to return the amount of Candida fungi to the normal rate. But if the bacterial vaginosis is not treated, the fungi starts actively replicating. This is the endless circle that does not give 50% of the infected women to get rid of the unpleasant symptoms in the genitals. 

Women should be more attentive to the health and avoid the self-treatment. The incorrect combination of the drugs is not good. Therefore, if you have the first symptoms of the fungal or bacterial infection, go to a doctor and have a medical examination.      

Metronidazole online purchase. Flagyl over-the-counter (OTC)

Metronidazole is for sale in any pharmacy by prescription. But the standard course of the treatment will cost fair amount of money. Having analyzed the prices on the market, you may see that 10-day-therapeutic course will cost $250-280. This is the cost of the Metronidazole tablets. In addition to that, you will have to buy Fluconazole and other antibiotics with the broad action. A cost of Metronidazole significantly exceeds a real cost in the common pharmacy because a customer has to overpay for all trade extra charges.  

Metronidazole online purchase. OTC

A great solution of this problem is buying Metronidazole in online pharmacy.

Online pharmacies offer more profitable cost of Metronidazole because the overhead costs for the pre-sale preparations is significantly lower than in the common pharmacy. Online pharmacies do not have a big staff. They do not need to open dozens offices all over the city or country and invest money in the space lease.

A main task of the online pharmacies consists in the optimization of the current expenses. It allows to successfully compete with common retail pharmacies and offer customers the lowest prices at Metronidazole. But the essential benefit of the online pharmacies is not even the lowest prices. You will find Metronidazole over-the-counter in the online pharmacy only. 

If you do not have an expensive medical insurance, you should pay for the private doctor. You may go to a doctor in the hospital but your line may take 1-2 weeks. In case of the infectious process, an instant use of Metronidazole is required.   

You will not find Flagyl over-the-counter in any city in the USA. This drug is for sale by prescription only and you do not have chances to get it without doctor’s prescription. A doctor should give you a paper, or electronic blank to the pharmacy. You will be called when you can take your Flagyl. 

Online pharmacies are not judicable by the USA. They are registered in the countries where it is allowed to sell Flagyl over-the-counter. Therefore they can supply Metronidazole OTC all over the world.

The restrictions for the sale of Flagyl over-the-counter do not fall to customers. You have the right to get a prescription on the internet even if you do not have a prescription. The government of the USA is not able to restrict your right to get medications. Therefore, you should not think whether it is legal to buy Flagyl over-the-counter online. It is legal and you will not have any problems.

Even if the customs did not find a Flagyl prescription in the package and confiscate your product, you should contact a seller. The seller will send you a new package that will be delivered to your house with a probability of 99%.  

Do you need a prescription for Flagyl?

Flagyl is a prescription drug which is for sale in every pharmacy of the USA. FDA has approved the active ingredient Metronidazole for the treatment of the bacterial infections but under doctor’s supervision.

If you want to buy Flagyl in the pharmacies of the USA, Canada, or EU countries, you need a prescription. If the government detects that the pharmacy sells Flagyl without prescription, a fine will be imposed. The pharmacy will lose the license during many violations.

Prescription for Flagyl

The prescription sale of Flagyl is needed to control:

  • A spread of the infections among the population;
  • A control of the use of the antibacterial products.

The incorrect use of Metronidazole induces a complete resistance of microorganisms. It means that you will not be able to treat the disease sooner or later. Bacteria will not be vulnerable to the action of the drug. There are some alternatives to Metronidazole, and therefore doctors cannot offer you the same effective product.

The sale of Flagyl by prescription is a logical solution of the USA government. However, you may not always need a prescription. For example, if you continue the treatment and you do not have time to visit a doctor, or if you lose the prescription, you will not be able to get a new one. The doctor has the right to prescribe prescription for one person with certain periodicity. Or if you are prescribed expensive Flagyl, you should pay a big sum for the treatment. It is easier to buy Metronidazole in the online pharmacy.

To buy Metronidazole on the internet, a prescription is not needed. You may order it at any time. And you do not have to buy the expensive brand Flagyl. Choose cheap Metronidazole Generic and your treatment will cost not more than $50. 

Despite a wide availability of Metronidazole without prescription, we do not recommend you to self-treat. You may go to a doctor and get personal recommendations. According to these recommendations, you may select a dose of Metronidazole online and a number of tablets.

Author: Dr. Eddie Louie , Infectious Diseases & Immunology, Internal Medicine, Phone: (212) 682-9202