Clinical medicine profile
Metronidazole oral gel
Nitroimidazole antimicrobial / antiprotozoal
- Route
- ORAL / IV / TOPICAL / VAGINAL
- Schedule
- POM
- ATC
- Not assigned
- PPB status
- registered
Safety essentials
The information most likely to change a prescribing or dispensing decision.
Contraindications
- Hypersensitivity to nitroimidazoles.
- First trimester use traditionally avoided unless essential (practice evolving — follow current obstetric guidance).
- Disulfiram within 2 weeks.
Precautions
- Avoid alcohol during and for 24–72 h after (disulfiram-like reaction).
- Neurologic toxicity with prolonged/high dose (neuropathy, seizures).
- Metallic taste common.
- Dark urine possible.
Dosing matrix
Population and organ-function guidance, shown together for faster comparison.
Apply BD for 7-10 days. Apply a small quantity of gel on the toothbrush or on a finger and rub on the gums and interdental parts. Up to 30 minutes post-application the patient should not eat or rinse the mouth cavity.
See label paediatric section if present; otherwise use paediatric formulary — do not extrapolate adult doses.
Metabolites accumulate in renal failure; review dosing in ESRD.
- CrCl 0–120: Confirm renal dosing in product SmPC / primary label.
Hepatic metabolism — reduce dose in severe liver disease.
Use, effects & interactions
Indications
- Gingivitis, ulcerative gingivitis, gingival edema, periodontitis, stomatitis, pulpitis, post extractive alveolitis, toothache of infectious character.
- Clinical selection for Metronidazole oral gel should follow culture results where relevant, Kenya STG/EML recommendations, and the current product SmPC.
- Class context: Nitroimidazole antimicrobial / antiprotozoal.
- Confirm site-specific dose, duration and monitoring before prescribing.
Adverse effects
- Metallic taste, nausea, anorexia, headache.
- Serious: peripheral neuropathy, encephalopathy, seizures (rare), severe hypersensitivity, Stevens–Johnson (rare).
Drug interactions
Open multi-drug checker ↗- Cornerstone for anaerobic coverage and protozoa (giardia, amoeba, trichomonas).
- Combine with other agents for mixed aerobic–anaerobic infections as indicated.
- Warn every patient about alcohol.
Mechanism & disposition
Nitroimidazoles are reduced by ferredoxin-like systems in anaerobic bacteria and protozoa to reactive nitro radicals that damage DNA and other macromolecules, causing cell death.
Read complete mechanism
Nitroimidazoles are reduced by ferredoxin-like systems in anaerobic bacteria and protozoa to reactive nitro radicals that damage DNA and other macromolecules, causing cell death. Selective for anaerobic/microaerophilic organisms.
1–2 hours
8–24 hours
ORAL / IV / TOPICAL / VAGINAL
including abscesses and CSF. Hepatic
Pregnancy, lactation & diet
Widely used in later pregnancy for BV/trichomoniasis in many protocols; avoid unnecessary first-trimester exposure — follow current guidance.
Single-dose regimens often compatible with pumping/timing advice; prolonged high dose — review.
Brands & loaded prices
| Brand | Manufacturer | Pack | Observed price |
|---|---|---|---|
| No reviewed brand listings are linked yet. | |||
Sources & review state
Decision support only. Confirm patient-specific decisions against the current product SmPC, Kenya STG/EML, and professional judgement.