How do I use Metrogel (metronidazole) vaginal gel?

How to Use Metrogel Vaginal (Metronidazole Vaginal Gel)

For bacterial vaginosis treatment, apply one applicator full of metronidazole vaginal gel (approximately 5 grams) intravaginally once daily at bedtime for 5 days. 1

Application Instructions

Preparing the Applicator

1. Remove cap and puncture metal seal on tube with the pointed tip of cap
2. Screw end of applicator onto tube
3. Slowly squeeze gel out of tube and into applicator until the plunger stops (indicates applicator is full)
4. Unscrew applicator and replace cap on tube

Inserting the Gel

1. Find a comfortable position (lying on your back with knees bent works well)
2. Hold the filled applicator by the barrel
3. Gently insert applicator into vagina as far as it will comfortably go
4. Slowly press the plunger until it stops to deposit gel
5. Withdraw the applicator

Important Usage Information

• Dosing schedule: Apply one applicator full at bedtime for 5 days 2, 1
• Alternative dosing: Some physicians may prescribe twice-daily dosing (morning and evening) for 5 days 1, 3
• For vaginal use only: Do not use in eyes, on skin, or in mouth 1
• Avoid alcohol: Do not consume alcohol during treatment and for 24 hours afterward to prevent disulfiram-like reactions (nausea, vomiting, flushing, headache) 2
• Storage: Keep at room temperature and avoid extreme heat or cold 1

Applicator Care (for twice-daily dosing)

If using twice daily:

1. After use, pull the plunger out of the barrel
2. Wash both plunger and barrel in warm soapy water and rinse thoroughly
3. Reassemble by gently pushing plunger back into barrel

Precautions and Warnings

• Discontinue use if significant irritation develops and consult your physician 1
• Not recommended during first trimester of pregnancy 2
• Keep medication out of reach of children 1
• Oil-based vaginal products might weaken latex condoms and diaphragms 2

Expected Results and Follow-up

• Clinical cure rates range from 75-87% when used as directed 3, 4
• Symptoms typically begin resolving within 6 days of starting treatment 5
• No routine follow-up is necessary if symptoms resolve 2
• Recurrence is common (50-80% within a year), so contact your healthcare provider if symptoms return 2

Common Side Effects

• Mild vaginal irritation
• Metallic taste
• Gastrointestinal disturbances
• Potential for vaginal candidiasis (yeast infection) after treatment 6

Remember that completing the full course of treatment is important even if symptoms improve before finishing the medication.