Flagyl Over the Counter

Flagyl over the counterThe modern variety of antibiotics may seem overwhelming. The thing is that one does not need to know everything about them, as they must be prescribed by the physician after careful analysis and diagnostics of the disease.

Still, when you are prescribed with, for example, Flagyl, you may have many questions about it. Here we answer the most common of them and explain the basics about of this remedy, including its utilization rules and precautions.

What is Flagyl

The active ingredient of this remedy is metronidazole. The compound is of a synthetic origin and was created based on the natural substance azomycin. The latter is produced by Streptomyces microorganisms and reveales an ability to kill different pathogens.
The synthetic analog first appeared in clinical practice in the middle of the XX century and was utilized for thetreatment of trichomoniasis. Later, other activities were discovered for it. Thus, when the patent expired, variousgenericswere introduced to the pharmaceutical market.

The initial developer was Rhone-Poulenc (France). Nowadays this company belongs to Sanofi. It gave the drug its common name Flagyl. It belongs to the so-called nitroimidazoles group of antibiotics and is quite popular due to the wide spectrum of activity and not very pronounced side effects.

Different forms of Flagyl

According to the various indications for usage, this medicine is produced in different dosage forms. Thus, you can find Flagyl as:

  • immediate-release tablets and capsules;
  • tablets with extended-release;
  • topical cream, gel or lotion;
  • vaginal gel.

They also have a different dosage. Thus, in each case, the doctor selects the dosage form individually.

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Tablet Strength: 400 mg, 200 mg
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Where to Buy Flagyl?

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How Does Flagyl Work

As well as for other antibiotics, the main aim of this substance is to kill harmful pathogens and stop their negative effects on the body of the host. Flagyl has its own ways to achieve this.

Antibacterial Mechanism

Due to its chemical structure, this compound is able to interact with the DNA of microbes. When it does this, the latter loses its ability to replicate and produce proteins. This leads to the death of pathogens and recovery.

Anti-Protozoal Mechanism

This type of action is backed by science but the exact mechanism is still being under investigation. The scientists believe, that in the case of protozoa, Flagyl also hinders the normal functioning of DNA.

Flagyl Common Uses

The utilization of this remedy corresponds to its activity. Thus, it is highly active against various pathogenic microorganisms, including protozoa, anaerobic and aerobic bacteria. This list containsTrichomonasvaginalis, Gardnerellavaginalis, Giardia intestinalis, Entamoebahistolytica, Bacteroides species, Fusobacterium species, Veillonela species, Eubacterium species, Clostridium species, Peptococcus species, Peptostreptococcus species and Helicobacter pylori.

Bacterial Infections

The most common causes of the utilization of bacterial infection treatment are:

  • gardnerellosis (bacterial vaginosis);
  • infections caused by anaerobic bacteria, such as peritonitis, abdominal and liver abscesses, endometritis, ovarian and fallopian tube abscesses,pneumonia, lung abscess, meningitis, brain abscesses, skin and bone infections, endocarditis and sepsis;
  • mixed bacterial infections caused by both aerobic and anaerobic pathogens. In this case, Flagyl is usually combined with other antibiotics with a broad-spectrum action to cover as many pathogens as possible.

Parasitic Infections

Protozoa that cause various parasitic infections can be also successfully combated with the help of this drug, namely:

  • trichomoniasis (including chronic and complicated);
  • giardiasis;
  • amoebiasis and amoebic liver abscess.

Surgical Prophylaxis

This medicine is utilized to prevent complications that may occur during different surgical interventions on the colon, intestines and gynecological operations. If the risk is high, it is combinedwith intravenous or intramuscular administration of cefazolin.


One more useful utilization of this drug is the eradication of Helicobacter pylori for the treatment of duodenal or gastric ulcers. Its combination with proton pump inhibitors, bismuth preparations and antibiotics like amoxicillin gives positive dynamics and contributes to faster recovery.

In addition, it can be useful for the treatment of different resistant strains when other options are not suitable or do not give appropriate results. Various combinations are also commonly prescribed in such a case.

How to take Flagyl

The rules of the intake depend on the disease and chosen dosage form. Thus, the healthcare provider will give all the necessary recommendations. Oral forms are taken before or after the meal with pure water. Topical dosage forms are utilized only on the problematic area.

Dosage and Timing

The oral dosage forms usually contain 250 or 500 mg of an active ingredient. They can be prescribed both once or several times per day depending on the disease. It is important to follow the given recommendations to achieve the active concentration of the substance in the blood.

Duration of Treatment

On average, the treatment lasts one week. It may take from 5 to 10 days and is prescribed individually.

What should I do if I miss a dose of Flagyl?

It is not recommended to take two doses at a time. Thus, if one dose is missed, continue the treatment at the previous speed and do not add doses.

Who should not take Flagyl?

This drug is not recommended for patients under 18 years of age, as well as for children younger than 5 years. In addition, it is contraindicated for utilization in the first trimester of pregnancy. The use in the second and third trimesters is possible only in rare cases and under a doctor’s control.

Utilization during the breastfeeding period is also prohibited or the woman has to stop feeding the baby while taking the medicine.


The main contraindication is hypersensitivity or allergic reactions to metronidazole or other nitroimidazole derivatives.

In addition, if the patient consumes any other medicines on a daily basis, the doctor must check for possible interactions.


Although this remedy is considered safe according to its basic profile, the following precautions are important for its proper utilization:

  • Patients with any issues of the central nervous and the hematopoietic system should be under close supervision;
  • In the case of impaired liver function, the dosage regimen should be adjusted due to the possible accumulation of an active ingredient;
  • Caution is required for those predisposed to the edema or receiving corticosteroids due to the high sodium content;
  • The intake of the remedy may change the color of the urine and the results of the liver tests.

One of the main things to remember about this remedy is the prohibition of taking it simultaneously with alcohol. Any ethanol-containing beverage can be taken only after 48 hours after the last dose, since acetaldehyde may accumulate due to impaired ethanol oxidation. As a result, the development of severe side effects is possible, which include blood pressure drop, nausea and vomiting, headache, etc.

Due to the possibility of dizziness, while taking the drug, caution is required for any activities that require increased attention and speed of psychomotor reactions. This relates especially to drivers and those patients who work with complex mechanisms. Thus, they should stay aware and avoid such activity during the first days of the treatment.

Can Flagyl be taken during pregnancy or breastfeeding?

It is prohibited to take it, especially during the first trimester and the breastfeeding period. If there is no other choice, the drug may be prescribed in the second and third trimesters but it is better to avoid the intake. The doctor must control the intake and check the response of the child.

Can Flagyl be taken with other medications?

The simultaneous utilization of metronidazole and different other medicines may lead to bad consequences, such as:

  • it potentiates the effect of warfarin and other indirect anticoagulants that may provoke bleeding;
  • together withdisulfiram,it promotes acute psychosis and disorientation;
  • during treatment with lithium salts, it is possible to increase their concentration in the blood and toxicity and cause symptoms of renal dysfunction;
  • combination with phenobarbital leads to the accelerated metabolism of metronidazole and a decrease in its efficiency;
  • the simultaneous use of bismuth salts and proton pump inhibitors increases gastric pH.

These are only a few examples, so caution is required and consolation with the doctor about the possibility of any combination.

Possible Side Effects of Flagyl

While utilizing Flagyl, the patient should be aware of some side effects, which may occur, namely:

  • headache;
  • changes in the appetite;
  • cramps in the abdomen;
  • diarrhea or constipation;
  • heartburn;
  • vomiting;
  • metallic aftertaste;
  • yeast infections;
  • vaginal discharge.

Topical forms (lotions, gels and creams) may cause burning and stinging, irritate theskin and make it dry and red. The same is sometimes observedfor the vaginal dosage forms that cause unpleasant side effects in the vagina.

Can you buy Flagyl Over the Counter?

As a base, this medicine is considered a prescription one. Thus, to get it, one has to visit the doctor and get a prescription. In addition, it is an important step, as the specialist will help to determine the required dose and regimen of the treatment.

Furthermore, some online pharmacies provide the possibility to get this consultation online and then make a purchase on the website. This is a convenient modern option that helps to start the treatment as soon as possible.

What are the alternatives to Flagyl?

Different antibiotics have similar mechanisms of action or combat a similar variety of pathogens. For instance, ciprofloxacin has a similar activity or secnidazole, tinidazoleand clindamycinare often prescribed for bacterial vaginosis as often as Flagyl.

However, only the specialist is able to determine the problem, diagnose the disease and select the proper treatment. Therefore, do not try to find an alternative for Flagyl by yourself. If there are any issues or side effects, consult the specialist and he will help you to substitute the medicine.


In a nutshell, Flagyl is a well-known and quite powerful remedy that successfully combats even resistant and rare pathogens. Due to its peculiarities and unique features, it should be prescribed by the specialist and after careful diagnostics.

If there are any questions left on this drug, do not hesitate to ask your healthcare provider and always follow the recommendations given on the treatment to get a fast and efficient recovery.


Can I take 2 flagyl at once?

No, this medicine must be taken only according to the prescription to avoid overdose and the occurrence of side effects. If you’ve missed a dose, consult your healthcare provider on your further actions but do not multiply the doses.

Is flagyl an over the counter drug?

No, the prescription is usually required to purchase this remedy. Still, some online pharmacies allow getting an online prescription from the pharmacist.

What can I substitute for Flagyl?

Ciprofloxacin has a similar range of activity. However, one should not replace antibiotics without a consultation with a specialist.

Is there an alternative to Flagyl for BV?

Other options that are commonly prescribedfor treatment include secnidazole, tinidazoleand clindamycin. Still, only the physician should make a prescription and select the dose and regimen of the intake.