What is Metronidazole? 

Metronidazole 400mg is used in the treatment of bacterial vaginosis and other infections caused by bacteria. Nitroimidazoles are its class of tablets. It kills the bacteria responsible for infection by acting on them. Because of its effective cure for the bacterial infection in the vaginal region, it has become one of the most prescribed antibiotics. This medicine restores a normal balance to the bacteria and is usually prescribed for quite a few varieties of bacterial infections. 

What are metronidazole 400mg tablets used For? 

Bacterial Vaginosis: It is usually prescribed to treat bacterial vaginosis. It kills the bacteria that cause the infection. 
Anaerobic Infections: Metronidazole is highly effective against anaerobic bacteria, which exist in environments with a very low level of oxygen or no oxygen. 

How do metronidazole tablets work?

Metronidazole works by targeting the DNA of the bacteria. This kills the infection-causing microbes. The restoration of the normal balance of bacteria in the body is made possible by this process, primarily in the vagina, where the bacterial vaginosis is. 

Mechanism of action: 

Targets Bacterial DNA: The mechanism through which Metronidazole acts is to interfere with the DNA of the bacteria so they cannot multiply and thus kill the bacteria. 
Disrupts Bacterial Metabolism: It inhibits the metabolism of bacteria by interfering with the critical enzymes required for bacterial respiration, causing the death of bacterial cells. 
Restores Bacterial Balance: The medicine also helps restore the normal balance between good and harmful bacteria, which in this case, in particular, occurs in the vaginal microbiome. 

When is bacterial vaginosis confirmed, and medication needed? 

The condition of BV is confirmed when a woman consistently experiences the thin, greyish-white vaginal discharge with a fishy smell over time. Indeed, unlike changes in the colour or amount of vaginal discharge some other time, BV is very much a sexual health condition and affects one's psychological well-being in most cases. There are many factors that cause BV, and all these are physical or lifestyle-related ones. 

Physical Causes of bacterial vaginosis: 

Hygiene Habits: Douching or the use of perfumed feminine products tends to disrupt the balance of bacteria that occur naturally in the private part. 
Multiple Sexual Partners: Having multiple sex partners increases likelihood of illness. 
Smoking: Smoking can also be the major cause of increasing BV. 

Symptoms of bacterial vaginosis: 

• Vaginal discharge, which is typically thin and greyish-white in colour. 
• Vaginal discharge that smells strong like fish and especially so after having sexual intercourse. 
• A sensation of vaginal itching or burning. 
  Painful or burning sensation on urination 

These symptoms can last for several weeks or even longer and, therefore, are of great medical concern. Doctors determine the presence of illness by the history provided during your sexual or medical examination. The provider may conduct a pelvic exam.  

Treatment usually consists of an antibiotic called Metronidazole, given to rebuild the normal balance of bacteria inside the vagina. It is essential to complete the full treatment course as directed to avoid recurrence. Unnecessary douching should be avoided, and only unscented feminine products should be used. 

Can metronidazole tablets be purchased over the counter? 

Metronidazole 400mg will indeed be only dispensed through prescription in the UK. This is because it is for the treatment of bacterial vaginosis and other similar bacterial infections. It is an antibiotic, and antibiotics must be prescribed only by a healthcare provider for proper use and to prevent resistance. This may be checked and reviewed by a doctor or pharmacist in terms of appropriateness for use with your history, as well as regarding your symptoms. Self-medication and self-diagnosis may lead to improper treatment and undesirable effects. 

Alternative medications 

Although Metronidazole 400mg is the most prescribed antibiotic for bacterial vaginosis, there are many other medications that can be prescribed for the patient depending on his/her needs.

Some of them are as follows: 

Clindamycin: It is used in patients who cannot tolerate Metronidazole. It is applied both orally and topically and acts on the bacteria causing BV. It is used for a course of 7 days by inhibiting bacterial growth. 
Tinidazole: This is another alternative to Metronidazole. This also works like Metronidazole. This medicine acts by attacking and eradicating the bacteria causing BV. It is administered in a single dose. 
Boric Acid: In cases of chronic BV, Boric Acid can be an alternative treatment. It is in suppository form and is used as a supplement when other treatments with antibiotics do not respond. It works through the correction of the pH balance in the vagina. 

All of the alternative treatments above, including Metronidazole, should always be used only under the supervision of a healthcare provider in order to ensure safety and effectiveness. 

How to Take Metronidazole 400mg tablets? 

Timing: Take the medication as advised by your doctor. The antibiotic is typically prescribed once or twice a day, depending on the condition of the patient. For bacterial vaginosis, the typical treatment is one 400mg tablet once or twice a day for 7 days. One must follow the prescribed schedule to treat the infection fully. 

Dosage: For bacterial vaginosis, the usual dose is 400mg twice a day for 7 days. Dosage and treatment duration may be adjusted according to your condition and how your body reacts to the medication. So, always take the dose as prescribed by your doctor. Never exceed the prescribed amount because this might cause unnecessary side effects or complications. 

With Food: The medicine can be taken after or before a meal or without food. But if the medicine irritates your stomach, it could be taken easily when accompanied with food or milk. The medication is better tolerated by most who take it with a meal; but taking the medication does not rely on that. 

Avoid Alcohol: Alcohol should not be taken while on Metronidazole. Alcohol causes adverse reactions such as nausea, vomiting, headaches, and abdominal cramps when interacting with the medicine. To avoid these uncomfortable side effects, alcohol must not be taken during treatment and for at least 48 hours after the end of the treatment with Metronidazole. 

Missing Dose: If you forget a dose of Metronidazole, you take it whenever you remember; do not delay or make an excuse because of this missed dose, but in case the next dose is approaching, then ignore that one dose and keep your schedule going. You do not take double the amount as one dose because of forgetting another one. 

Active Ingredient: 

Metronidazole is the active ingredient of Metronidazole 400mg tablets. It is an antibiotic that kills the bacteria causing the infections, including bacterial vaginosis. This is achieved through the disruption of the DNA of the bacteria so that they cannot multiply and hence remove the infection. 

Inactive Ingredients: 

The inactive ingredients of Metronidazole 400mg tablets are lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium starch glycolate, and others. These will further enhance the stability, absorption, and manufacturing of the tablets. 

Always read the patient information leaflet (PIL) in your pack for the complete list of ingredients, and to check for any you might be allergic to.

Metronidazole 400mg tablets is safe to use when employed appropriately, though, like other tablets, side effects may occur. Most of these side effects are mild and temporary, but some may need to be evaluated further for necessary medical attention. 

Common Side Effects: 

Metallic Taste: There may be a metallic or other unusual taste in the mouth after administration of the medicine. 
Headache: A common but often mild side effect. 
Dizziness: Some patients experience dizziness or light-headedness. 
Stomach Upset: Some patients have stomach cramps, indigestion, or diarrhoea. 
Dry Mouth: There may be a temporary feeling of dry mouth during treatment. 

Less Common but Serious Side Effects: 

Severe Allergic Reactions: For serious allergic reactions, be sure to contact a doctor right away for any rash, itching, swelling of the face, lips, or throat, or difficulty breathing. 
Peripheral Neuropathy: Tingling, numbness, and pain in hands or feet are symptoms of peripheral neuropathy, which is a symptom of nerve damage and should be seen early. 
Severe Stomach Pain: Abdominal pain with unexplained vomiting or dark-coloured urine could be a symptom of liver disease and should be checked. 
Severe Headache or Blurred Vision: If your headaches are very severe or continue for a while, or you have vision problems, you must see a doctor. 

If any of the above side effects get worse or include allergic reactions, neuropathy, or severe abdominal pain, contact a doctor immediately. With prompt treatment, further complications could be avoided. 

Any pre-existing conditions, such as liver problems or other medications, must be discussed with the healthcare provider before starting on Metronidazole 400mg to minimise the risk. All advice given should be followed carefully, and an overdose should not be taken; hence, treatment becomes safe and effective.