Metrogel vs Flagyl

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For patients dealing with rosacea, a skin condition causing redness and visible blood vessels in the face, certain topical treatments can help manage symptoms. Metrogel and Flagyl are two such medications often prescribed for this purpose. Both contain the active ingredient metronidazole which has anti-inflammatory effects that can reduce swelling and redness associated with rosacea. However, their application methods differ; Metrogel is applied directly to the skin where it controls pimples by reducing inflammation whereas Flagyl is taken orally or intravenously depending on the severity of infection. It's essential to know that while both drugs have similar uses, they also carry different side effect profiles due to their respective modes of administration.

What is Metrogel?

Metronidazole (the generic name for Metrogel) was a significant advancement in the class of nitroimidazole antibiotics, primarily used to treat various infections caused by anaerobic bacteria and protozoa. It was first approved by the FDA in 1963. Metrogel works by interacting with bacterial DNA, disrupting its structure and ultimately causing bacterial cell death. It is commonly prescribed for topical treatment of rosacea, a skin condition that causes redness and visible blood vessels on the face. Unlike oral metronidazole (Flagyl), which impacts throughout the body and may therefore result in more side effects such as nausea or altered taste sensation, Metrogel acts only where it is applied leading to fewer systemic side effects making it preferable for long-term use.

What conditions is Metrogel approved to treat?

Metrogel and Flagyl are both approved for the treatment of different types of bacterial infections:

  • Metrogel is mostly used topically to treat rosacea, a chronic skin condition that causes redness and pimples on the face.
  • Flagyl (metronidazole) is an oral or intravenous drug used to treat various infections including those caused by certain parasites and bacteria. It's commonly prescribed for conditions like bacterial vaginosis, pelvic inflammatory disease, colitis due to Clostridium difficile, abscesses in the liver or abdomen, stomach and intestinal ulcers caused by Helicobacter pylori when used with other antibiotics.

How does Metrogel help with these illnesses?

Metrogel is a topical medication used to manage rosacea by reducing the inflammation and swelling in the skin. It does this by entering bacterial cells and interfering with their genetic material, DNA. This disruption of the bacteria's functions inhibits its ability to produce proteins that are vital for its survival, leading to its death. Rosacea is often associated with an overgrowth of certain types of bacteria on the skin, so by killing these bacteria, Metrogel can limit the negative effects of rosacea and help patients manage their condition.

Flagyl, on the other hand, works similarly but it's taken orally or via injection and used for treating various systemic infections caused by certain bacteria and parasites throughout different parts of body including but not limited to genital areas, stomach or intestines. Thus Flagyl has a broader range in terms of application compared to Metrogel which mainly targets skin related issues.

What is Flagyl?

Flagyl, or metronidazole, is an antibiotic and antiprotozoal medication that inhibits the growth of bacteria and parasites. It works by damaging bacterial DNA and preventing it from being repaired. This action disrupts their structure and impairs their ability to survive, thus effectively treating many bacterial infections.

Flagyl was first approved by the FDA in 1963. Unlike Metrogel which is a topical gel formulation of metronidazole primarily used for skin conditions like rosacea, Flagyl is typically taken orally as tablets or capsules but can also be administered intravenously if required. Its systemic absorption means that it's effective against internal infections such as those affecting the gastrointestinal tract or reproductive system.

The side-effect profile of Flagyl differs from Metrogel due to its method of use; common side effects include nausea, diarrhea and a metallic taste in the mouth whereas topical applications rarely cause these issues. However, both medications are generally well-tolerated with only mild side-effects reported.

What conditions is Flagyl approved to treat?

Flagyl is an effective treatment for the following conditions:

  • Bacterial vaginosis
  • Trichomoniasis, a sexually transmitted infection
  • Certain types of infections, such as skin or joint infections and intra-abdominal infections

How does Flagyl help with these illnesses?

Flagyl, also known as metronidazole, is an antibiotic and antiprotozoal medication that stops the growth of certain bacteria and protozoa. This in turn helps to eliminate infections, particularly those affecting reproductive organs, skin conditions such as rosacea, or gastrointestinal tract issues caused by specific organisms. Flagyl works by damaging the DNA of microbes, thereby stopping their ability to reproduce and thrive. It's a systemic treatment which means it affects the whole body and is therefore utilized when an infection is severe or has spread to various parts of the body. Conversely Metrogel, while containing metronidazole too but used topically rather than orally like Flagyl, might be more suitable for localized skin issues due its targeted action. However when comparing both treatments depending on severity of condition one might respond better to Flagyl over Metrogel.

How effective are both Metrogel and Flagyl?

Both Metrogel (topical metronidazole) and Flagyl (oral metronidazole) are effective treatments for the skin condition rosacea, and both were initially approved by the FDA in the 1980s. These medications work on similar principles, as they are both derivatives of nitroimidazole antibiotics which have anti-inflammatory effects that help reduce redness, swelling, and acne-like lesions associated with rosacea.

The effectiveness of Metrogel and Flagyl in treating rosacea has been studied extensively. A 2002 double-blind clinical trial compared topical metronidazole to oral tetracycline among patients with papulopustular rosacea; it was found that both treatment modalities yielded significant improvements without notable differences between them.

A review article from 2011 highlighted a study showing that topical metronidazole demonstrated marked improvement in symptoms within three weeks of initiation of therapy. Its safety profile is generally favorable over many other treatments due to its limited systemic absorption resulting in fewer side effects.

On the other hand, although oral Flagyl can be just as effective as topical agents like Metrogel for managing moderate to severe cases of rosacea or when ocular involvement is noted, it is typically considered a second-line option because systemic use may lead to more side effects such as gastrointestinal upset or yeast infections. However, there's no denying its efficacy especially in individuals who don't respond well to first-line treatments or those who require faster resolution due to severe flare-ups.

abstract image of a researcher studying a bottle of drug.

At what dose is Metrogel typically prescribed?

Topical applications of Metrogel are typically recommended at a frequency of once to twice daily, depending on the severity and type of infection. The amount applied should be enough to cover the affected area. For Flagyl, oral dosages usually range from 250-500 mg/day for adults, taken three times daily. Children's dosage is often determined by their weight and the nature of their condition. In either case, if there is no improvement after a few weeks or if symptoms worsen, medical advice should be sought immediately. It is important not to exceed prescribed doses without consulting your healthcare provider.

At what dose is Flagyl typically prescribed?

Flagyl treatment is usually initiated at a dosage of 500–750 mg/day, typically divided into two to three doses spread throughout the day. The dose can then be increased as necessary based on your doctor's recommendations. For severe infections, the maximum daily dose can go up to 4 grams per day divided into four doses of 1 gram each and spaced six hours apart. This regimen might be introduced if there's no significant response to initial treatment after a certain period. As with any medication, it's essential not to exceed the prescribed dosage without consulting with your healthcare provider first.

What are the most common side effects for Metrogel?

Common side effects of Metrogel include:

  • Skin irritation, dryness, stinging, burning
  • Redness or other skin discoloration
  • Metallic taste in the mouth
  • Nausea

Whereas Flagyl can potentially cause a wider range of systemic symptoms such as:

  • Upset stomach and vomiting
  • Diarrhea
  • Loss of appetite or metallic taste in the mouth
  • Dizziness or balance problems
  • Dry mouth and thirstiness
    -Anxiety or mood changes -Sinusitis (inflammation of sinuses)

Both medications should be used under medical supervision; if any side effect becomes severe or persistent it's important to consult with your healthcare provider.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Metrogel?

While Metrogel and Flagyl both contain the same active ingredient, metronidazole, their side effects can vary due to differences in administration. Both medications are used to treat bacterial infections of different kinds but Metrogel is a topical medication while Flagyl is taken orally.

With Metrogel, potential serious side effects could include:

  • Severe skin reaction: hives, difficulty breathing or swallowing
  • Swelling in your face or throat
  • Skin redness or other signs of irritation not present before use of this medicine
  • Eye pain or color changes

Flagyl has more systemic side effects which may include:

  • Neurological symptoms such as seizures and numbness/tingling in extremities
  • Mood changes (confusion, hallucinations) indicative of central nervous system involvement
  • Rapid heart rate with dizziness (potentially leading to fainting)
  • Liver problems - nausea/vomiting that doesn't stop; loss of appetite; stomach/abdominal pain; yellowing eyes/skin; dark urine

If you experience any severe adverse reactions from either medication seek medical help immediately.

What are the most common side effects for Flagyl?

Flagyl, a potent antibiotic often used to treat bacterial infections, can present with a range of side effects:

  • Nausea, vomiting or loss of appetite
  • Dry mouth and metallic taste
  • Stomach pain
  • Diarrhea or constipation
  • Headache, dizziness or lightheadedness
  • Sleep problems (insomnia)
  • Mild skin rash or itching
  • Dark-colored urine Feeling anxious, nervous and potential for confusion in some cases.

Are there any potential serious side effects for Flagyl?

While Flagyl is generally safe for use, it can cause several notable side effects in some patients. These can include:

  • Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
  • Severe stomach pain, diarrhea that is watery or bloody (even if it occurs months after your last dose)
  • Trouble sleeping, depression, irritability
  • A headache that will not go away
  • Dizziness, confusion
  • Unusual changes in mood or behavior
  • Fast or pounding heartbeats (tachycardia), shortness of breath
  • Numbness or tingling in your hands and feet

If you notice any of these symptoms while using Flagyl, discontinue the use and seek medical attention immediately.

Contraindications for Metrogel and Flagyl?

Both Metrogel and Flagyl, like many other antibiotic medications, may cause side effects such as nausea or diarrhea in some people. If you notice worsening of these symptoms, or an onset of more serious complications such as persistent vomiting, abdominal pain, signs of a new infection (fever), please seek immediate medical attention.

Neither Metrogel nor Flagyl should be used if you are consuming alcohol or have been consuming it recently; this includes any products that contain alcohol like certain cough syrups and mouthwashes. The combination with alcohol can lead to severe reactions such as flushing, headaches, nausea etc.

Always mention all the medications you are currently taking to your physician; using metronidazole while taking Cimetidine (Tagamet) for example can increase the levels of metronidazole in your body hence increasing the risk for side effects. Other drugs could also interact adversely with either Metrogel or Flagyl leading to increased risks.

How much do Metrogel and Flagyl cost?

For the brand name versions of these drugs:

  • The price of a 45g tube of Metrogel (1%) averages around $370, which works out to about $8/day if used once daily.
  • The price for 60 tablets of Flagyl (500 mg) is approximately $110, working out to roughly $3.50/day.

Thus, if you are using Metrogel on a regular basis (i.e., applying it once per day), then brand-name Flagyl is less expensive on a per-day treatment basis. Please note that cost should not be your primary consideration in determining which drug is right for you.

As for the generic versions:

  • Generic metronidazole gel costs significantly less than its branded counterpart, with prices averaging around $70–$90 for a 45g tube at most pharmacies. This means you could pay as little as around $2/day when used once daily.
  • Generic metronidazole tablets also offer savings compared to their branded equivalent, with average prices ranging from approximately $.30 to $.50 per tablet depending upon strength and quantity purchased; this equates to potentially under $.50 - .75/day when taking two doses daily.

Popularity of Metrogel and Flagyl

Metronidazole, in both generic form and under brand names such as Flagyl, is a widely prescribed antibiotic that was estimated to have been dispensed to about 12.7 million people in the US in 2018. Accounting for roughly 2% of all antibiotic prescriptions, metronidazole has been relatively steady in use over the past decade.

In contrast, Metrogel, which also contains metronidazole but is formulated as a topical gel specifically for treating rosacea symptoms, was not quite as prevalent on prescription lists. However, it remains popular among dermatologists due to its localized application and minimal systemic absorption which minimizes potential side effects compared to oral antibiotics like Flagyl. Over recent years there has been an increasing preference towards using topical treatments like Metrogel when managing conditions such as rosacea.


Both Metrogel (topical metronidazole) and Flagyl (oral metronidazole) have a long history of use in the treatment of bacterial infections, including rosacea. Numerous clinical studies have demonstrated their effectiveness compared to placebo treatments. In some circumstances, they could be used together under careful consideration by the physician as there are no known contraindications between them. Their mechanisms differ primarily due to how they are administered: Metrogel is applied topically on the skin while Flagyl is taken orally.

Flagyl can address systemic infections throughout the body, whereas Metrogel focuses more on treating localized skin conditions such as rosacea or certain types of dermatitis. Hence, these drugs tend to be prescribed under different circumstances but could also work synergistically if needed.

Both medications are available in generic form which represents significant cost savings, especially for patients paying out-of-pocket costs. Both drugs may require an adjustment period meaning that effects may not be noticeable immediately after starting treatment.

The side effect profile differs between these two medications because of their routes of administration; oral Flagyl has broader systemic effects and thus a wider array of potential side effects like upset stomach or nausea than topical Metrogel which mostly causes local reactions like dryness or irritation at application site. For both drugs, patients should monitor any adverse reactions closely when initiating therapy and seek medical attention promptly if severe symptoms occur.