These antibiotic medicines can be taken by mouth in pill form (orally) or inserted into the vagina in cream, gel, or suppository form (ovules). Vaginal creams and gels are used with an applicator that inserts the correct amount of medicine. (Tinidazole is only taken by mouth.)
How It Works
Metronidazole, clindamycin, and tinidazole are antibiotics that destroy some of the bacteria that cause symptoms of bacterial vaginosis.
Why It Is Used
Some women prefer oral medicine rather than vaginal administration.
Especially for pregnant women who are high-risk for preterm labor, only oral medicines are used to treat bacterial vaginosis. Some doctors recommend that all pregnant women avoid vaginal treatment.
Vaginal medicines are less likely than the oral forms to cause systemic side effects, such as nausea and vomiting.
How Well It Works
Women who aren't pregnant
Oral or vaginal metronidazole and vaginal clindamycin cream cure bacterial vaginosis in as many as 8 out of 10 cases.1
Although medicine usually cures bacterial vaginosis, it often comes back. Some doctors have women use medicine for a longer time to prevent this.
Women who are pregnant
Oral antibiotics, such as metronidazole, work well for treating bacterial vaginosis during pregnancy.2
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call911or other emergency services right away if you have:
Call your doctor if you have:
Side effects of vaginal clindamycin and metronidazole are generally minor. The most common is a vaginal yeast infection during or after treatment.
The oil in clindamycin cream and ovules can weaken latex. This means condoms and diaphragms may break, and you may not be protected from sexually transmitted infections (STIs) or pregnancy.
Oral treatment can cause:
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Completely avoid alcohol use (including alcohol-based nonprescription medicines, such as NyQuil) while you are taking metronidazole or tinidazole, because combining alcohol with these medicines may cause severe nausea and vomiting.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for pregnant women
When you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Marrazzo J, Sobel J (2010). Vaginal infections. In SA Morse et al., eds., Atlas of Sexually Transmitted Diseases and AIDS, 4th ed., pp. 76-85. Philadelphia: Saunders.
Brocklehurst P, et al. (2013). Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database of Systematic Reviews (1).
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Specialist Medical ReviewerDevika Singh, MD, MPH - Infectious Disease
Current as ofMarch 12, 2014