metronidazole topical (Rx)

Brand and Other Names:MetroCream, MetroGel, more...MetroLotion, Noritate
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

topical gel

  • 1% (MetroGel)

topical cream

  • 0.75% (MetroCream)
  • 1% (Noritate)

topical lotion

  • 0.75% (MetroLotion)

Rosacea

Indicated for the topical treatment of inflammatory lesions of rosacea

1%: Apply topically qDay to affected area(s)

0.75%: Apply topically BID to affected area(s)

Administration

Cleanse treated areas prior to application

Apply thin film and rub into skin

Cosmetics may be applied ≥5 minutes after application

Safety and efficacy not established

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Interactions

Interaction Checker

and metronidazole topical

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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             activity indicator 

            Contraindicated (0)

              Serious - Use Alternative (0)

                Monitor Closely (0)

                  Minor (3)

                  • disulfiram

                    disulfiram increases toxicity of metronidazole topical by decreasing metabolism. Minor/Significance Unknown. Enhanced CNS & cardiac toxicity with oral metronidazole and disulfiram; less likely to occur with topical administration because of low absorption.

                  • ethanol

                    metronidazole topical will increase the level or effect of ethanol by decreasing metabolism. Minor/Significance Unknown. Disulfiram-like reaction with oral metronidazole and alcohol; less likely to occur with vaginal administration because of low absorption

                  • warfarin

                    metronidazole topical will increase the level or effect of warfarin by decreasing metabolism. Minor/Significance Unknown. Oral metronidazole potentiates the effect of warfarin; less likely to occur with topical administration because of low absorption

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                  Adverse Effects

                  >10%

                  Skin dryness (25.4%)

                  Skin scaling (24.6%)

                  Pruritus (15.8%)

                  Cutaneous stinging/burning (10.3%)

                  Frequency Not Defined

                  Application site reaction

                  Aggravated condition

                  Paresthesia

                  Acne

                  Dry skin

                  Tearing of eyes

                  Postmarketing Reports

                  Peripheral neuropathy

                  Allergic reactions

                  Skin and eye irritation

                  Rash

                  Headache

                  Nausea

                  Constipation

                  Contact dermatitis

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                  Warnings

                  Contraindications

                  Hypersensitivity

                  Cautions

                  For external use only

                  Avoid contact with eyes; tearing may occur

                  Nitroimidazole; use caution with evidence or history of blood dyscrasia

                  Discontinue use if dermatitis occurs

                  Administer with caution in patients with CNS diseases due to risk of numbess or paresthesia of an extremity

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                  Pregnancy & Lactation

                  Pregnancy Category: B

                  Lactation: Unknown if excreted in human milk; caution advised

                  Pregnancy Categories

                  A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                  B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                  C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                  D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                  X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                  NA: Information not available.

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                  Pharmacology

                  Mechanism of Action

                  Mechanism by which metronidazole acts in the treatment of rosacea is unknown, but appears to include an anti-inflammatory effect

                  Inhibits nucleic acid synthesis by disrupting DNA

                  Pharmacokinetics

                  Peak Plasma Time: 6-10 hr

                  Peak Plasma Concentration: 32 ng/mL (<1% of PO dose)

                  AUC: 595 ng•hr/mL (<1% of single PO dose)

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                  Images

                  No images available for this drug.
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                  Patient Handout

                  A Patient Handout is not currently available for this monograph.
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                  Formulary

                  FormularyPatient Discounts

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                  The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                  Tier Description
                  1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                  2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                  3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                  4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                  NC NOT COVERED – Drugs that are not covered by the plan.
                  Code Definition
                  PA Prior Authorization
                  Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                  QL Quantity Limits
                  Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                  ST Step Therapy
                  Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                  OR Other Restrictions
                  Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                  Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.