How Safe is Taking Metronidazole Tablet while Pregnant or Breastfeeding

Metronidazole is categorized as nitroimidazole antibiotic drug formulated for the treatment of anaerobic bacteria and protozoa. It works by exerting amebicide, antiprotozoal, and antibiotic activity. Metronidazole is considered as the first choice treatment for mild to moderate Clostridium difficult infection. The medicine is also available in the form of a gel to treat dermatological conditions like fungating tumors and rosacea.

Uses of Metronidazole

Metronidazole is prescribed for the following conditions:

• Bacterial vaginosis
• Pelvic inflammatory disease in combination with antibiotics such as levofloxacin, ceftriaxone, and ofloxacin
• Pseudomembranous colitis due to Clostridium difficile
• Anaerobic bacterial infections
• Helicobacter pylori eradication treatment for peptic ulcer disease
• Infection of the small intestine
• Amoebiasis, infection caused by Entamoeba histolytica
• Trichomoniasis, infection caused by Trichomonas vaginitis

Dosage instructions

• For adults- The recommended dose is 250 mg thrice daily.
• For pediatrics- 15 mg/kg is the suggested dose, which is to be given three times daily for five days.

It is very important that you check with your doctor before initiating the treatment with Metronidazole.

Adverse effects of Metronidazole

• The common adverse events associated with Metronidazole therapy include diarrhea, metallic taste, and nausea. Intramuscular administration is associated with thrombophlebitis.
• Infrequent adverse reactions include vomiting, paraesthesia, stomatitis, headache, hypersensitivity reactions, dizziness, dark urine, glossitis, etc.
• Long-term therapy or high dose of Metronidazole may give rise to the development of neutropenia, leukopenia, and increased risk of peripheral neuropathy.
• Some adverse reactions associated with topical forms of medication include dryness, eye watering, irritation, and local dryness.

Alcohol-Metronidazole interaction

Alcohol consumption during Metronidazole treatment has been thought to have a disulfiram-like reaction with effects that can include an accelerated heart rate, breathlessness, flushing of the skin, nausea, and vomiting. Consumption of alcohol should be avoided during the treatment or two days after completing the course.

Pregnancy and lactation

According to an older study, there is a link between an increase in birth defects and metronidazole. Earlier such studies raised some concerns. However, these studies were not up to the mark and make it difficult to be sure if these birth defects were caused by metronidazole. More recent researches performed on thousands of women, but unable to find evidence that can show metronidazole during pregnancy increases the risk of birth defects. While some studies still state that metronidazole should not be given to pregnant women. The current data do not support an increased risk of harmful effects on the baby while taking this medication and there is no evidence of harm to the fetus due to metronidazole.

It has been reported that the antibiotic medication (metronidazole) excreted into human breast milk in large amounts. However, the dose received by the infant via breast milk is lower than therapeutic dose given to treat infants who were unable to tolerate this medication with minimal adverse effects. The infant may experience loose stools, especially when the medication is injected into the veins. Because the antibiotic drug has been shown to be carcinogenic in studies, a decision should be made whether to discontinue the treatment or discontinue breastfeeding.

While making a decision, the importance of the medication to the mother should be taken into account. Lactating mothers are advised to consult a doctor and check about all your choices of breastfeeding. Some recommend discontinuing breastfeeding for one day following maternal treatment for Trichomonas infection after a single dose. Also, nursing infants should be monitored for gastrointestinal symptoms. As an alternative option, a nursing mother may also choose to pump and discard breast milk for the period of metronidazole treatment and one day after the treatment ends and feed her infant stored breast milk.