Last update June 28, 2021

Metronidazole (Dermal and Vaginal use)

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Metronidazole is used topically in the treatment of acne (Kong 2013) and vaginitis.

Metronidazole, when taken orally, is excreted in small amounts in breastmilk (van Wattum 2019, Geballa 2018, Zhang 1997, Passmore 1988, Heisterberg 1983, Erickson 1981, Gray 1961) and does not cause problems in infants (Passmore 1988, Gray 1961), and is considered compatible with breastfeeding.

The low content in topical preparations (<1% metronidazole) and its poor absorption through skin or vaginal mucosa makes it unlikely that it transfers to breastmilk in significant amounts.
Compared with oral administration, the plasma levels reached are 1% through the skin and 2% through the vagina (AEMPS 2018, Sanofi 2018, FDA 2005, AEMPS 2001) and is considered even more compatible with breastfeeding than via systemic administration (Rowe 2013, Kong 2013).


See below the information of this related product:

  • Metronidazole ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Alternatives

We do not have alternatives for Metronidazole (Dermal and Vaginal use) since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Metronidazole (Dermal and Vaginal use) is also known as


Tradenames

Main tradenames from several countries containing Metronidazole (Dermal and Vaginal use) in its composition:

  • Blastoestimulina óvulos™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Fangan Plus™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Gano Dexacort Plus™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Ginal Cent™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Ginkan™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Linfol Cicatrizante™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Mailen™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Metrogel™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Metrogyl™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Neo Pelvicillin™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Ovufem™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Ovumix™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Pentol™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Rozex™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Septigyn™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition
  • Vagicural Plus™. Contains other elements than Metronidazole (Dermal and Vaginal use) in its composition

Pharmacokinetics

Variable Value Unit
Oral Bioavail. Vaginal: 20 %
Molecular weight 171 daltons
Protein Binding 20 %
VD 0,5 - 1,1 l/Kg
pKa 15,4 -

References

  1. van Wattum JJ, Leferink TM, Wilffert B, Ter Horst PGJ. Antibiotics and lactation: An overview of relative infant doses and a systematic assessment of clinical studies. Basic Clin Pharmacol Toxicol. 2019 Jan;124(1):5-17. Abstract
  2. AEMPS-Meda. Metronidazol vaginal. Ficha técnica. 2018 Full text (in our servers)
  3. Sanofi. Metronidazole (cream). Drug Summary. 2018 Full text (in our servers)
  4. Geballa-Koukoula A, Panderi I, Zervas K, Geballa-Koukoulas K, Kavvalou E, Panteri-Petratou E, Vourna P, Gennimata D. A porous graphitized carbon LC-ESI/MS method for the quantitation of metronidazole and fluconazole in breast milk and human plasma. J Chromatogr B Analyt Technol Biomed Life Sci. 2018 May 1;1084:175-184. Abstract
  5. Kong YL, Tey HL. Treatment of acne vulgaris during pregnancy and lactation. Drugs. 2013 Jun;73(8):779-87. Abstract
  6. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  7. FDA-Teva. Metronidazole (Vaginal). Drug Summary. 2005 Full text (in our servers)
  8. AEMPS-Galderma. Metronidazol Gel. Ficha técnica. 2001 Full text (in our servers)
  9. Zhang Y, Zhang Q, Xu Z. [Tissue and body fluid distribution of antibacterial agents in pregnant and lactating women]. Zhonghua Fu Chan Ke Za Zhi. 1997 Abstract
  10. Passmore CM, McElnay JC, Rainey EA, D'Arcy PF. Metronidazole excretion in human milk and its effect on the suckling neonate. Br J Clin Pharmacol. 1988 Abstract Full text (link to original source) Full text (in our servers)
  11. Heisterberg L, Branebjerg PE. Blood and milk concentrations of metronidazole in mothers and infants. J Perinat Med. 1983 Abstract
  12. Erickson SH, Oppenheim GL, Smith GH. Metronidazole in breast milk. Obstet Gynecol. 1981 Abstract
  13. GRAY MS, KANE PO, SQUIRES S. Further observations on metronidazole (Flagyl). Br J Vener Dis. 1961 Abstract Full text (link to original source) Full text (in our servers)

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