Buy Metronidazole (Flagyl) — Online Prescription
An antibiotic and antiprotozoal sold as oral tablets, topical gel/cream, and vaginal gel — treats everything from bacterial vaginosis to rosacea, and every form requires a prescription in the US.
Medically reviewed Medically reviewed by Sabrina Griswold, Pharm.D. — NPI 1821451063 · Last updated 2026-08-31
| Active ingredient | Metronidazole |
|---|---|
| Dosage form | Oral tablet/capsule, topical gel/cream, vaginal gel, IV injection |
| Administration route | Oral, topical, vaginal, intravenous |
Class: Nitroimidazole Antimicrobial [EPC]
Indications: INDICATIONS AND USAGE Symptomatic Trichomoniasis. Metronidazole tablets are indicated for the treatment of T. vaginalis infection in females and males when the presence of the trichomonad has been confirmed by appropriate laboratory procedures (wet smears and/or cultures). Asymptomatic Trichomoniasis. Metronidazole tablets are indicated in the treatment of asymptomatic T. vaginalis infection in females when the organism is associated with endocervicitis, cervicitis, or cervical erosion. Since th…
Boxed warning: WARNING Metronidazole has been shown to be carcinogenic in mice and rats (see PRECAUTIONS ). Unnecessary use of the drug should be avoided. Its use should be reserved for the conditions described in the INDICATIONS AND USAGE section below.
Contraindications: CONTRAINDICATIONS Hypersensitivity Metronidazole tablet are contraindicated in patients with a prior history of hypersensitivity to metronidazole or other nitroimidazole derivatives. In patients with trichomoniasis, metronidazole tablet are contraindicated during the first trimester of pregnancy (see PRECAUTIONS ). Psychotic Reaction with Disulfiram Use of oral metronidazole is associated with psychotic reactions in alcoholic patients who were using disulfiram concurrently. Do not administer met…
openFDA label data — Updated 2026-09-02Metronidazole (brand name Flagyl) is prescription-only in every form the FDA has approved. Oral tablets treat trichomoniasis, bacterial vaginosis, and certain anaerobic/parasitic infections; topical gel or cream treats rosacea; vaginal gel treats bacterial vaginosis — three different products, three different jobs, all requiring a prescription. Once you have one, we can fill it quickly.
What metronidazole actually treats
This is the single biggest source of confusion about metronidazole: the oral form, the topical form, and the vaginal form treat completely different conditions, even though they share the same active ingredient.
| Form | What it's FDA-approved to treat |
|---|---|
| Oral tablet/capsule | Trichomoniasis (confirmed by lab testing); certain anaerobic bacterial infections; often prescribed off-label for bacterial vaginosis and giardiasis |
| Topical gel/cream (face) | Inflammatory rosacea — the bumps and redness, not the flushing itself |
| Vaginal gel | Bacterial vaginosis (BV) |
| IV injection | Serious anaerobic infections requiring hospital-level treatment |
If you were prescribed one form for a condition and searched for information about a different one, that's normal — just make sure the product you have matches what your prescriber intended.
Forms, strengths, and what each one is for
| Product | Typical strength | Common brand(s) |
|---|---|---|
| Oral tablet | 250 mg, 500 mg | Flagyl |
| Extended-release tablet | 750 mg | Flagyl ER |
| Topical gel/cream (rosacea) | 0.75%, 1% | MetroGel, MetroCream, MetroLotion, Noritate |
| Vaginal gel (BV) | 0.75% | Metrogel-Vaginal |
| Injection | Varies (hospital use) | Generic only |
All of these require a prescription — there is no OTC metronidazole product in any form.
Metronidazole and alcohol — what the evidence actually shows
Nearly everyone has heard "don't drink on metronidazole, or you'll get violently sick." Here's the more complete, and more interesting, picture:
The practical guidance hasn't changed: the FDA label still directs patients to avoid alcohol during treatment and for 72 hours after the last oral dose, and that's what pharmacists will tell you.
A 2023 case-control study and a broader literature review found that well-controlled human and animal data do not show the increase in acetaldehyde levels that the traditional "disulfiram-like reaction" explanation depends on — meaning the textbook mechanism for the warning is not as well-supported as commonly taught, even though case reports of reactions do exist and the official guidance stands.
In plain terms: this isn't settled science, and "just a myth" oversimplifies it as much as the old textbook explanation does. The safest, simplest approach is still the one on the label — skip alcohol during treatment and for three days afterward — regardless of which mechanism turns out to be right.
Side effects and pregnancy
The FDA label for metronidazole carries a warning that it has been shown to be carcinogenic in mice and rats in long-term studies; the agency advises against unnecessary use and reserves it for confirmed indications. Common side effects include a metallic taste, nausea, and headache; topical forms can cause local skin irritation.
Pregnancy is individualized: oral metronidazole is generally avoided in the first trimester for trichomoniasis specifically, per the FDA label, but may be appropriate later in pregnancy or for other indications depending on your prescriber's assessment. Metronidazole is also contraindicated in anyone with a known hypersensitivity to it or other nitroimidazole medications — severe hypersensitivity reactions, including serious skin reactions, have been reported. Seek medical attention for any unusual rash or swelling.
None of this replaces your prescriber's guidance for your specific diagnosis and dose — this is general information, not a substitute for the counseling you'll get when we fill your prescription.
Filling your prescription
- Generic vs. brand. Metronidazole is sold almost exclusively as a generic today — Flagyl brand tablets are rarely stocked or prescribed since the generic is chemically identical and far less expensive.
- Right form matters. Make sure your pharmacy fills the exact form (oral, topical, or vaginal) and strength your prescriber ordered — they are not interchangeable.
- Ask about the cash price. Generic metronidazole is inexpensive at the wholesale level — ask your pharmacist for a cash-price quote or about discount options before assuming your insurance copay is cheapest.
- Speed. Call us at (860) 522-9289 and we can have a new prescription, in any form, ready quickly.
Shortage reported — Affects: Flagyl I.v. Rtu In Plastic Container, Injection, 500 mg/100 mL (NDC 0338-1055-48). If that's not the oral form you take, ask your pharmacist whether your specific product is affected.
FDA openFDA — Updated 2026-09-02National Average Drug Acquisition Cost (NADAC): $0.103 per tablet (METRONIDAZOLE 500 MG TABLET). This is the average price pharmacies pay wholesalers — not your out-of-pocket cost — published by CMS for pricing transparency.
CMS NADAC — Updated 2026-09-02Metronidazole Prices in the USA
| Dosage | Brand-name avg. price | Generic avg. price |
|---|---|---|
| 250 mg tablet (14-day course) | $120–200 (Flagyl, rarely stocked) | $10–22 |
| 500 mg tablet (7–10 day course) | $150–250 (Flagyl, rarely stocked) | $12–28 |
| Topical gel/cream 0.75%–1% (rosacea, per tube) | $150–220 (MetroGel/Noritate) | $20–45 |
| Vaginal gel 0.75% (per course) | $90–150 (Metrogel-Vaginal) | $20–40 |
Frequently asked questions
Can I buy metronidazole over the counter?
No. Metronidazole requires a prescription in the United States in every approved form — oral tablets and capsules, topical gel or cream, vaginal gel, and injection. A clinician needs to confirm the diagnosis (for example, trichomoniasis is confirmed by lab testing) before it's prescribed.
What is metronidazole used for?
It depends entirely on the form. Oral metronidazole treats trichomoniasis, bacterial vaginosis, and certain anaerobic bacterial and parasitic infections (including giardiasis, often off-label). Topical metronidazole gel or cream is FDA-approved for rosacea. Vaginal metronidazole gel is FDA-approved for bacterial vaginosis. These are different products for different problems, even though they share an active ingredient.
Is metronidazole the same as Flagyl?
Yes — Flagyl is the original brand name for oral metronidazole. It's sold almost exclusively as a generic today, which is typically far less expensive than the brand name for the same medication.
Can I drink alcohol while taking metronidazole?
Follow the label and your pharmacist's guidance: avoid alcohol during treatment and for at least 72 hours (3 days) after your last oral dose. That guidance hasn't changed — but see the "metronidazole and alcohol" section below for what recent research actually shows about why this warning exists, which is more nuanced than the traditional explanation.
How long does it take for metronidazole to work?
Many people notice symptom improvement within a few days, but this varies by infection and form. Finish the complete course exactly as prescribed even if you feel better early — stopping early is a common reason infections recur or don't fully clear.
Is metronidazole safe during pregnancy?
This is individualized. Oral metronidazole is generally avoided in the first trimester for trichomoniasis specifically, per the FDA label, but may be used later in pregnancy or for other indications when your prescriber determines the benefit outweighs the risk. Never start, stop, or continue metronidazole during pregnancy without your OB or prescriber's guidance.
What's the difference between metronidazole gel and metronidazole cream for rosacea?
Both are FDA-approved topical treatments for the inflammatory bumps and redness of rosacea, available in different strengths (commonly 0.75% and 1%) and brand formulations (MetroGel, MetroCream, MetroLotion, Noritate). Your prescriber or pharmacist can advise which formulation and strength fits your skin type and prescription.
Can metronidazole treat a UTI or yeast infection?
No. Metronidazole targets specific bacteria and protozoa (like Trichomonas and Gardnerella-associated bacterial vaginosis) — it doesn't treat typical UTIs (usually caused by E. coli) or yeast infections (caused by Candida, a fungus). Taking the wrong antimicrobial for the wrong organism won't work and delays proper treatment.
Sources
- Metronidazole — FDA-approved prescribing information (label) — U.S. Food and Drug Administration
- Metronidazole / Flagyl price data (average retail cash price) — GoodRx (consumer price reference)
- Can Metronidazole Cause a Disulfiram-Like Reaction? A Case-Control Study — PubMed / Wisconsin Medical Journal
- Metronidazole topical gel (MetroGel) — FDA-approved prescribing information for rosacea — U.S. Food and Drug Administration
- NADAC (National Average Drug Acquisition Cost) — CMS