$16.16

NIDAGEL

(Also Known As: METRONIDAZOLE)

Wash your hands before and after using the medicine. Also, keep the medicine out of your eyes.

If this medicine does get into your eyes, wash them out immediately, but carefully, with large amounts of tap water. If your eyes still burn or are painful, check with your doctor.

Vaginal metronidazole products usually come with patient directions. Read them carefully before using this medicine.

Use vaginal metronidazole exactly as directed by your doctor.

• To fill the applicator
  • For cream or gel dosage forms:
    • Break the metal seal at the opening of the tube by using the point on the top of the cap.
    • Screw the applicator onto the tube.
    • Squeeze the medicine into the applicator slowly until it is full.
    • Remove the applicator from the tube. Replace the cap on the tube.
  • For vaginal tablet dosage form:
    • Place the vaginal tablet into the applicator. Wet the vaginal tablet with water for a few seconds.
• To insert vaginal metronidazole using the applicator
  • For all dosage forms:
    • Relax while lying on your back with your knees bent.
    • Hold the full applicator in one hand. Insert it slowly into the vagina. Stop before it becomes uncomfortable.
    • Slowly press the plunger until it stops.
    • Withdraw the applicator. The medicine will be left behind in the vagina.
• To care for the applicator
  • For all dosage forms:
    • Clean the applicator after use by pulling the plunger out of the applicator and washing both parts completely in warm soapy water.
    • Rinse well.
    • After drying the applicator, replace the plunger.

To help clear up your infection completely, it is very important that you keep using this medicine for the full time of treatment , even if your symptoms begin to clear up after a few days. If you stop using this medicine too soon, your symptoms may return. Do not miss any doses. Also, continue using this medicine even if your menstrual period starts during the time of treatment .

Dosing

The dose of vaginal metronidazole will be different for different patients. The following information includes only the average doses of vaginal metronidazole. If your dose is different, do not change it unless your doctor tells you to do so.

• Forvaginal cream dosage form:
  • For bacterial vaginosis or trichomoniasis:
    • Adults and teenagers One applicatorful (500 milligrams [mg]), inserted into the vagina. Use the medicine one or two times a day for ten or twenty days.
    • Children Use and dose must be determined by your doctor.
• Forvaginal gel dosage form:
  • For bacterial vaginosis:
    • Adults and teenagers One applicatorful (37.5 mg), inserted into the vagina one or two times a day for five days.
    • Children Use and dose must be determined by your doctor.
• Forvaginal tablets dosage form:
  • For bacterial vaginosis or trichomoniasis:
    • Adults and teenagers One 500-mg tablet, inserted high into the vagina. Use the medicine once a day in the evening for ten or twenty days.
    • Children Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of this medicine, use it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the vaginal tablets in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Keep this medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding whether to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For vaginal metronidazole, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to metronidazole. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy Vaginal metronidazole has not been studied in pregnant women. Metronidazole given by mouth (e.g., Flagyl) has not been shown to cause birth defects. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding Use is not recommended in nursing mothers since metronidazole passes into breast milk and may cause unwanted effects in the baby. In addition, metronidazole may change the taste of your breast milk. Your doctor may want you to stop breast-feeding and use this medicine for a short time. During this time the breast milk should be pumped or drawn out with a breast pump and thrown away. Two days after you finish using this medicine, you may go back to breast-feeding.

Children Studies on these medicines have been done only in adult patients, and there is no specific information comparing use of vaginal metronidazole in children with use in other age groups.

Older adults Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of metronidazole in the elderly with use in other age groups.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using vaginal metronidazole it is especially important that your health care professional know if you are taking any of the following:

• Alcohol or alcohol-containing medicines (e.g., NyQuil, Geritol) Metronidazole can cause serious side effects such as abdominal cramping, flushing, headache, nausea, or vomiting when it is used with alcohol

• Anticoagulants (blood thinners) Taking metronidazole may increase the effects of anticoagulants, changing the amount you need to take

• Disulfiram (e.g., Antabuse) Severe confusion or mental problems can occur if metronidazole is used together with disulfiram or if it is used up to 2 weeks after disulfiram treatment has been stopped

• Central nervous system (CNS) disease, including epilepsy Metronidazole may increase the chance of seizures (convulsions) or other side effects

• Liver disease, severe Patients with severe liver disease may have an increase in side effects

• Low white blood cell count (or history of) Metronidazole may make the condition worse