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Bacterial Vaginosis (BV) Treatment

Metronidazole Tablets 400mg
Pack Size: 14 tablets
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RRP*: £45.95
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Our Price: £17.49
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Take ONE tablet TWICE daily for SEVEN days. Metronidazole should be taken with or after food.

Always ensure that you complete the course, even if you think your symptoms have improved. This will help to prevent the infection coming back.

You should avoid alcohol whilst taking Metronidazole and for at least 48 hours after your course has finished. Alcohol can cause a serious interaction with Metronidazole that results in nausea and vomiting.

Metronidazole 400mg tablets are a type of antibiotic. Metronidazole can be used to treat a number of different infections however, they can be supplied online by The Independent Pharmacy to treat Bacterial Vaginosis (BV) in women. They are an effective treatment, taken for one week, that normally helps to clear symptoms in two to three days.

Metronidazole is suitable to buy online if you have previously suffered with Bacterial Vaginosis before that has been diagnosed and successfully treated by your GP. If your symptoms are the the same as when previously treated, you should be suitable for self-diagnosis and treatment online. You are also suitable for treatment if you have had a positive test for Bacterial Vaginosis and now require treatment. If you have not suffered with BV before, your symptoms are different or you have had a negative test result, you should see your GP for further investigation.

Bacterial Vaginosis is not a sexually-transmitted disease and normally presents as white or grey vaginal discharge that is thin and watery. It may have a 'fishy' smell that is particularly strong after sex. To find out more about Bacterial Vaginosis, see our Bacterial Vaginosis page

Metronidazole may alter the effectiveness of your contraceptive pill. Additional precautionary measures may be necessary whilst you are taking Metronidazole.

Side effects when taking Metronidazole do not affect everyone, however there is always a chance that any of the effects listed below could occur. Side effects are less likely at lower doses (such as the dose for Bacterial Vaginosis) and when it is taken with or after food.

Side effects of unknown frequency:

  • Numbness, tingling, pain, or a feeling of weakness, in the arms or legs
  • Unpleasant taste in the mouth
  • Furred tongue
  • Feeling sick (nausea), being sick (vomiting), upset stomach, or diarrhoea
  • Loss of appetite
  • Fever
  • Feeling depressed
  • Pain in your eyes (optic neuritis)

Rare side effects include:

  • Anaphylactic reactions
  • Abnormal laboratory test results
  • Blood and bone marrow problems - these may be fatal
  • Brain and central nervous system problems including neurological problems. Seek medical advice if you have symptoms such as fever, paralysis, photosensitivity, balance or coordination problems, stiff neck, tremors or epileptic seizures
  • Convulsions
  • Double vision
  • Eye or eyesight problems
  • Feeling dizzy
  • Feeling drowsy
  • Flushing
  • Headaches
  • Itching
  • Jaundice
  • Joint pain
  • Liver problems
  • Muscle pain or tenderness
  • Myopia
  • Pancreatitis
  • Psychotic problems including confusion and hallucinations
  • Skin problems
  • Skin rash
  • Urine colour changes

You should not take Metronidazole tablets if any of the following apply to you:

  • You have or have ever had a liver problem
  • You are having kidney dialysis
  • You have a disease of nervous system
  • You are pregnant or breast-feeding

You should not take Metronidazole tablets if you take any of the following medicines:

  • Anti-coagulants (blood thinning agents), such as warfarin. The dosage of warfarin may need to be reduced if you are taking Metronidazole.
  • Lithium - if taken at the same time as metronidazole, the kidneys may be affected.
  • Medicines used to treat epilepsy (e.g. phenytoin, primidone, phenobarbitone).
  • 5-fluorouracil (for cancer).
  • Disulfiram (for alcohol abuse)
  • Cimetidine (for indigestion and heartburn)

Metronidazole & alcohol

You should not drink alcohol during your course of Metronidazole tablets and for 48 hours afterwards. The combination of Metronidazole and alcohol can cause unwanted side effects such as nausea, vomiting, flushing, stomach pain, palpitations and headache.

About Bacterial Vaginosis

Bacterial Vaginosis Background

The Independent Pharmacy Online Doctor service allows patients who have bacterial vaginosis to have a private consultation with a doctor and receive the treatment they require in a safe and discreet manner.

Bacterial Vaginosis (BV) is a common condition where the normal balance of bacteria inside the vagina becomes disrupted. In most cases BV does not cause any pain or itching. The most common symptom is an unusual vaginal discharge. A sufferer of bacterial vaginosis may present with vaginal discharge that:

  • Has a strong fishy smell that is particularly strong after sexual intercourse.
  • Is white or grey in colour.
  • Is thin and watery.

Bacterial vaginosis does not pose a serious threat to health for the majority of sufferers. Around half of those affected with BV do not present with any symptoms at all. BV should only be treated as a concern should the condition develop during pregnancy and there is a history of pregnancy-related complications.

The vagina is naturally a slightly acidic environment. This is due to a bacteria called lactobacilli. Lactobacilli produce lactic acid and the resulting acidity prevents other bacteria from growing inside the vagina. Women presenting with bacterial vaginosis tend to lack sufficient numbers of lactobacilli, which means the vagina isn’t acidic enough to prevent other bacteria from growing. It’s this imbalance of bacteria that causes BV.

It is not clear what exactly causes the imbalance that results in bacteria vaginosis, although certain factors are known to increase the chances of developing the condition. These include:

  • Being sexually active. Especially if you have a new or multiple sexual partners.
  • Using an intrauterine device such as a contraceptive that fits inside the womb.
  • Using scented soaps, bubble baths or antiseptic bath liquids.
  • Using vaginal deodorants.
  • Using a strong detergent to wash your underwear.

Generally, bacterial vaginosis isn’t considered a sexually transmitted infection as the condition can sometimes occur in women who aren’t sexually active. Also, the rates of BV are significantly varied within different ethnic groups, which cannot be explained by sexual activity alone. However, it is apparent that occurrences of bacterial vaginosis are much higher in women who are sexually active, especially in those with multiple partners. In contrast, the rates of BV are lower in women who practice safe sex. From this it is safe to conclude that sexual activity can play a role in developing bacterial vaginosis, although other unrelated factors are also probably responsible for the condition. 

Bacterial Vaginosis Symptoms

Bacterial vaginosis will usually present as an unusual discharge from the vagina. This discharged may be thin and watery and appear white or grey in colour. It may also develop a strong, fishy odour, particularly after sex. BV does not usually present with any itching or soreness of the vagina.

Bacterial Vaginosis Diagnosis

A GP or healthcare professional will be able to diagnose bacterial vaginosis from a description of the symptoms coupled with a visual examination of the vagina, if necessary. In the examination they will be looking for a thin, greyish discharged as well as an unpleasant smell. In most cases this will be enough to confirm a diagnosis. However, further testing may be necessary if you are sexually active. This is because the symptoms of BV can resemble the symptoms of some sexually transmitted infections (STIs), such as gonorrhoea and trichomoniasis. Further testing will usually involve a sample of cells being taken from the vaginal wall. This will be done using a plastic loop or swab. This sample is then examined in a laboratory to look for signs of bacterial vaginosis.

Another method of diagnosing BV may include performing a pH (acidity) test of the vagina. A swab will be used to take a sample from inside the vagina. This sample will then be wiped over a piece of specially treated paper. The paper will change colour depending on the pH level of the sample. If the paper indicates a pH higher than 4.5 then this will be a strong indication that bacterial vaginosis is the cause.

Bacterial Vaginosis Treatment

Bacterial vaginosis can be successfully treated using antibiotics. The antibiotic of choice for BV treatment is Metronidazole. The most effective form of treatment using metronidazole is a seven day course, taking one 400mg tablet twice a day. Occasionally a different antibiotic may be more suitable if the patient is allergic or has had a bad reaction to metronidazole in the past. Clindamycin Cream is usually used as an alternative treatment if this is the case.

When taking Metronidazole 400mg tablets for BV it is very important to complete the course, even if the symptoms have subsided. Finishing the course will help reduce the risk of the symptoms persisting or returning. When taking Metronidazole 400mg Tablets it is very important not to drink any alcohol during the course, and for at least 48 hours after completing the course as this can cause serious nausea and sickness.

Some women may require an additional course of Metronidazole should the initial course be unsuccessful. This is quite normal. The prescriber may need to check that the medicine was taken correctly as a further course or an alternative treatment will be required.

If the bacterial vaginosis is believed to be the result of an intrauterine device, such as a contraceptive diaphragm, then it may be advised to have it removed and an alternative means of contraception should be used instead.

There are treatments available known as vaginal pH correction treatments. These topical gels are available over-the-counter and are designed to rebalance the pH levels inside the vagina. It is generally acknowledged that treating bacterial vaginosis with Metronidazole is more effective than using a pH balancing gel.

Bacterial Vaginosis Prevention

Not fully understanding the causes of bacterial vaginosis means it is very difficult to completely prevent it. However, there are self-help techniques that can reduce your risk of developing the condition. These include:

  • Avoid using scented or perfumed soaps, antiseptics or bubble baths.
  • Avoid using vaginal deodorants.
  • Avoid washing your underwear in strong detergents.
  • Avoid vaginal douching.

By following the recommendations above you will be less likely to disturb the natural bacterial balance inside the vagina. This will reduce the chances of developing bacterial vaginosis.

*RRP is based on the highest price found for a comparable online service found on 04/09/14.

Bacterial Vaginosis Treatment Frequently Asked Questions



Bacterial Vaginosis Treatment Frequently Asked Questions

How many metronidazole tablets do I need to take to treat bacterial vaginosis?

Can I take the metroniadazole tablets with or after food?

I am due to go to a party this weekend, can I take metroniadazole and still have a drink?

My symptoms have got better but haven't cleared completely. What do I do now?

Will these antibiotics interfere with my contraceptive pill?

Can I have sex whilst taking the antibiotics?

What should I do if I forget to take a tablet?




How many metronidazole tablets do I need to take to treat bacterial vaginosis?

Take 1 tablet twice a day for 7 days and ensure you complete the course.

Can I take the metroniadazole tablets with or after food?

Metroniadazole tablets can be taken with or without food.Some people feel sick or may be sick (vomit) when they take metronidazole. If this happens then take the tablets with or after food. A metallic taste is also a common side-effect.

I am due to go to a party this weekend, can I take metroniadazole and still have a drink?

Do not drink any alcohol while taking metronidazole.This is a well documented intereaction that can cause vomitting,flushing or an increased heart rate. This advice also applies to items that contain alcohol like mouthwash. Allow 2 days for the any trace of the antibiotic to come out of your system before consuming any alcohol or alchol containing products.

My symptoms have got better but haven't cleared completely. What do I do now?

Some women may require an additional course of Metronidazole should the initial course be unsuccessful. This is quite normal. The prescriber may need to check that the medicine was taken correctly as a further course or an alternative treatment will be required. Another course can be ordered here.

Will these antibiotics interfere with my contraceptive pill?

It was previously recommended that if you were taking antibiotics, that you use another form of contraception whilst taking them and for 7 days after. This advice has now been changed.
The antibiotics used to treat tuberculosis and meningitis called rifampicin and rifabutin are the only types of antibiotic that make the pill less effective.They affect the combined pill, the mini pill ( which only contains progesterone) the contraceptive patch, the implant and the vaginal ring.

Other forms of contraception like, the injection, IUD (Inter Uterine Device) and barrier methods will not be affected.

Can I have sex whilst taking the antibiotics?

It is best to avoid sex until the infection has cleared and the you have finished the course of tablets.

What should I do if I forget to take a tablet?

Take the missed dose as soon as you remember.  Do not take extra medicine to make up the missed dose.



The Independent Pharmacy is an online pharmacy and online doctor service is owned and operated by ABSM Healthcare Ltd (Company Reg. 08515600) and Red Label Medical Ltd (Company Reg. 08676338). All information that appears on this website is intended for information purposes only and should be used to supplement, not replace, your relationship with your local healthcare professionals. You should consult your doctor if you think you may have a health problem or before you start taking a new medicine. Please ensure you always read the information leaflets supplied with any medicinal products.For more information see our policies and terms and conditions at the bottom of every page. © 2014 ABSM Healthcare Ltd. All rights reserved.
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