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Flagyl® (Metronidazole) The goals of medical treatment for inflammatory bowel disease (IBD) are to achieve remission (absence of symptoms) and, to maintain remission (prevent flare-ups). To achieve these goals, treatment is aimed at reducing the inflammation in the intestine and helping the lining of the intestine to heal. What is Flagyl and how does it work? Flagyl is an antibiotic that may help stop infection and inflammation in IBD. It works by killing anaerobic bacteria, which are bacteria that do not require oxygen to live. This type of bacteria is found in the lumen of the GI tract. Antibiotics work on bacteria but not on viruses. Flagyl is used to treat IBD by changing the bacteria in the lumen of the intestine and helping decrease inflammation in the lining of the intestine. When should Flagyl be prescribed? Antibiotics like Flagyl are used to treat infections that arise from Crohn’s disease. They are most often used to treat patients with Crohn’s disease with inflammation of the large intestine (colon), patients who have fistulas, or abscesses in their GI tract or perianal Ver 1: Mar 15/09 www.MyGI.ca Page 1 of 4 and after surgery for Crohn’s disease to prevent recurrence of disease. Antibiotics such as Flagyl can also be used for severe ulcerative colitis. How is Flagyl taken? Flagyl can be taken by mouth (orally) as tablets or suspension or by the intravenous route. The exact dose and frequency will be determined by your doctor. Make sure that you complete the full course of antibiotics to get the full effect and to clear the bad bacteria. What are the possible side effects? When taking Flagyl, you may experience: Nausea Vomiting Appetite loss Diarrhea Dark or reddish brown urine Dizziness Headaches Metallic taste in your mouth Vaginal yeast infections In the long-term, Metronidazole may cause numbness or tingling in your hands and feet. If this happens, consult your doctor. What precautions need to be taken while you are on Flagyl? Drink lots of water while taking Flagyl. Flagyl can be taken with meals. If you miss a dose, you can take it later but do not take two doses at the same time Ver 1: Mar 15/09 www.MyGI.ca Page 2 of 4 Do not drink alcohol or take any over the counter medications that contain alcohol while taking Flagyl. Taking antibiotics along with anticoagulants (blood thinners such as warfarin/Coumadin) can make your blood too thin and increase the risk of bleeding. Talk to your doctor before taking antibiotics so that your medications can be adjusted to prevent such effects. If you are pregnant or breastfeeding talk with your doctor before taking Flagyl How do I know if Flagyl is working? Flagyl should start working within a few days of starting the medication. You may start to feel better before you have taken all of the pills, but that doesn’t mean all the bacteria are gone and that the inflammation of the intestine has settled. Sources http://www.ccfa.org/info/treatment/antibiotics http://ibdcrohns.about.com/od/antibiotics/a/flaglfaq.htm http://www.medicinenet.com/metronidazole/article.htm http://www.sanofi-aventis.ca/products/en/flagyl.pdf Questions If you are a patient of the Gastroenterology Clinic at BC Children’s Hospital and have any questions or concerns please contact us at 604-875-2332. More Information You may visit our website at www.MyGI.ca for more information and signup for our email newsletter to stay up to date. Ver 1: Mar 15/09 www.MyGI.ca Page 3 of 4 Disclaimer The following information, i.e. educational material/guideline, has been developed for use only within the Gastroenterology Clinic at BC Children's Hospital (BC Children's GI Clinic).There are support systems at BC Children's that may not exist in other clinical settings, and therefore, any adoption of these materials cannot be the responsibility of BC Children's GI Clinic. Agencies other than BC Children's GI Clinic should use this information as a guideline for reference purposes only. Patients should not use this information as a substitute for proper medical advice. Unless otherwise noted, all materials are the property of BC Children's GI Clinic and may only be reprinted in whole or in part with our expressed permission. Ver 1: Mar 15/09 www.MyGI.ca Page 4 of 4