Metronidazole and Nystatin are combined in this medicine.
Metronidazole + Nystatin is used on its own or together with other medicines to treat vaginal infections caused by a certain parasite called Trichomonas vaginalis and a certain fungus called Candida albicans.
Use Metronidazole + Nystatin exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.
This medicine is used intravaginally (inserted inside the vagina). It is best to use it at bedtime or as instructed by your doctor.
Metronidazole + Nystatin is available as a vaginal ovule (vaginal tablet).
To use the vaginal ovule, follow these steps:
- Wash your hands thoroughly.
- Pull back the plunger of the applicator for about an inch.
- Remove the ovule from its plastic wrapper, then insert the ovule into the cup at the end of the hollow tube (applicator).
- Lie on your back with both knees bent and legs apart.
- Gently insert the applicator with the ovule into your vagina as far as it will comfortably go.
- Press the plunger to release the ovule after it was properly positioned in the vagina.
- Remove the applicator. Wash the applicator with mild soap and warm water. Rinse thoroughly and dry.
- Wash your hands thoroughly after application.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the severity of your infection and your response to the medication.
Use Metronidazole + Nystatin at regular intervals. Do not skip any doses. You must complete the entire course of this medicine. If you don't, the infection will not be properly controlled.
If you miss a dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose to make up for a missed dose.
If you often forget to use your medicine, let your doctor and pharmacist know.
Do not use Metronidazole + Nystatin if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to Metronidazole, Nystatin or similar medicines such as clotrimazole and miconazole.
Alert your doctor if you have the following conditions, particularly if you are also taking oral metronidazole:
- disorders that affect the brain and/or spinal cord
- history of blood problems
- history of hypothyroidism (underactive thyroid gland)
- history of hypoadrenalism (underactive adrenal glands)
as this medicine may not be suitable for you.
Inform your doctor if you have the following conditions:
- Cockayne syndrome (a rare inherited disorder characterised by unusually short height, premature ageing, sensitivity to sunlight, visual and hearing problems)
- hepatic encephalopathy (brain impairment associated with liver disease)
- history of liver injury associated with metronidazole
- severe liver disease
Let your doctor know if you are pregnant. Metronidazole + Nystatin is not recommended to be used during the 1st trimester of pregnancy, and the applicator must not be used after the 7th month of pregnancy.
This medicine may decrease the effectiveness of condoms and diaphragms (shallow, bendable cups inserted inside the vagina to prevent pregnancy). You may wish to discuss other reliable methods of birth control with your doctor or pharmacist.
Avoid using Metronidazole + Nystatin if you are breastfeeding.
Avoid using menstrual tampons or any soaps, douches or washes for your vagina while you are being treated with this medicine.
If you are going to have certain laboratory tests (e.g. liver function, blood sugar or triglycerides [fats in the blood] levels), inform your doctor that you are using Metronidazole + Nystatin.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver function, blood counts) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Regular monitoring of mental status and skin reactions may also be needed.
Metronidazole + Nystatin may cause drowsiness, dizziness, or vision problems. If affected, do not drive or take part in any activity in which you need to be alert or need to see clearly.
Other side effects include any of the following: headache, nausea, vomiting, bitter or metallic taste, dry mouth, and irritation or burning sensation in your vagina.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- yellowing of the skin or eyes, abdominal pain, dark coloured urine, decreased appetite, tiredness, swelling in the legs and ankles
- having thoughts of self-harm
- rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
- numbness or tingling feeling on the skin, fits or seizures, trouble speaking or moving
- severe diarrhoea or diarrhoea with severe stomach cramps or bloody stools
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- disulfiram (medicine used to treat drinking problems)
- lithium (medicine for mood disorders)
- ciclosporin (medicine used in organ transplants or certain immune disorders)
- blood-thinning medicines e.g. warfarin
- medicines for cancer e.g. busulfan, fluorouracil
- medicines for epilepsy (fits or seizures) e.g. phenytoin, phenobarbital
This list does not include all medicines that may interact with Metronidazole + Nystatin.
Always notify your doctor and pharmacist if you are taking or using any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol while you are using Metronidazole + Nystatin and for at least 1 day after finishing the course of your treatment. Taking alcohol or products with alcohol while you are using this medicine may cause flushing, vomiting, or rapid heartbeat.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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