Metronidazole + nystatin - vaginal

Patient Medicine Information
Why do I need this medicine?
Metronidazole and Nystatin are combined together in this medicine.

Metronidazole + Nystatin is used on its own or together with other medicines to treat an infection of the vagina that is caused by a particular bacteria known as Trichomonas vaginalis and Candida albicans.
How do I use this medicine?
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.

Metronidazole + Nystatin is to be used intravaginally (inserted inside the vagina). It is best to use it at bedtime or as instructed by your doctor.

This medicine is available as a tablet/ovule or as a cream.

To use the vaginal tablet/ovule with an applicator:
  1. Empty your bladder. Wash your hands before using the tablet/ovule.
  2. Pull back the plunger of the applicator for about an inch and place the tablet/ovule into the cup.
  3. Lie on your back with both knees bent and legs apart.
  4. Gently insert the applicator with the tablet/ovule into your vagina as far as it will comfortably go.
  5. Press the plunger to release the tablet/ovule.
  6. Remove the applicator from your vagina.
  7. Wash the applicator with mild soap and warm water. Rinse thoroughly and dry.
  8. Wash your hands after using the tablet/ovule.
To use the cream with an applicator:
  1. Empty your bladder. Wash your hands before using the cream.
  2. Open the tube by puncturing the metal seal with the pointed tip of the cap.
  3. Screw the end of the applicator securely onto the tube.
  4. Slowly squeeze the tube such that the medication fills the applicator completely.
  5. The applicator plunger will stop moving once the applicator is full. Do not overfill by pushing it past this point.
  6. Unscrew the applicator.
  7. Lie on your back with both knees bent and legs apart.
  8. Hold the applicator at the middle portion.
  9. Gently insert the applicator into the vagina. Insert only as far as it will comfortably go.
  10. Slowly press the applicator plunger until it stops. This will deposit the medication into the vagina.
  11. Gently withdraw the applicator.
  12. Wash the applicator with mild soap and warm water. Rinse thoroughly and dry.
  13. Wash your hands after using the cream.
If you are pregnant and is in the 3rd trimester, an applicator is not recommended for you to use.

To use the vaginal tablet/ovule without an applicator:
  1. Empty your bladder. Wash your hands before using the tablet/ovule.
  2. Lie on your back with both knees bent and legs apart.
  3. Gently insert the tablet/ovule into your vagina as far as it will comfortably go.
  4. Wash your hands after using the tablet/ovule.
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.

Metronidazole + Nystatin must be used regularly for it to be effective. Do not skip any doses. You must complete the entire course of medicine. If you don't, the infection will not be properly controlled. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor.
What should I do if I have forgotten to use this medicine?
Use the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

Do not use more than what is instructed by your doctor to make up for the missed dose.

If you often forget to use your medicine, let your doctor and pharmacist know.
When should I not use this medicine?
Do not use Metronidazole + Nystatin if you ever had an allergic reaction (rashes, breathlessness, swollen face or eyes) to Metronidazole, Nystatin or any other similar medicines such as clotrimazole, miconazole.

Do not breastfeed while you are being treated with this medicine.
What should I take note of while using this medicine?
Inform your doctor if you have the following conditions:
  • Cockayne syndrome (rare condition characterised by slow growth and development, sensitivity to sunlight, problems with the eyesight or hearing)
  • severe liver impairment
  • nervous system (brain, spinal cord) disease
Let your doctor know if you are pregnant.

Metronidazole + Nystatin may decrease the effectivity of condom and diaphragm. You may wish to discuss birth control methods with your doctor or pharmacist.

Avoid using menstrual tampons or any soaps, douches or washes for your vagina while you are being treated with this medicine.

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
  • Routine liver function test may be done before, during and after treatment.
  • Regular monitoring of your leukocyte (a type of white blood cell) count may also be needed.
Your doctor will advise you about how often you will need to have these tests.
What side effects could I experience?
Metronidazole + Nystatin may cause dizziness. If affected, do not drive or take part in any activity in which you need to be alert.

Other side effects may include any of the following: headache, tiredness, dry mouth, bitter or metallic taste in your mouth, nausea, vomiting, stomach pain or discomfort, dark urine discolouration, burning or grainy feeling in your vagina.

If you develop rashes, breathlessness, swollen mouth or eyes, stop taking Metronidazole + Nystatin and inform your doctor quickly. These could be signs of an allergic reaction.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
  • signs and symptoms of problems in the nervous system e.g. numbness, fits or seizures, difficulty in controlling movements
  • signs and symptoms of liver problems e.g. weakness, tiredness, nausea, vomiting, stomach pain, yellowing of skin or eyes, loss of appetite
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Can I use this with other medicines?
Inform your doctor or pharmacist if you are taking any of these medicines:
  • blood-thinning medicines e.g. warfarin
  • medicines for epilepsy (fit or seizures) e.g. phenobarbital, phenytoin
  • medicine for mood disorders e.g. lithium
  • medicine used in organ transplant or certain immune disorders e.g. ciclosporin
  • medicines for cancer e.g. busulfan, 5-fluorouracil
  • medicines to treat drinking problems e.g. disulfiram
This list does not include all medicines that may interact with Metronidazole + Nystatin.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
What special dietary instructions should I follow?
Avoid alcohol during and until one day after treatment.
How should I store this medicine?
Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.
This information is independently developed by MIMS based on metronidazole + nystatin - vaginal and is provided for your reference only. It is not a replacement for and should only be used in conjunction with full consultation with a licensed healthcare professional, the information provided by your pharmacist and/or the manufacturer of the medication. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, we shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by
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