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MetroCream (Metronidazole Topical Cream): Side Effects, Uses, Dosage, Interactions, Warnings

MetroCream

Medical Editor: John P. Cunha, DO, FACOEP Last updated on RxList: 10/11/2022

Drug Summary

What Is MetroCream?

Metrocream (metronidazole) Topical Cream is a topical (for the skin) antibiotic used to treat skin lesions caused by rosacea. Metrocream is available in generic form.

What Are Side Effects of MetroCream?

MetroCream may cause serious side effects including:

  • hives,
  • difficulty breathing,
  • swelling of your face, lips, tongue, or throat, and
  • severe stinging or burning where the medicine is applied

Get medical help right away, if you have any of the symptoms listed above.

Common side effects of Metrocream include:

  • stinging or burning where the medication is applied,
  • skin irritation,
  • dryness,
  • scaly or itchy skin,
  • redness,
  • metallic taste in your mouth,
  • nausea,
  • headache,
  • numbness or tingly feeling in your hands or feet,
  • cough,
  • stuffy nose,
  • sore throat,
  • cold symptoms, or
  • vaginal itching or discharge.

Tell your doctor if you have severe stinging or burning when you apply Metrocream topical.

Seek medical care or call 911 at once if you have the following serious side effects:

  • Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
  • Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in your chest; shortness of breath; and sudden dizziness, lightheadedness, or passing out;
  • Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors.

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

Dosage for MetroCream

Apply and rub in a thin layer dose of Metrocream Topical Cream twice daily, morning and evening, to entire affected areas after washing. Areas to be treated should be washed with a mild cleanser before application.

What Drugs, Substances, or Supplements Interact with MetroCream?

Metrocream may interact with blood thinners such as warfarin (Coumadin).

MetroCream During Pregnancy or Breastfeeding

It is not likely that other drugs you take orally or inject will have an effect on topically applied Metrocream. But many drugs can interact with each other. Tell your doctor all medications and supplements you use. Metrocream should be used only when prescribed during pregnancy. This drug passes into breast milk. Consult your doctor before breastfeeding.

Additional Information

Our Metrocream (metronidazole) Topical Cream Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

Description for MetroCream

METROCREAM® Topical Cream contains metronidazole, USP, at a concentration of 7.5 mg per gram (0.75%) in an emollient cream consisting of benzyl alcohol, emulsifying wax, glycerin, isopropyl palmitate, purified water, sorbitol solution, lactic acid and/or sodium hydroxide to adjust pH. Metronidazole is a member of the imidazole class of antibacterial agents and is classified therapeutically as an antiprotozoal and anti-bacterial agent. Chemically, metronidazole is 2-methyl-5-nitro-1H-imidazole-1-ethanol. The molecular formula is C6H9N3O3 and molecular weight is 171.16. Metronidazole is represented by the following structural formula:

MetroCream (metronidazole) Structural Formula Illustration

Uses for MetroCream

METROCREAM® (metronidazole topical cream) Topical Cream is indicated for topical application in the treatment of inflammatory papules and pustules of rosacea.

Dosage for MetroCream

Apply and rub in a thin layer of METROCREAM® (metronidazole topical cream) Topical Cream twice daily, morning and evening, to entire affected areas after washing.

Areas to be treated should be washed with a mild cleanser before application. Patients may use cosmetics after application of METROCREAM® (metronidazole topical cream) Topical Cream.

HOW SUPPLIED

METROCREAM® (metronidazole topical cream) Topical Cream, 0.75% is supplied in a 45 g aluminum tube - NDC 0299-3836-45.

Storage conditions: STORE AT CONTROLLED ROOM TEMPERATURE, 68° to 77°F (20° to 25°C), EXCURSIONS PERMITTED BETWEEN 59° AND 86°F (15° - 30°C).

Marketed by: GALDERMA LABORATORIES, L.P., Fort Worth, Texas 76177 USA. Revised: Jan 2017

Side Effects for MetroCream

In controlled clinical trials, the total incidence of adverse reactions associated with the use of METROCREAM Topical Cream was approximately 10%. Skin discomfort (burning and stinging) was the most frequently reported event followed by erythema, skin irritation, pruritus and worsening of rosacea. All individual events occurred in less than 3% of patients. The following additional adverse experiences have been reported with the topical use of metronidazole: dryness, transient redness, metallic taste, tingling or numbness of extremities and nausea.

Drug Interactions for MetroCream

Oral metronidazole has been reported to potentiate the anticoagulant effect of warfarin and coumarin anticoagulants, resulting in a prolongation of prothrombin time. The effect of topical metronidazole on prothrombin time is not known.

Warnings for MetroCream

No information provided.

Precautions for MetroCream

General: Topical metronidazole has been reported to cause tearing of the eyes. Therefore, contact with the eyes should be avoided. If a reaction suggesting local irritation occurs, patients should be directed to use the medication less frequently or discontinue use. Metronidazole is a nitroimidazole and should be used with care in patients with evidence of, or history of blood dyscrasia.

Carcinogenesis, mutagenesis, impairment of fertility

Metronidazole has shown evidence of carcinogenic activity in a number of studies involving chronic, oral administration in mice and rats but not in studies involving hamsters.

Metronidazole has shown evidence of mutagenic activity in several in vitro bacterial assay systems. In addition, a dose-response increase in the frequency of micronuclei was observed in mice after intraperitoneal injections and an increase in chromosome aberrations have been reported in patients with Crohn's disease who were treated with 200-1200 mg/day of metronidazole for 1 to 24 months. However, no excess chromosomal aberrations in circulating human lymphocytes have been observed in patients treated for 8 months.

Pregnancy

Teratogenic effects: Pregnancy category B

There are no adequate and well-controlled studies with the use of METROCREAM® (metronidazole topical cream) Topical Cream in pregnant women. Metron-idazole crosses the placental barrier and enters the fetal circulation rapidly. No fetotoxicity was observed after oral metronidazole in rats or mice. However, because animal reproduction studies are not always predictive of human response and since oral metronidazole has been shown to be a carcinogen in some rodents, this drug should be used during pregnancy only if clearly needed.

Nursing mothers

After oral administration, metronida-zole is secreted in breast milk in concentrations similar to those found in the plasma. Even though blood levels are significantly lower with topically applied metronida-zole than those achieved after oral administration of metronidazole, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

Pediatric use

Safety and effectiveness in pediatric patients have not been established.

Overdose Information for MetroCream

No Information provided

Contraindications for MetroCream

METROCREAM® (metronidazole topical cream) Topical Cream is contraindicated in individuals with a history of hypersensitivity to metronidazole, or other ingredients of the formulation.

Clinical Pharmacology for MetroCream

The mechanisms by which metronidazole acts in the treatment of rosacea are unknown, but appear to include an anti-inflammatory effect.

Patient Information for MetroCream

This medication is to be used as directed by the physician. It is for external use only. Avoid contact with the eyes.

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