Order Flagyl Er (Flagyl ER) online from a USA pharmacy

Product name	Flagyl ER (metronidazole extended-release)
Dosage strength	750 mg ER tablets
Active ingredient	Metronidazole
Form	Oral extended-release tablets (do not crush or chew)
Indication (USA)	Treatment of bacterial vaginosis (BV) in nonpregnant women, per US labeling. Not effective for viral or yeast infections.
How to obtain in the USA	Prescription required. Available via US-licensed pharmacies; telehealth clinicians may provide an e‑prescription when appropriate.

Flagyl ER is the extended-release formulation of metronidazole, a nitroimidazole-class antibiotic widely used in the United States for the treatment of anaerobic bacterial infections and certain protozoal conditions. The ER tablet is specifically indicated in the US for bacterial vaginosis (BV) in nonpregnant adult women. Unlike immediate-release metronidazole, which is dosed multiple times per day for various infections, Flagyl ER provides once-daily dosing designed to maintain therapeutic drug levels with convenient administration.

As a prescription medication in the USA, Flagyl ER should be taken only under the guidance of a licensed healthcare professional. The most commonly used regimen for its labeled indication is 750 mg once daily for 7 days, swallowed whole on an empty stomach. Patients should not drink alcohol during therapy and for at least 3 days after the last dose due to the risk of a disulfiram-like reaction (flushing, cramping, nausea, vomiting, headache). Metronidazole carries a boxed warning regarding potential carcinogenicity observed in animal studies; therefore, it should be used only for approved or well-established indications where the expected benefit justifies the risk.

Flagyl ER price and affordability in the USA

Medication prices in the United States vary widely by pharmacy, location, manufacturer, dosage, and whether you use insurance, coupons, or a prescription discount program. As an extended‑release branded tablet, Flagyl ER typically costs more than immediate‑release metronidazole tablets. Some plans may classify it under a higher copay tier; others may prefer generic immediate‑release metronidazole. If cost is a concern, discuss alternatives with your clinician, such as immediate‑release regimens that are more broadly available and often less expensive.

Ways to manage your out‑of‑pocket expense include:

• Using prescription savings cards or pharmacy coupons accepted by many US chains
• Checking mail‑order options through your insurer’s preferred pharmacy
• Asking your prescriber whether an immediate‑release metronidazole regimen would be clinically appropriate and more affordable
• Comparing prices between local and online US‑licensed pharmacies

Final costs depend on your individual prescription, pharmacy contract pricing, and insurance benefits. Your pharmacist can provide a real‑time price quote once they process your prescription.

Where can I get Flagyl ER in the United States?

If your clinician determines Flagyl ER is appropriate, they can send an electronic prescription directly to your preferred US‑licensed pharmacy. You can choose a neighborhood pharmacy, a large retail chain, or a mail‑order service. Telehealth platforms staffed by US‑licensed providers may also evaluate you and, when clinically indicated, issue an e‑prescription to a participating pharmacy for home delivery or in‑store pickup.

Because Flagyl ER is prescription‑only, there is no lawful over‑the‑counter equivalent in the USA. For your safety and to comply with US regulations, always use metronidazole under medical supervision. Avoid purchasing antibiotics from unverified sources that do not require a valid prescription.

We aim to support a straightforward, safe, and compliant ordering experience through reputable partners. If you have questions about availability, your pharmacist or prescriber can advise you on in‑stock options, substitutes, and timing for refills or partial fills.

Flagyl ER in the U.S.: how to get started

The general process is simple:

1. Consult a US‑licensed healthcare professional (in person or via telehealth) about your symptoms and medical history.
2. If bacterial vaginosis is diagnosed and Flagyl ER is appropriate, your clinician will send a prescription electronically to your chosen US pharmacy.
3. Pick up in store or arrange mail delivery. Follow your clinician’s instructions and read the Medication Guide before use.

What is Flagyl ER (metronidazole extended‑release)?

Metronidazole is an antimicrobial agent in the nitroimidazole class. It is active against many anaerobic bacteria and certain protozoa. Flagyl ER is the extended‑release oral tablet formulation designed to release metronidazole slowly, supporting once‑daily dosing. In the United States, the ER formulation is indicated to treat bacterial vaginosis in nonpregnant women.

Metronidazole works by entering susceptible microorganisms and undergoing reduction of its nitro group. The resulting reactive intermediates interact with DNA and critical cellular components, inhibiting nucleic acid synthesis and leading to microbial cell death. Its spectrum includes many gram‑negative and gram‑positive anaerobes (e.g., Bacteroides spp., Peptostreptococcus species), though activity can vary by region and organism. Metronidazole is not effective against aerobic bacteria, fungi (such as Candida), or viruses.

Important safety points include avoiding alcohol, watching for neurologic adverse effects with prolonged therapy, and reviewing drug interactions—especially with warfarin and disulfiram. Patients with severe hepatic impairment may require closer monitoring and dosage adjustments due to reduced clearance.

Flagyl ER for bacterial vaginosis (BV)

Bacterial vaginosis is a common vaginal condition caused by a disruption of the normal microbiota, often with an overgrowth of anaerobic bacteria. Symptoms may include thin discharge, an unpleasant “fishy” odor—often more noticeable after intercourse—mild irritation, or no symptoms at all. Diagnosis is typically clinical, using Amsel criteria (discharge characteristics, elevated vaginal pH, clue cells on microscopy, and positive whiff test) or Nugent scoring on Gram stain.

For nonpregnant adult women, Flagyl ER (metronidazole 750 mg) is taken once daily for 7 days as a labeled regimen in the United States. Take on an empty stomach, swallowing the tablet whole without crushing, splitting, or chewing. Avoid alcohol during therapy and for at least 72 hours after the final dose.

BV can recur; if symptoms return, follow up with your clinician. Douching is not recommended and may increase the risk of recurrence. Partners generally do not require treatment unless another sexually transmitted infection is identified. If you have new or multiple partners, or if symptoms are atypical, your clinician may also evaluate for other causes of vaginitis.

Why consider extended‑release metronidazole?

Extended‑release dosing offers potential advantages for suitable patients:

• Once‑daily convenience may support adherence to the full regimen
• Steady plasma concentrations designed to maintain therapeutic exposure
• A single daily dose may simplify timing relative to meals (empty stomach)

However, extended‑release tablets should not be crushed or split. In some clinical scenarios, immediate‑release formulations may be preferred or more cost‑effective. Your clinician will choose the best option based on your medical history, symptom severity, insurance coverage, and tolerance.

Mechanism of action and antimicrobial spectrum

Metronidazole passively diffuses into susceptible microorganisms. Within anaerobic environments, bacterial nitroreductases reduce the nitro group of metronidazole, forming reactive species that disrupt DNA structure and synthesis. This bactericidal effect is most pronounced against obligate anaerobes and several protozoa. Notably:

• Active against many Bacteroides spp., Fusobacterium spp., Prevotella spp., and anaerobic cocci
• Active against certain protozoa (e.g., Trichomonas vaginalis, Entamoeba histolytica, Giardia lamblia) with immediate‑release regimens
• Not active for Candida or other yeasts; not active for viruses
• Limited or no activity against aerobic bacteria

Does metronidazole treat yeast or viral infections?

No. Metronidazole does not treat yeast infections (e.g., Candida) or viral illnesses. If you are unsure of the cause of symptoms, consult a clinician before starting treatment. Misuse of antibiotics can delay proper care and contribute to antimicrobial resistance.

Metronidazole: oral vs. topical formulations

Metronidazole is available in several formulations in the United States. Flagyl ER is an oral extended‑release tablet taken once daily for BV in nonpregnant women. Immediate‑release oral tablets (typically 500 mg twice daily for 7 days) are widely used for BV and for a number of other infections as directed by a clinician. Topical metronidazole creams, gels, and lotions are indicated for inflammatory lesions of rosacea and are applied to the skin, not taken by mouth.

Each formulation has specific directions, indications, and safety considerations. Do not substitute one form for another unless your clinician advises it. For vaginal symptoms, self‑treating with nonprescription products may not help and can complicate diagnosis—formal evaluation can save time and prevent recurrences.

Other infections treated with metronidazole (immediate‑release)

While Flagyl ER is indicated for BV in nonpregnant women, metronidazole immediate‑release tablets are commonly used by clinicians to treat anaerobic infections and certain protozoal diseases, including trichomoniasis, amebiasis, giardiasis, and selected intra‑abdominal or dental infections in appropriate combinations. Dosing and duration vary by indication and patient factors. Use only as prescribed by a licensed clinician who can ensure the regimen and duration are correct for your condition.

How Flagyl ER works in your body

Each extended‑release tablet is formulated to dissolve gradually, maintaining systemic exposure over a 24‑hour period. After oral administration on an empty stomach, metronidazole is absorbed and distributed throughout many tissues and body fluids. It is metabolized primarily in the liver and eliminated by renal and fecal routes. Because hepatic metabolism is an important pathway, individuals with severe liver impairment may need dosing adjustments or additional monitoring. Always follow your prescriber’s advice.

Safety profile and boxed warning

Metronidazole has a long history of clinical use. However, it carries a boxed warning in the United States: metronidazole has shown carcinogenicity in mice and rats. Unnecessary use should be avoided. Use only for approved or well‑supported indications and at the lowest effective dose for the appropriate duration. Common adverse effects include nausea, abdominal discomfort, diarrhea, metallic taste, headache, and darkened urine. Rare but serious effects include peripheral neuropathy, encephalopathy, seizures, and severe hepatotoxicity (especially in patients with Cockayne syndrome). Stop the drug and seek medical attention if you experience neurologic symptoms (e.g., paresthesias, weakness, seizures), severe allergic reactions, severe skin reactions, or signs of liver injury (e.g., jaundice, dark urine plus malaise, abdominal pain).

Flagyl ER dosage (adults)

For its US‑labeled indication in nonpregnant women with bacterial vaginosis: 750 mg once daily for 7 days. Take on an empty stomach—one hour before or two hours after a meal. Swallow tablets whole with water. Do not crush, chew, or split.

If you miss a dose, take it as soon as you remember unless it is almost time for your next dose. Do not take two doses at the same time. Completing the full course is important, even if you begin to feel better sooner, unless your clinician tells you to stop due to side effects.

Immediate‑release regimens (for reference)

Many US guidelines list metronidazole 500 mg orally twice daily for 7 days as a standard BV regimen. Other infections require different dosing strategies and durations. Your clinician will select an appropriate regimen based on diagnosis, severity, and your medical history.

Bacterial vaginosis: dosing and practical tips

Use Flagyl ER precisely as prescribed. Practical guidance:

• Take on an empty stomach each day at the same time
• Avoid alcohol during treatment and for 72 hours after your last dose
• Complete the full course even if symptoms improve earlier
• Do not douche; consider avoiding scented products that may disrupt vaginal flora
• If symptoms persist or return, schedule a follow‑up evaluation

Trichomoniasis and other STIs: important distinctions

Metronidazole immediate‑release is a standard treatment for trichomoniasis. However, diagnosis must be confirmed and partners should be treated to prevent reinfection. Flagyl ER is not the typical regimen for trichomoniasis. If you have symptoms suggestive of an STI, consult a clinician for proper testing and management, including partner notification and treatment when indicated.

How to take Flagyl Er correctly

Follow these key steps for safe use:

• Take on an empty stomach with a glass of water
• Swallow whole—do not crush, split, or chew
• Skip alcohol during treatment and for 3 days after the last pill
• Store at room temperature away from moisture and heat
• Keep out of reach of children

Pregnancy and breastfeeding

Discuss pregnancy status and plans with your clinician before starting metronidazole. For symptomatic bacterial vaginosis in pregnancy, immediate‑release regimens may be used under medical supervision. The extended‑release tablet is labeled for nonpregnant adults. Metronidazole is excreted in breast milk; your clinician can help you weigh the benefits and risks. In some cases, temporary interruption of breastfeeding may be considered depending on the dose and regimen.

Pharmacist’s tips for using Flagyl ER

To get the most from your therapy:

• Set a daily reminder to improve adherence
• Avoid alcohol, including hidden alcohol in cough syrups, tonics, and some mouthwashes
• Report numbness, tingling, or unusual neurologic symptoms promptly
• If you take warfarin, plan for closer INR monitoring—metronidazole can increase anticoagulant effects
• If you recently used disulfiram (Antabuse), tell your clinician; do not combine with metronidazole

Important precautions

Do not take metronidazole if you have taken disulfiram in the last two weeks due to risk of psychotic reactions. Avoid alcohol during treatment and for 72 hours afterward due to the risk of a disulfiram‑like reaction. Use caution and consult your clinician if you have severe hepatic impairment, a history of blood dyscrasias, Cockayne syndrome (report any liver symptoms immediately), or prior neuropathy or seizure disorders. Use only for appropriate indications to limit unnecessary exposure and antimicrobial resistance.

Possible side effects of metronidazole

Not everyone experiences side effects, but some are more common. Most are mild and self‑limited. Seek urgent care for signs of severe reactions.

Common effects:

• Nausea, vomiting, abdominal discomfort, diarrhea
• Metallic taste, dry mouth, coated tongue
• Headache, dizziness
• Darkened urine (usually benign)

Less common but important:

• Peripheral neuropathy (numbness, tingling, burning in hands/feet), especially with prolonged use
• Encephalopathy or seizures (rare)
• Hypersensitivity reactions (rash, pruritus, anaphylaxis—seek immediate care)
• Hepatotoxicity, including severe liver injury (stop drug and seek help if jaundice, dark urine, abdominal pain, fatigue)
• Leukopenia or other hematologic changes (rare)

This is not a complete list. If side effects worry you or do not go away, speak with your clinician or pharmacist.

Side effect categories

Gastrointestinal:

• Loss of appetite, epigastric discomfort, nausea, vomiting, diarrhea or constipation, stomatitis

Neurologic:

• Dizziness, headache, confusion; rarely ataxia, seizures, peripheral neuropathy

Dermatologic and hypersensitivity:

• Rash, pruritus, flushing; rare severe skin reactions warrant urgent evaluation

Hepatic and hematologic:

• Elevated liver enzymes, cholestatic hepatitis, rare severe hepatotoxicity; occasional leukopenia

How to report side effects

If you believe you are experiencing a side effect, contact your healthcare professional. In the United States, you can also report adverse events to FDA MedWatch at 1‑800‑FDA‑1088 or online at www.fda.gov/medwatch.

Metronidazole drug interactions

Tell your clinician and pharmacist about all medications, vitamins, and herbal supplements you take. Significant interactions include:

• Warfarin and other oral anticoagulants: metronidazole may increase anticoagulant effect (higher bleeding risk); INR monitoring and dose adjustments may be needed
• Alcohol (including hidden sources): risk of a disulfiram‑like reaction—avoid during therapy and for 72 hours after the last dose
• Disulfiram: contraindicated; risk of psychotic reactions—separate by at least two weeks
• Lithium: metronidazole can raise lithium levels and toxicity risk; monitor levels and clinical status
• Busulfan: potential for markedly increased busulfan exposure—avoid combination when possible
• Cyclosporine or tacrolimus: may increase levels; monitor drug levels and renal function
• Phenytoin and phenobarbital: can reduce metronidazole levels; monitor efficacy
• Cimetidine: may increase metronidazole levels; monitor for toxicity
• Fluorouracil: metronidazole may increase toxicity—close monitoring required

This list is not exhaustive. Keep an updated medication list and share it with each of your providers and your pharmacist.

Clinical advice from our team

Antibiotic stewardship matters. Use Flagyl ER only when prescribed for an appropriate indication, follow the exact dose and duration, and avoid alcohol during and for 3 days after treatment. If you develop neurologic symptoms, severe abdominal pain, yellowing of the skin or eyes, or an allergic reaction, stop the medication and seek medical care immediately. For cost concerns, ask about immediate‑release alternatives or pharmacy discount programs. And if symptoms recur after therapy, schedule a reassessment rather than self‑treat.

Ready to begin treatment? Get Flagyl Er with a valid US prescription

When a licensed US clinician prescribes Flagyl Er, you can arrange fast, discreet dispensing through a US‑licensed pharmacy with shipping options that fit your schedule.

• Prescription‑only, US compliant — evaluated by licensed clinicians
• Fast, secure delivery — nationwide shipping available
• Authentic medication — sourced from trusted, US‑licensed pharmacies
• Competitive pricing options — explore insurance, mail‑order, and savings programs
• Supportive care — pharmacists and clinicians available for questions

Join patients across the United States who value convenience, safety, and guidance from licensed professionals. If your clinician recommends metronidazole ER, stay on track with once‑daily dosing and complete the full course as directed.

Buy Flagyl Er Now