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[10] [11] Metronidazole is available orally (by mouth), as a cream or gel, and by slow intravenous infusion (injection into a vein). [10] [4] Common side effects include nausea, a metallic taste, loss of appetite, and headaches. [10] Occasionally seizures or allergies to the medication may occur. [10]
The metronidazole tablet may have an unpleasant metallic taste, deteriorating drug compliance. [47] This medication may also induce rare side effect in the central nervous system, including neurotoxicity (encephalopathy, peripheral neuropathy, seizure). [48] [49] [50] [51]
Benefits of topical metronidazole include its effectiveness in reducing symptoms, extensive clinical experience supporting its use, and generally good tolerability with minimal systemic side effects; still, some patients may experience mild local irritation upon initial use, and it may have limited impact on persistent facial redness (erythema).
The side effects of oral treatment are significant and people without an infection should not take these drugs. [36] Azoles are the group of antifungals which act on the cell membrane of fungi. They inhibit the enzyme 14-alpha-sterol demethylase, a microsomal CYP, which is required for the biosynthesis of ergosterol for the cytoplasmic membrane.
Additional side effects can result from interaction with other drugs, such as the possibility of tendon damage from the administration of a quinolone antibiotic with a systemic corticosteroid. [ 51 ] Some antibiotics may also damage the mitochondrion , a bacteria-derived organelle found in eukaryotic, including human, cells. [ 52 ]
These effects are known from the drug's components as well as from other antibiotics. A very rare but dangerous reaction is Stevens–Johnson syndrome , a life-threatening condition affecting the skin, which has also been described under metronidazole and tetracycline as separate drugs.
Treatment for angular cheilitis is typically based on the underlying causes along with the use of a barrier cream. [2] Frequently an antifungal and antibacterial cream is also tried. [2] Angular cheilitis is a fairly common problem, [2] with estimates that it affects 0.7% of the population. [3]
For people who are symptomatic, it is used after treatment with metronidazole or tinidazole. [2] It is taken by mouth. [1] Diloxanide generally has mild side effects. [3] Side effects may include flatulence, vomiting, and itchiness. [1] During pregnancy it is recommended that it be taken after the first trimester. [1]