Metrogel is a topical formulation of the antibacterial drug, metronidazole, and is available only by prescription. It is approved for use in the treatment of a skin condition known as rosacea.
About Rosacea
Metrogel is approved by the Food and Drug Administration (FDA) only for the treatment of inflammatory lesions caused by rosacea. Rosacea is a condition affecting the skin of the face including forehead, chin, cheeks, nose and sometimes eye areas. Rosacea causes frequent redness or flushing, small red lines under the skin, thickened skin and bumps that may be painful or filled with pus similar to pimples. Pus-filled bumps may spread into larger inflammatory lesions that can be painful. The exact cause of rosacea is unknown but it may be an inherited disorder and is more common in those who have lighter skin and blush easily.
How It Works
Metrogel is a 1 percent concentration of the drug metronidazole, which is a unique anti-infective agent that works by disrupting nucleic acid synthesis and breaking DNA strands in susceptible bacteria and protozoa causing bacterial cell death. The exact cause of rosacea is still unknown but may be a result of the infection of skin lesions and pus-filled bumps with bacteria. Metrogel appears to help reduce the occurrence, frequency and severity of the lesions and bumps. Treatment of the inflammatory lesions and bumps with Metrogel may reduce the swelling and pain associated with rosacea and may help prevent future thickening of skin by reducing inflammation.
Other Uses
Metrogel topical formulation has also been used as an "off-label" treatment or treatment that is not yet approved by the FDA for fungating ulcers. Fungating ulcers are skin infections that have developed ulcer-like formations that produce a smelly discharge. These ulcers are possibly gangrenous wounds such as pressure ulcers or bedsores, venous ulcers, neuropathic ulcers caused by diabetes and other inflammatory ulcers that have not responded to other therapies.
Available Forms
Metrogel is available as a topical gel as well as a solution and cream form with the same amount of active ingredient. Application of Metrogel is strictly limited to the skin of the face and should not be used for oral, ophthalmic or vaginal application. A thin film of Metrogel gel, solution or cream should be applied to affected areas of clean skin once daily. Cosmetics may be applied after use of Metrogel with no difficulties. Although topical Metrogel should not be used vaginally, metronidazole is available in a vaginal formulation called MetroGel Vaginal. It is used to treat bacterial vaginitis caused by Haemophilus, Corynebacterium, Gardnerella and other anaerobic bacteria.
Side Effects and Drug Interactions
Common side effects of Metrogel use may include burning, dryness and scaling at the application site. Occasionally the medication in Metrogel is absorbed into the body and may cause a metallic taste in the mouth along with nausea and headache. Application near the eyes is known to cause stinging and tear formation. In some rare cases, the active ingredient in Metrogel may be absorbed into the body and increase the anticoagulant effect of warfarin, a common blood thinner also known as Coumadin and may increase the chance for bleeding. Physicians should be informed if warfarin is also prescribed. Another rare but potentially serious interaction with Metrogel is an interaction between alcohol and metronidazole which may cause serious nausea, vomiting and headache when a significant amount of metronidazole is absorbed into the body.
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