flagyl and liver problems

[beth22]

Does anyone know if Flagyl can contribute to liver problems/diseases?

[sks001]

Beth -

The Patient Prescription Information sheet that comes with the Rx when you get it filled says "Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver problems, nervous system disorders (e.g., seizures), blood disorders, Crohn's disease"

It also mentions "This medication may interfere with certain laboratory tests (including liver function tests, blood triglyceride levels), possibly causing false test results. Make sure laboratory personnel and your doctors know you use this drug."

So it sounds like it doesn't affect the liver unless you had previous problems.

Of course, we all know it can cause pseudomembranous colitis, oral thrush, vaginal yeast infection, oral or vaginal fungal infection, and, in my case, irreversible Peripheral Neuropathy.

Why are you asking?

Moderators note (Roy)
pseudomembranous colitis is a complication of C.diff.
It is not caused by Flagyl

[beth22]

I'm asking because the SIBO specialist wants me to take it along with Xifaxan. Since I never took Flagyl before and my mom also got irreversible peripheral neuropathy from it, I told him I would try it alone first. I took one pill today at lunch and my urine came out dark, like with people with liver problems. My liver function tests have always been normal, but I do have about 4 benign tumors in my liver called hemangiomas - which is why I can't take estrogen in pill form - it is contraindicated. So, I wonder if Flagyl can make that worse. I think I will call my internist on Monday and check and only take the Xifaxan starting tomorrow. I'm supposed to take another 10 days course. I tolerated it ok last time, except after the last dosage, but it may have been what I ate too because I didn't have any more problems after stopping it and actually had some improvement with my IBS symptoms. That medication is the one that is usually given. The doctor said that he usually prescribes neomycin along with it for severe cases, but it does give D* and with my history of c diff he prefers not to. But, he has only given the Flagyl with Xifaxan to 2 other patients, so I don't feel that comfortable taking it until I know for sure about the effects. He said I could take the Xifaxan in an even higher dose - that was my first choice - but I don't think I can tolerate that. Two pills 3 x per day was hard enough.

Thanks for looking up the Flagyl - I read that too, but it doesn't explain how it alters the liver tests, so I wondered if anyone had any experience with it. Did you get the peripheral neuropathy right away? When I told the doctor about my mother, he said you generally get it after being on it for a longer time, not just ten days, but if a person is sensitive, I thought it could happen right away. I don't know about my mom - she was in a nursing home and had so many symptoms from different conditions that it was hard to tell.

[TheVike]

Very true of Flagyl as it happened to me while taking...I was so sick and really didn t care as long as I was urinating well and no blood shown! I was sick enuf as helll dealing with the best and the other REALLY scary side effects like trembklinbg of the fee hads and ankles and the arythmnia of my heart with if not for XANAX proabbaly would have died!

[beth22]

I've had the heart arrythmia ever since I first got c diff - when on vanco it was better, but since I stopped testing positive I've still had it, with or without meds. I don't know if the toxin damaged my heart permanently or what, but it is not a pleasant sensation.

[sks001]

100's of references on Internet that, while rare, Flagyl can cause pseudomembranous colitis. Here are just a few examples:

http://www.medscapecrm.net/druginfo/pat ... enthandout
Metronidazole is used to treat a variety of infections. It belongs to a class of antibiotics known as nitroimidazoles. It works by stopping the growth of bacteria and protozoa. This antibiotic only treats bacterial and protozoal infections. This medication may rarely cause a severe intestinal condition (pseudomembranous colitis) due to a type of resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped.

http://www.drugs.com/sfx/flagyl-side-effects.html
Rarely, metronidazole has been associated with pseudomembranous colitis and pancreatitis. Although metronidazole has been used to treat pseudomembranous colitis, it has rarely also been implicated as a causative agent.

http://www.rxlist.com/flagyl-drug.htm
This medication may rarely cause a severe intestinal condition (pseudomembranous colitis) due to a type of resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped.

http://www.healthcentral.com/ibd/drug-i ... 57-73.html
This medication may be used to treat a severe intestinal condition (pseudomembranous colitis) due to a type of resistant bacteria. However, sometimes treatment with metronidazole for other types of infections may also cause this intestinal condition.

[sks001]

Beth - In answer to your qustion, I got Peripheral Neuropathy after being on IV Flagyl for five days following what was supposed to be a routine gallbladder removal where you are discharged the next day as soon as you can eat soft foods. I ended up sick as a dog and was barely able to drink a bit of clear liquids. Had IV Flagyl in one arm, and IV electrolytes in other, and anti-emetic shots every 4 hours for nausea. Was discharged on the 6th day still on clear liquids.

Peripheral Neuropathy didn't rear it's ugly head until several weeks later ... went to bed walking fine ... woke up and could only take a few awkward steps and legs felt like rubber. Didn't even know what PN was and didn't know what was wrong with me. An awful dr. nonchalantly brushed me off and said "just walk!" even though I was in a wheelchair to get to his office with the help of an aide as I'm alone with no family.

Then I got C-Diff which I don't know was from the gallbladder Flagyl or touching something dirty in hospital during a subsequent ER visit. Know you're more susceptible after any type of abdominal surgery. Flagyl was only A/B I had been on in many, many years.

Naturally they had me on Flagyl again during 9 days in hospital & took it for 2 weeks at home. A month later was admitted again for another nine days and gave me Flagyl again the first 2 days then switched me to liquid Vanco. Discharged on a long taper of Vanco, but included Flagyl along with the first 2 weeks.

It wasn't until about 5 months later that I finally was able to get to a Neurologist who did tests and announced I had PN. By this time I had lost sooooo much weight and was so weak and leg muscles had deteriorated. Perhaps if I had been diagnosed immediately and had aggressive physical therapy, I might be able to walk more than 10 feet today, and be able to walk and drive and get out of apt.

[beth22]

I'm so sorry you went through that Sandy. What is worse is that the doctor didn't even put two and two together and just didn't take your symptoms seriously. There is no excuse for that! My mom is in a similar situation, but she did break her hip and had a screw put in, but that is not what caused her to be unable to walk and certainly did not cause her hands to be frozen in place without being able to open her fingers. She was on several doses of Flagyl at the rehab hospital because she contracted c diff there and then I got it too later when I took AB and visited her every day.

I only took 2 pills of the Flagyl - one yesterday and another this morning and had enough. It made me feel really bad and gave me a horrible headche which I still have. With dinner I started the Xifaxan - only one pill tonight, but my stomach feels better already. I will just take the Xifaxan as I did before and if it is not enough to beat the SIBO then I will either have to up the dose as the dr. suggested or go on the Vivonex for 2 weeks, although I'm really reluctant to do that with my weight loss. I have gotten so bony that it even hurts to sit on a chair now - no more padding.

If I hadn't had the c diff then I could have taken doxycycline with the Xifaxan. I know that that is one of the AB that is not as likely to cause c diff, but I don't want to chance it if I can help it. I know that Flagyl can cause a relapse of c diff - thanks for posting the information. The dr. told me that it has a higher likelihood of causing a relapse than Xifaxan, although both are rare. Hope he's right.

[paulah]

beth22, I had just gone thru a liver operation when I got cdiff. I was in the hands of a spectacular liver specialist and he had no qualms about giving me flagyl even after going thru the operation.

[Vikingjeff28]

My urine also was darker and smelled as well. Mouth tasted like metal all the time. My liver tests had some elevated levels so they tested me for hepatitis, it was negative, that was it.

[Nancy1]

Pseudomembranous colitis is a more severe form of cdiff. Not all cdiff is p colitis. But all p colitis is cdiff. P colitis and cdiff are treated the same way. Is this all clear as mud now :) ?

[beth22]

Thanks everyone for your imput. I spoke to my internist today and he told me to quit taking the Flagyl and just take the Xifaxan. I still have a headache from the medication and got pins and needles sensation in my hands yesterdy, so he didn't think it was a good idea to continue. I also felt itchy all over my body, even though I couldn't see a rash. Originally I did have pseud. colitis - bad case of it - that is why I was treated right away with Vanco rather than Flagyl and have no experience with it as such. Hopefully, the Xifaxan will work this time around for the SIBO and I won't have to worry about taking a second AB.

[Vikingjeff28]

Funny you should mention the itching. I itched for weeks after I got out of hospital. Eczema has been on my arm ever since and I treat it with steroid cream. The general body itching went away after a few weeks when I could work out and sweat again. I took Zyrtec for weeks and it helped.