Why You Can’t Buy Metronidazole Over the Counter
Metronidazole (Flagyl) is an antibiotic prescribed for bacterial vaginosis (BV) and other infections, and in the US it is a prescription-only medicine, so it is not sold on the pharmacy shelf. Its FDA label is a prescription drug label.[1]
The same is true of the other treatments the CDC recommends for BV.[2] Metronidazole gel is sold on a prescription label as well,[3] and so is clindamycin cream. Products sold on the shelf for vaginal odor or pH are not on the CDC’s list of recommended BV treatments.
To get metronidazole, you need a prescription, but not an office visit. With Starfish.com, you answer a short questionnaire, a licensed clinician reviews it, and if treatment is right for you the prescription goes to the pharmacy you choose, usually within 1 to 2 hours.
The Treatments the CDC Recommends for BV
The CDC’s treatment guidelines list three recommended treatments for BV.[2] All three are prescription medicines.
| Treatment | How it’s used | Good to know |
|---|---|---|
| Metronidazole tablets (Flagyl) | A tablet by mouth, twice a day for 7 days | Nothing to apply |
| Metronidazole gel (MetroGel) | A gel applied inside the vagina once a day for 5 days | A shorter course |
| Clindamycin cream (Cleocin) | A cream applied inside the vagina at bedtime for 7 days | Oil based, so it can weaken latex condoms |
The CDC notes that clindamycin cream might weaken latex condoms and diaphragms for 5 days after use.[2] If you rely on either, plan for that.
Why It’s Worth Getting the Right Treatment
BV is easy to confuse with other infections. The CDC describes BV as causing a thin white or gray discharge and a strong fish-like odor, especially after sex.[4] A yeast infection causes itching, soreness and discharge too, but it needs an antifungal rather than an antibiotic. A clinician who reviews your symptoms can tell you which fits, including yeast infection treatment if your answers point that way.
Finishing the course matters. The CDC advises taking all the medicine your provider prescribes, even if your symptoms go away.[4]
The clinician checks your health history. A prescription means someone reviews your other medicines and health conditions before you start, rather than you guessing at a product on the shelf.
Get BV Treatment Without an Appointment
Answer a short questionnaire about your symptoms. A licensed clinician reviews it and, if it is appropriate, sends a prescription to the pharmacy you choose.
How to Get Metronidazole Online
- Choose BV treatment on Starfish.com. You can ask for metronidazole tablets, metronidazole gel, clindamycin or clindamycin cream, or let the clinician decide.
- Answer the questionnaire about your symptoms and health history, and pick your pharmacy.
- A licensed clinician reviews it. If a prescription is appropriate, it is sent to your pharmacy, usually within 1 to 2 hours. If your state’s telehealth rules require a short phone call first, Starfish.com arranges it at no extra cost.
- Pick up your medication at the pharmacy.
The Starfish.com fee covers the clinician’s review and the prescription. You pay for the medication at the pharmacy, the same way you would with a prescription from your own doctor.
When to See a Clinician in Person
You are pregnant. The CDC says treating BV during pregnancy is very important.[4] Starfish.com does not treat anyone who is pregnant, so contact your obstetrician.
Treatment has not worked, or BV keeps coming back. A clinician who can examine you and test a sample is the right next step.
FAQ
Is there an over-the-counter version of Flagyl?
No. Flagyl is metronidazole, and in the US it needs a prescription in every form, including the tablets and the vaginal gel.[1][3]
Can I get metronidazole without seeing a doctor?
You need a prescription, but not an office visit. With Starfish.com, a licensed clinician reviews your questionnaire and, if metronidazole is appropriate, sends the prescription to your pharmacy.
Is metronidazole gel better than the tablets?
Both are recommended by the CDC for BV.[2] The tablets are taken by mouth for 7 days, and the gel is used inside the vagina for 5 days. The clinician can help you choose, or you can ask for the one you prefer.
Treat BV Today
A licensed clinician reviews your answers and sends a prescription to your pharmacy, usually within 1 to 2 hours.
References
- U.S. National Library of Medicine, DailyMed. “Flagyl (metronidazole) capsule.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a2883ca1-5a9a-4259-9d80-46ab67274384
- Centers for Disease Control and Prevention. “Bacterial Vaginosis.” Sexually Transmitted Infections Treatment Guidelines, 2021. https://www.cdc.gov/std/treatment-guidelines/bv.htm
- U.S. National Library of Medicine, DailyMed. “Metronidazole vaginal gel, 0.75%.” Human prescription drug label. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=63ed1e7e-d264-4e35-af83-ec37fa5b06d1
- Centers for Disease Control and Prevention. “About Bacterial Vaginosis (BV).” https://www.cdc.gov/bacterial-vaginosis/about/index.html
