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- Given the common need to treat conditions such as Clostridium difficile colitis, refractory bacterial vaginosis/trichomoniasis, and bacteremia/sepsis with prolonged courses of metronidazole, the astute clinician should be mindful of metronidazole-induced neuropathy as the possible etiology of numbness, tingling, and parasthesias in patients taking this medication.
- This is a rare, but serious side effect which is dose and duration dependent; doses of 1000 mg to 2400 mg for at least 30 days duration is typically required to cause neuropathy.
- The lower extremities are most commonly affected.
- In suspected cases, use of metronidazole should immediately be stopped; sometimes symptoms never completely resolve even after cessation of use, particularly in cases of prolonged oral therapy.