Medication: Flagyl

Flagyl or more commonly known by its generic name metronidazole is used to treat a variety of bacterial infection. One of the first things every patient is counseled on other than how to take the medication is to avoid alcohol. Avoiding that combo is so important that we warn patients not to use mouth washes and certain cough syrups due to the amount of gastrointestinal distress it can cause. I bring this up for two reasons.

  • To convey how important it is to listen to our warnings when talking to someone about medication from the pharmacy.
  • There’s normally a story to go along with it.

So of course I’ve had the patient say to me, “Why didn’t you tell me the medication would react poorly with alcohol?” Well the fact of the matter is we did. The consultation upon pick up, the hand written note on the bag, or the warning sticker that is on the bottle. Three strikes and you’re out. The only person to blame is you. It was the equivalent of driving your car off the end of the unfinished highway because the warning signs, flares, and cones weren’t a great enough signal.

The first story comes via my manager. When first starting out in San Francisco she worked alongside a female pharmacist of the Asian persuasion. While consulting a patient on why not to consume alcohol while taking Flagyl the pharmacist expressed it as such “you drink while taking this you die”. (Insert best bad Asian accent here.) While I agree with this sentiment it probably could have been expressed better.

The second story is a patient interaction of my own. After informing the patient that they needed to avoid consuming any kind of alcohol while taking the medication they proceeded to ask me if just one beer would be ok. If I go to the extent of warning you to avoid mouth wash and cough syrups that contain alcohol CLEARLY ONE BEER IS NOT GOING TO BE OKAY! I ask the patient how intimate they wanted to get with their toilet because that would most likely be the end result.

The patient then proceeds to tell me that they had a party they needed to attend and would just start the medication on Monday so as not to ruin their weekend. I advised them about delaying the medication was not a wise decision, but since I was not their mother that I cannot make them take the medication either. Said patient took the medication and went on their merry way. Find out about a week later that the patient did not heed our warning and ended up vomiting so much that they dehydrated themselves enough to end up being admitted to the ER. Not a huge believer in Karma, but I’m pretty sure it caught up with them on this one.


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