My husband got a prescription for pouchitis - flagyl (metronidazole) of a dose of 500 mg. every six hours for ten days (totaling 2,000 mg) - he has bad side effects of stomach cramps, little constipation, heartburn.  Isn't 2000 mg. too much?  He wants to cut it in 1/2 to 1,000 mg a day for ten days.  Should he go lower?  He is also taking two sachets of VSL3 daily for the same ten days.  Thanks all. 

Original Post

I love VSL, but it doesn’t do much for acute pouchitis. If a prescribed medication is causing unacceptable side effects the best thing to do is call the doctor and try to make a revised plan (different dose or different drug). None of us know enough details about your husband’s circumstances to know if the prescribed dose is inappropriate for him.

I agree with Scott above. Call your Dr. I take the same 2000mg of Flagyl and additional antibiotics when I have pouchitis and I think that’s the same dose I’ve always taken. So I think it’s normal.... but, the side effects seem to be the concern. There are multiple other options. Good Luck!

2000 is a high dose, but his pouchitis could be bad and warrant a higher dosing. Before I went on Remicade I needed 1000 mg Cipro and 1000 mg Flagyl to keep the pouchitis under wraps. Now it’s like 250 mg of each. I never had side effects with Flagyl although a lot of people are bothered by it. Xifaxin. tinidazole and Augmentin are other antibiotics that can be substituted or rotated. 

BTW this should be common sense but always take Flagyl with meals or food and never on an empty stomach. I remember a poster once complaining of the taste and I wondered why anyone would savor a pill in his or her mouth that is not meant to dissolve? Power swallow it and wash down with plenty of water!

Regarding the constipating effect, it’s  a sign that the drug is working because the previously watery stools were due to the pouchitis. However you really have to watch the Imodium intake because when you take antibiotics and are used to popping a bunch of Imodium to thicken stools before antibiotics u can go from watery to constipation overnight. Use Imodium judiciously once on antibiotics because you have double barreled action and can go from one extreme to the other in a hurry.

Last edited by CTBarrister

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