Drug Interaction Report

Mebendazole and Metronidazole Topical: Interaction Details

A pharmacist-reviewed analysis of the Mebendazole and Metronidazole Topical interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Metronidazole Topical

MetroCream® MetroGel MetroGel® MetroLotion® Noritate® Cream Nydamax Rosadan
+

Mebendazole

Emverm Emverm® Vermox Vermox®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
established
Severity
Major

What happens

Increased risk of Stevens-Johnson syndrome and/or toxic epidermal necrolysis

Interaction Deep Dive

Avoid coadministration of mebendazole and metronidazole2. The risk of developing Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) is increased 9.5-fold with concomitant use compared with use of only metronidazole, only mebendazole, or use of pyrantel pamoate 1.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) Concomitant use of mebendazole and metronidazole was associated with an increased risk of Stevens-Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN). In a case-control study involving 46 cases and 92 matched controls, odds of developing SJS, TEN, or SJS/TEN overlap were increased 9.5-fold among cases with exposure to concomitant mebendazole and metronidazole in the 6 weeks preceding the event compared with those who received only metronidazole, only mebendazole, or only pyrantel pamoate 1.

Common questions

Can I take Mebendazole and Metronidazole Topical together?

Increased risk of Stevens-Johnson syndrome and/or toxic epidermal necrolysis Always confirm with your pharmacist or prescriber before making any change.

How serious is the Mebendazole and Metronidazole Topical interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "established". Well documented — supported by controlled studies or strong clinical data.

Questions for your pharmacist

  • Does my dose of Mebendazole or Metronidazole Topical need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (2)

  1. Chen KT, Twu SJ, Chang HJ, et al: Outbreak of Stevens-Johnson syndrome/toxic epidermal necrolysis associated with mebendazole and metronidazole use among Filipino laborers in Taiwan. Am J Public Health 2003; 93(3):489-492. PubMed
  2. Product Information: VERMOX(TM) oral chewable tablets, mebendazole oral chewable tablets. Janssen Pharmaceuticals, Inc (per FDA), Titusville, NJ, 2016. DailyMed
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Metronidazole Topical

Keep reading about Metronidazole Topical

All Metronidazole Topical interactions (242) Metronidazole Topical drug information
Also serious with: Mesoridazine Pimozide Piperaquine Saquinavir
Mebendazole

Keep reading about Mebendazole

All Mebendazole interactions (4) Mebendazole drug information
Also serious with: Metronidazole Metronidazole Injection Metronidazole Vaginal
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Mebendazole + Activated Charcoal Coffee Charcoal European Mandrake Glucomannan Guar Gum Gum Arabic Slippery Elm Tragacanth + 9 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.