Drug & supplement interaction

Dimethylsulfoxide (dmso) + Metronidazole

Metronidazole brand names: Flagyl, Protostat, Metronidazole, Nidazol, Trikacide, and others.

Moderate Interaction
The bottom line Moderate

Dimethylsulfoxide (dmso) has a moderate interaction with Metronidazole. Topical DMSO might increase the effects and adverse effects of topical drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Dimethylsulfoxide (dmso) and Metronidazole

Here is the interaction we found between these two, with the evidence behind it.

Moderate

TOPICAL DRUGS

Why this applies to Metronidazole

Metronidazole falls under TOPICAL DRUGS — the group Dimethylsulfoxide (dmso) interacts with.

Topical DMSO might increase the effects and adverse effects of topical drugs.
Evidence from animal studies and limited human studies suggests that DMSO may potentiate the action of numerous topical medications by increasing their absorption through the skin. This increase in absorption seems to depend on the concentration of DMSO and the molecular weight of the medication.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the practical angle for metronidazole. DMSO is what we call a penetration enhancer, meaning it can push other chemicals through your skin more easily. So this concern really only applies to a topical form of metronidazole, like MetroGel that you rub on. If you smear DMSO over the same area, more of the medicine may soak in than intended.

For a skin product, that mostly means a higher chance of local irritation, redness, dryness, or stinging where you apply it. The good news is the evidence here is limited and the effect depends on the DMSO concentration. If you take metronidazole as a pill or capsule, this skin interaction doesn't really apply. Before pairing DMSO with any topical, check with your pharmacist or doctor first.

References
  1. Jacob SW, Herschler R. Pharmacology of DMSO. Cryobiology 1986;23:14-27. PubMed
  2. Capriotti K, Capriotti JA. Dimethyl sulfoxide: history, chemistry, and clinical utility in dermatology. J Clin Aesthet Dermatol. 2012;5(9):24-6.
  3. DOMOSO SOLUTION (90% Dimethyl Sulfoxide). Fort Dodge Animal Health, Fort Dodge, Iowa. Avaliable at: https://www.zoetisus.com/_locale-assets/mcm-portal-assets/products/pdf/domoso_solution_pi.pdf. Accessed 8/3/2020.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Dimethylsulfoxide (dmso) Also Interacts With Other Medications

Dimethylsulfoxide (dmso) has 338 moderate known drug interactions in our database — the Metronidazole one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Dimethylsulfoxide (dmso)

Covers the 2,830 medications we’ve checked against Dimethylsulfoxide (dmso). Pick one to open its full report.

From our Q&A

Questions About Dimethylsulfoxide (dmso) or Metronidazole

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Dimethylsulfoxide (dmso) or Metronidazole, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Metronidazole

This page covers Dimethylsulfoxide (dmso) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metronidazole page lists 83 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 7 major · 63 moderate · 13 minor.

From our pharmacist’s overview on the Metronidazole page

“Metronidazole (Flagyl) can stretch the heart's QT interval on its own, and most of the seven major-rated interactions among its 83 flagged supplement ingredients do the same thing, so I read this list with more wariness than most antibiotics earn. Grapefruit and ephedra stand out for adding to that heart-rhythm risk, while activated ch…”

Reviewed by 2 · Jul 18, 2026

Open the Metronidazole interaction page

How much people look this up

Where Dimethylsulfoxide (dmso) and Metronidazole Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Dimethylsulfoxide (dmso)
Top half

#659 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Metronidazole
Top 25%

#632 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Dimethylsulfoxide (dmso)

What is Dimethylsulfoxide (dmso)?

Dimethylsulfoxide (dmso)
  • Muscle and joint pain
  • Arthritis
  • Sprains and strains
  • Interstitial cystitis (bladder pain)
  • Skin penetration enhancer for other medicines

DMSO is a colorless liquid solvent that people apply to the skin for pain and inflammation, and it is FDA-approved (as a prescription) only for interstitial cystitis placed directly into the bladder. Most over-the-counter uses for pain and arthritis have limited or low-quality evidence, and DMSO can carry impurities or push other chemicals through your skin. Talk to your pharmacist or doctor before using it, and avoid industrial-grade products.

Read the full Dimethylsulfoxide (dmso) monograph & all interactions
Medication

About Metronidazole

What Is Metronidazole Used For?

Brand names: Flagyl, Protostat, Metronidazole, Nidazol, Trikacide, MetroGel, Flagyl IV, Metronidazole Redi-Infusion, Flagyl IV RTU, Metro IV, Anabact, Metrosa, Metrotop, Noritate, Rozex Cream, Rozex Gel, Zyomet, Likmez

Metronidazole treats three main types of infections. It's used for trichomoniasis (a sexually transmitted parasitic infection), amebiasis (an intestinal or liver infection caused by a parasite), and serious anaerobic bacterial infections — infections caused by bacteria that thrive without oxygen, which can affect the abdomen, skin, bones, lungs, and other areas.

Because sexual partners can pass trichomoniasis back and forth, both partners are typically treated at the same time, even if one has no symptoms.

See full Metronidazole drug information
Keep checking

Other Drugs & Dimethylsulfoxide (dmso)

Browse every other medication we’ve checked against Dimethylsulfoxide (dmso) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
338Moderate
0Minor
2,491No known interaction
Moderate

338 interactions

Showing 60 of 338 moderate interactions — see all 338 on the Dimethylsulfoxide (dmso) page.

No interaction 2,491 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Dimethylsulfoxide (dmso) and Metronidazole Together: Common Questions

Can you take Dimethylsulfoxide (dmso) with Metronidazole?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Dimethylsulfoxide (dmso) and Metronidazole interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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