Drug & supplement interaction

Equol + Metronidazole

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

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 20, 2026
The bottom line No known interaction

We found no known interaction between Equol and Metronidazole in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Equol and Metronidazole

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Metronidazole and Equol in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Equol safety at a glance

Equol overall Use caution Generally well tolerated in studies, but long-term safety and effects on hormone-sensitive conditions are not well established.
Pregnancy Avoid Not enough safety data and possible hormone-like effects, so it is best avoided.
Breastfeeding Avoid There is no reliable safety information, so avoid use while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Metronidazole and Equol? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Metronidazole

Interactions in our licensed database are recorded against drug classes, not just single drug names. Metronidazole is filed under 8 classifications — including cytochrome p450 2c9 (cyp2c9) inhibitors, qt interval-prolonging drugs, cytochrome p450 3a4 (cyp3a4) inhibitors. Equol has documented interactions with 4 drug classes — the most serious being contraceptive drugs (moderate), estrogens (moderate) and testosterone (moderate) — and none of Metronidazole’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Equol Does Interact With Other Medications

Equol has 58 moderate, 75 minor known drug interactions in our database — Metronidazole isn’t one of them. If you take anything else, check it against the full list below.

Moderate 58 Minor 75 No known interaction 2,697 (incl. Metronidazole)
Taking anything else?

Check Another of Your Medications Against Equol

Covers the 2,830 medications we’ve checked against Equol. Pick one to open its full report.

What to actually watch for

No Interaction Found — But Data Suggests Equol and Metronidazole May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. One of them is worth acting on rather than waiting out — marked below.

  • Low mood Worth acting on Additional detail

    Equol

    “Orally, equol has been rarely reported to cause depression.”

    Equol · Natural Medicines adverse-effect record, reported in depression.

    1 source cited
    1. 19075. Jenks BH, Iwashita S, Nakagawa Y, et al. A pilot study on the effects of S-equol compared to soy isoflavones on menopausal hot flash frequency. J Womens Health (Larchmt) 2012;21:674-82.

    Metronidazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Metronidazole. Read the label on DailyMed ›

  • Constipation Additional detail

    Equol

    “Orally, equol has been reported to cause abdominal distention and constipation.”

    Equol · Natural Medicines adverse-effect record, reported in constipation.

    1 source cited
    1. 19075. Jenks BH, Iwashita S, Nakagawa Y, et al. A pilot study on the effects of S-equol compared to soy isoflavones on menopausal hot flash frequency. J Womens Health (Larchmt) 2012;21:674-82.

    Metronidazole

    Listed in the ADVERSE REACTIONS section of the FDA label for Metronidazole. Read the label on DailyMed ›

Reported for Equol but not commonly for Metronidazole: bloating or gas.

Effects for Metronidazole come from the ADVERSE REACTIONS section of its FDA label; effects for Equol come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 64,630 voluntary FDA FAERS reports for Metronidazole that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

From our Q&A

Questions About Equol 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 Equol 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 Equol 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 Equol 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 Equol
Steady interest

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

29 days ago today
Medication Metronidazole
Top 25%

#633 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Equol reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Equol and Metronidazole records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Equol

What is Equol?

  • Menopause symptoms (hot flashes)
  • Bone health support
  • Skin aging
  • Prostate health
  • General hormone balance

Equol is a compound made in the gut when some people break down soy isoflavones, and it is also sold as a supplement. Early research links it to possible benefits for menopause symptoms and bone or skin health, but the evidence is still limited and far from proven. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Not a plant part; a metabolite produced by gut bacteria from soy isoflavones (daidzein) · Capsules, tablets, and as a component of fermented soy or red clover supplements

An interaction check asks whether these two react with each other — it does not ask whether Equol is a good idea for someone in your situation. Here is what our Equol record says about it on its own.

Equol: dosing

There is no official or standardized dose of equol. Amounts used in research have varied, and supplement products differ in how much they contain.The best approach is to follow the directions on the product label and not take more than recommended.

From our Equol monograph — the full record covers uses, side effects and every documented interaction.

Read the full Equol 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.

Most-Reported Side Effects for Metronidazole

From FAERS, the FDA’s public side-effect reporting system (64,630 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Nausea 4,812 reports
Diarrhea 4,197 reports
Vomiting 3,393 reports
Fever 3,294 reports
Drug hypersensitivity 3,160 reports
See full Metronidazole drug information
Keep checking

Other Drugs & Equol

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

0Major
58Moderate
75Minor
2,696No known interaction
58 Moderate 75 Minor 2,696 No interaction
Moderate

58 interactions

Minor

75 interactions

Showing 60 of 75 minor interactions — see all 75 on the Equol page.

No interaction 2,696 drugs checked — show the list

We also checked Equol against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,696 medications checked with no known interaction — see the full Equol list.

See the full Equol interactions page
See every supplement checked against Metronidazole, ranked by severity
Evidence & sources

Equol References

The 7 references that drive our Equol monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Aso T. Equol improves menopausal symptoms in Japanese women. J Nutr 2010;140:1386S-9S. PubMed
  2. Jenks BH, Iwashita S, Nakagawa Y, et al. A pilot study on the effects of S-equol compared to soy isoflavones on menopausal hot flash frequency. J Womens Health (Larchmt) 2012;21:674-82.
  3. Oyama A, Ueno T, Uchiyama S, et al. The effects of natural S-equol supplementation on skin aging in postmenopausal women: a pilot randomized placebo-controlled trial. Menopause 2012;19:202-10. PubMed
  4. Gimenez I, Lou M, Vargas F, et al. Renal and vascular actions of equol in the rat. J Hypertens 1997;15:1303-8. PubMed
  5. Martin ME, Haouriqui M, Pelissero C, et al. Interactions between phytoestrogens and human sex steroid binding protein. Life Sci 1996;58:429-36. PubMed
  6. Martinez RM, Gimenez I, Lou JM, et al. Soy isoflavonoids exhibit in vitro biological activities of loop diuretics. Am J Clin Nutr 1998;68:1354S-57S. PubMed
  7. Alda JO, Mayoral JA, Lou M, et al. Purification and chemical characterization of a potent inhibitor of the Na-K-Cl cotransport system in rat urine. Biochem Biophys Res Commun 1996;221:279-85. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Equol and Metronidazole Together: Common Questions

Is it safe to take Equol with Metronidazole?
We do not list a known interaction between Equol and Metronidazole. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Equol and Metronidazole have any of the same side effects?
Yes — our sources link each of them separately to 2 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
How was the Equol and Metronidazole combination checked?
Interactions in our licensed database are recorded against drug classes. Metronidazole is filed under 8 classifications, and Equol has documented interactions with 4 drug classes — none of Metronidazole's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Equol interact with any other medications?
Yes. Equol has 133 documented drug interactions in our database — Metronidazole is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Metronidazole interact with any supplements?
Yes. Metronidazole has documented interactions with 83 supplements in our database — Equol is not one of them. The Metronidazole interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Equol monograph Uses, safety profile, and every drug interaction in one place Metronidazole drug information The full plain-English guide to this medication Metronidazole supplement interactions Every supplement checked against Metronidazole, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 7 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Metronidazole and Equol?

Our pharmacists answer your medication & supplement questions — free.

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.