Two medicines, side by side
Cefixime vs metronidazole
Cefixime and metronidazole are both labeled for bacterial infections. Drugs@FDA records approvals of cefixime since 1989 and of metronidazole since 1963. Pharmacies paid $10.03 per cefixime 400 mg capsule and $0.102 per metronidazole 250 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Metronidazole's other strengths are brand-only: $2.60 per mL (Likmez 500 mg/5 mL suspension). In FDA's classes, cefixime is a cephalosporin antibacterial and metronidazole a nitroimidazole antimicrobial.
Check it at the source: the cefixime FDA label on DailyMed (effective August 5, 2026); the metronidazole FDA label on DailyMed (effective September 3, 2024).
Highlights of the cefixime record
Cefixime (Suprax) · label of August 5, 2026
Used for
From the label: indicationsCefixime is a cephalosporin antibacterial drug indicated in the treatment of adults and pediatric patients six months and older with the following infections: Uncomplicated Urinary Tract Infections ( 1.1 ) Otitis Media ( 1.2 ) Pharyngitis and Tonsillitis ( 1.3 ) Acute Exacerbations of Chronic Bronchitis ( 1.4 ) Uncomplicated Gonorrhea (cervical/urethral) ( 1.5 ) Usage to Reduce Development of Drug-Resistant Bacteria […]
On the market
- Earliest approval on file
- April 28, 1989
- Generic labelers
- 6 labelers
- Pharmacy cost
- $10.03 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 8
Highlights of the metronidazole record
Metronidazole (Flagyl) · label of September 3, 2024
Metronidazole has been shown to be carcinogenic in mice and rats (see PRECAUTIONS ). Unnecessary use of the drug should be avoided. Its use should be reserved for the conditions described in the INDICATIONS AND USAGE section below.
Used for
From the label: indicationsSymptomatic Trichomoniasis. Metronidazole tablets are indicated for the treatment of T. vaginalis infection in females and males when the presence of the trichomonad has been confirmed by appropriate laboratory procedures (wet smears and/or cultures). Asymptomatic Trichomoniasis. […]
On the market
- Earliest approval on file
- July 18, 1963
- Generic labelers
- 55 labelers
- Pharmacy cost
- $0.102 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 7
Source: FDA drug labels via openFDA (Cefixime label of August 5, 2026, Metronidazole label of September 3, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do cefixime and metronidazole differ on the record?
In FDA's classes, cefixime is a cephalosporin antibacterial and metronidazole a nitroimidazole antimicrobial.
Half-life, in each label's words: Cefixime, “The serum half-life of cefixime in healthy subjects is independent of dosage form and averages 3 to 4 hours but may …”; Metronidazole, “The elimination half-life, measured during the first 3 days of life, was inversely related to gestational age.”
Only the metronidazole label carries a boxed warning.
Generics: cefixime since 2004; metronidazole since 1984 (Drugs@FDA).
| Cefixime | Metronidazole | |
|---|---|---|
| Labeled for | Bacterial infections, Urinary tract infections | Bacterial infections |
| Pharmacologic class | Cephalosporin Antibacterial | Nitroimidazole Antimicrobial |
| How it works (label) | Cefixime is a semisynthetic cephalosporin antibacterial drug [see Microbiology ( 12.4 )]. | n/a |
| Half-life (label) | The serum half-life of cefixime in healthy subjects is independent of dosage form and averages 3 to 4 hours but may range up to 9 hours in some normal volunteers. | The elimination half-life, measured during the first 3 days of life, was inversely related to gestational age. |
| Earliest approval on file (Drugs@FDA) | April 28, 1989 | July 18, 1963 |
| First generic approved | February 12, 2004 | December 6, 1984 |
| Generic labelers (NDC) | 6 labelers | 55 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $10.03 per capsule (Cefixime 400 mg capsule) | $0.102 per tablet (Metronidazole 250 mg tablet) |
| 12-month price change | -0.6% | +10% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | In shortage |
| Recalls recorded | 8 | 7 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 2,959 | 63,553 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to cefixime
- every medicine labeled for the same conditions