Metronidazole and Phenobarbital Interaction
Drug interaction information between Metronidazole and Phenobarbital.
Metronidazole and Phenobarbital have a documented minor interaction in FDA labeling.
FDA drug labeling documents a minor-severity interaction between Metronidazole and Phenobarbital. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.
How They Interact
Phenobarbital makes your liver break down metronidazole faster than normal. This can lower the amount of medicine in your blood and make it less effective at fighting infections.
What To Do
Your doctor may need to adjust your metronidazole dose or monitor you closely to ensure the treatment is working.
FDA Label Information
Drugs that Induce CYP450 Enzymes The simultaneous administration of drugs that induce microsomal liver enzymes, such as phenytoin or phenobarbital, may accelerate the elimination of metronidazole, resulting in reduced plasma levels; impaired clearance of phenytoin has also been reported.
Metronidazole Also Interacts With
- Theophylline major
- Lithium minor
- Disulfiram minor
- Cimetidine minor
- Phenytoin minor
Phenobarbital Also Interacts With
- Nirmatrelvir/Ritonavir major
- Ranolazine major
- Voriconazole major
- Canagliflozin moderate
- Cenobamate moderate
Frequently Asked Questions
Can I take Metronidazole and Phenobarbital together?
This is a minor interaction. Your doctor may need to adjust your metronidazole dose or monitor you closely to ensure the treatment is working.
How serious is the interaction between Metronidazole and Phenobarbital?
This interaction is classified as "minor" severity by the FDA. Minor interactions are unlikely to cause significant problems but should still be mentioned to your healthcare provider.
Why do Metronidazole and Phenobarbital interact?
Phenobarbital makes your liver break down metronidazole faster than normal. This can lower the amount of medicine in your blood and make it less effective at fighting infections.
Understanding the Metronidazole and Phenobarbital Interaction
FDA-approved prescribing information for these two drugs flags their combination as a minor-severity interaction. Metronidazole belongs to the Nitroimidazole Antibiotic class and Phenobarbital belongs to the Anticonvulsant (Barbiturate) class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Phenobarbital makes your liver break down metronidazole faster than normal. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.
Context around a specific patient determines real-world impact. Metronidazole has 10 total documented interactions on file in this dataset, and Phenobarbital has 59. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Your doctor may need to adjust your metronidazole dose or monitor you closely to ensure the treatment is working. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.
An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Metronidazole or Phenobarbital based on a web page, speak with your prescriber or pharmacist before making any change.
Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.
Read our methodology - how this data is sourced, computed, and verified.