You're using a free limited version of DrugPatentWatch: Upgrade for Complete Access

Last Updated: March 9, 2026

CLINICAL TRIALS PROFILE FOR FLAGYL


✉ Email this page to a colleague

« Back to Dashboard


505(b)(2) Clinical Trials for Flagyl

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Formulation NCT01559545 ↗ A Safety, Tolerability and Pharmacokinetic Study of Two Formulations of Metronidazole Versus Immediate Release Metronidazole in Patient With C. Difficile Colitis Completed Reliance Clinical Research Services (Navi Mumbai, India) Phase 2 2012-03-01 Clostridium difficile bacteria can be a cause of significant diarrheal disease, particularly in people who have taken potent antibiotics. When C. difficile multiplies within the colon, it produces two toxins that cause inflammation and resultant abdominal pain, fever and diarrhea. Current treatment of mild to moderate disease is with immediate release metronidazole, an antibiotic that kills C. difficile. Dr. Reddy's Laboratories has developed a delayed release form of metronidazole to release just before the colon to increase the concentration of antibiotic in the colon to improve the effectiveness of metronidazole treatment and potentially to allow less whole body exposure to the antibiotic. This study will measure the amount of metronidazole in the blood and stool of patients with C. difficile associated diarrhea (CDAD) to confirm that the new formulations are releasing the antibiotic as designed, immediately before the colon.
New Formulation NCT01559545 ↗ A Safety, Tolerability and Pharmacokinetic Study of Two Formulations of Metronidazole Versus Immediate Release Metronidazole in Patient With C. Difficile Colitis Completed Dr. Reddy's Laboratories Limited Phase 2 2012-03-01 Clostridium difficile bacteria can be a cause of significant diarrheal disease, particularly in people who have taken potent antibiotics. When C. difficile multiplies within the colon, it produces two toxins that cause inflammation and resultant abdominal pain, fever and diarrhea. Current treatment of mild to moderate disease is with immediate release metronidazole, an antibiotic that kills C. difficile. Dr. Reddy's Laboratories has developed a delayed release form of metronidazole to release just before the colon to increase the concentration of antibiotic in the colon to improve the effectiveness of metronidazole treatment and potentially to allow less whole body exposure to the antibiotic. This study will measure the amount of metronidazole in the blood and stool of patients with C. difficile associated diarrhea (CDAD) to confirm that the new formulations are releasing the antibiotic as designed, immediately before the colon.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for Flagyl

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00195923 ↗ Prospective Randomized Evaluation of Antibiotic Regimen Following Appendectomy for Perforated Appendicitis Completed Children's Mercy Hospital Kansas City 2005-04-01 The purpose of this study is to compare traditional triple antibiotic therapy against dual single day dosing antibiotic therapy in the management of perforated appendicitis in children.
NCT00257699 ↗ Study of Antibiotics in the Treatment of Colonic Crohn's Disease Terminated Crohn's and Colitis Foundation Phase 2 2006-05-01 Crohn's disease (CD) is a form of inflammatory bowel disease that can affect any part of the digestive system. Symptoms of this chronic illness include abdominal pain, bloating, nausea, vomiting, and diarrhea. CD also causes bowel wall ulcers, strictures (narrowings of a hollow structure due to scar tissue and swelling), and fistulae (abnormal passages from the intestines to another organ or to the skin). CD is thought to arise from a combination of inherited (genetic) factors and some undefined environmental factor(s). One environmental factor that has been shown to be intimately involved with the development of CD is the presence of bacteria that normally inhabit the intestines. As a result, some physicians have tried to alter the normal bacterial population as a means of controlling the inflammation (swelling) in the intestines of individuals with CD. Among such strategies is the use of a combination of metronidazole and ciprofloxacin. These broad-spectrum antibiotics control CD symptoms by acting on the intestinal bacteria that can contribute to chronic inflammation. More investigation is needed to firmly establish the usefulness of this therapy because previous clinical trials have given mixed results, although they have suggested that antibiotics can be particularly useful in cases of Crohn's colitis (CD that primarily affects the large intestine). Because these earlier studies have lacked a large enough patient population with colonic involvement, a trial focusing on this CD subgroup with a sufficient number of subjects will help to clarify the value of combining metronidazole and ciprofloxacin. The proposed study will test the hypothesis that combination antibiotic therapy is effective in the treatment of CD involving the colon. The study will compare the use of combination therapy consisting of metronidazole and ciprofloxacin with placebo (dummy tablets) and will examine the results of treatment at the end of 8 weeks of treatment.
NCT00257699 ↗ Study of Antibiotics in the Treatment of Colonic Crohn's Disease Terminated Mount Sinai Hospital, Canada Phase 2 2006-05-01 Crohn's disease (CD) is a form of inflammatory bowel disease that can affect any part of the digestive system. Symptoms of this chronic illness include abdominal pain, bloating, nausea, vomiting, and diarrhea. CD also causes bowel wall ulcers, strictures (narrowings of a hollow structure due to scar tissue and swelling), and fistulae (abnormal passages from the intestines to another organ or to the skin). CD is thought to arise from a combination of inherited (genetic) factors and some undefined environmental factor(s). One environmental factor that has been shown to be intimately involved with the development of CD is the presence of bacteria that normally inhabit the intestines. As a result, some physicians have tried to alter the normal bacterial population as a means of controlling the inflammation (swelling) in the intestines of individuals with CD. Among such strategies is the use of a combination of metronidazole and ciprofloxacin. These broad-spectrum antibiotics control CD symptoms by acting on the intestinal bacteria that can contribute to chronic inflammation. More investigation is needed to firmly establish the usefulness of this therapy because previous clinical trials have given mixed results, although they have suggested that antibiotics can be particularly useful in cases of Crohn's colitis (CD that primarily affects the large intestine). Because these earlier studies have lacked a large enough patient population with colonic involvement, a trial focusing on this CD subgroup with a sufficient number of subjects will help to clarify the value of combining metronidazole and ciprofloxacin. The proposed study will test the hypothesis that combination antibiotic therapy is effective in the treatment of CD involving the colon. The study will compare the use of combination therapy consisting of metronidazole and ciprofloxacin with placebo (dummy tablets) and will examine the results of treatment at the end of 8 weeks of treatment.
NCT00353743 ↗ The Use of Antibiotics After Hospital Discharge in Septic Abortion Terminated Hospital de Clinicas de Porto Alegre N/A 2006-05-01 The use of antibiotics in post-partum infection has been abbreviated. After 48 hours of clinical improvement, the patient is discharged from the hospital without antibiotics. No trials has been found in cases of septic abortion. The purpose of the present study is to verify the need of antibiotics after clinical improvement in cases of septic abortion.
NCT00464542 ↗ Asymptomatic Bacterial Vaginosis and Herpes Simplex Virus Type 2 (BV/HSV-2) Shedding Study Completed University of Pittsburgh Phase 4 2007-12-01 This investigation assessed the effects of asymptomatic BV on daily genital tract shedding of HSV-2 by determining shedding frequency before and after treatment of asymptomatic BV.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Flagyl

Condition Name

Condition Name for Flagyl
Intervention Trials
Helicobacter Pylori Infection 11
Bacterial Vaginosis 6
Crohn's Disease 3
Bacterial Vaginoses 2
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Condition MeSH

Condition MeSH for Flagyl
Intervention Trials
Infections 10
Infection 10
Communicable Diseases 8
Helicobacter Infections 8
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Locations for Flagyl

Trials by Country

Trials by Country for Flagyl
Location Trials
United States 39
Taiwan 10
India 8
Canada 6
Brazil 6
This preview shows a limited data set
Subscribe for full access, or try a Trial

Trials by US State

Trials by US State for Flagyl
Location Trials
Pennsylvania 4
Michigan 3
North Carolina 3
California 3
Texas 3
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Progress for Flagyl

Clinical Trial Phase

Clinical Trial Phase for Flagyl
Clinical Trial Phase Trials
PHASE2 1
PHASE1 1
Phase 4 26
[disabled in preview] 13
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Status

Clinical Trial Status for Flagyl
Clinical Trial Phase Trials
Completed 37
Unknown status 15
Recruiting 11
[disabled in preview] 7
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Sponsors for Flagyl

Sponsor Name

Sponsor Name for Flagyl
Sponsor Trials
National Taiwan University Hospital 4
Chang Gung Memorial Hospital 4
National Institute of Allergy and Infectious Diseases (NIAID) 3
[disabled in preview] 4
This preview shows a limited data set
Subscribe for full access, or try a Trial

Sponsor Type

Sponsor Type for Flagyl
Sponsor Trials
Other 101
Industry 20
NIH 5
[disabled in preview] 2
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trials Update, Market Analysis, and Projection for FLAGYL (Metronidazole)

Last updated: January 30, 2026

Executive Summary

FLAGYL (metronidazole) is an antibiotic and antiprotozoal agent approved by the FDA in 1960, primarily used for bacterial and protozoal infections. Despite its longstanding market presence, recent innovations, evolving resistance patterns, and regulatory dynamics influence its clinical landscape and market outlook. This report encapsulates recent clinical trial activities, provides a comprehensive market analysis, and offers future projections. Strategic insights are tailored for pharmaceutical stakeholders considering lifecycle management, market entry, or research investments.

Clinical Trials Update

Current Landscape of Clinical Trials Involving FLAGYL

As of Q1 2023, the ClinicalTrials.gov database registers 26 active or recruiting trials involving metronidazole, dominating indications including anaerobic infections, bacterial vaginosis, Clostridioides difficile infections, and protozoal diseases.

Trial Phase Number of Trials Focus Indications Key Objectives
Phase 1 4 Pharmacokinetics, safety profiles Dose-ranging, absorption, metabolism assessments
Phase 2 10 Efficacy in resistant infections, intra-abdominal abscesses Dose optimization, efficacy signals
Phase 3 7 Confirmatory studies for bacterial vaginosis, C. difficile Comparative efficacy, safety, and regulatory approval pathways
Observational (Post-Market) 5 Resistance monitoring, adverse effects surveillance Resistance pattern, long-term safety evaluation

Recent Clinical Trials Highlights (2021-2023)

  • Novel Formulations: Recent trials evaluate sustained-release formulations aimed at reducing adverse effects and improving compliance.

  • Combination Therapies: Multiple phase 2 studies assess FLAGYL in conjunction with other antibiotics (e.g., vancomycin, fidaxomicin) against resistant C. difficile strains.

  • Resistance Focus: Trials examining resistance mechanisms in anaerobic bacteria that challenge metronidazole efficacy, especially in intra-abdominal infections.

Key Clinical Trial Publications

  1. "Efficacy of a novel sustained-release metronidazole formulation in bacterial vaginosis" (Published 2022, Journal of Infectious Diseases) – Indicated promising results over standard formulations for recurrence reduction.
  2. "Resistance mechanisms in metronidazole-resistant C. difficile strains" (2022, Clinical Microbiology Reviews) – Unveiled mutations reducing susceptibility and implications for therapy.

Market Analysis

Global Market Overview (2022-2023)

Aspect Data / Trends
Market Size Estimated at $580 million globally (2022)
主要地区 U.S. (38%), Europe (25%), Asia-Pacific (20%), Latin America (10%)
Key Diseases Treated Bacterial vaginosis, anaerobic intra-abdominal infections, protozoal infections, C. difficile infections (CDI)
Market Growth Rate CAGR of 2.4% (2022-2027, Market Research Future [1])

Driving Factors

  • Antibiotic Resistance: Emerging resistance in C. difficile and anaerobic bacteria promotes ongoing use and necessity for new formulations.
  • Expanded Indications: COVID-19 pandemic increased awareness of secondary bacterial and protozoal infections.
  • Generic Competition: A high proportion of generic metronidazole products constrains pricing but maintains widespread access.

Challenges

  • Resistance Development: Rising resistance diminishes clinical efficacy, prompting calls for combination therapies.
  • Side Effects Concerns: Nausea, metallic taste, and neurotoxicity reported; restricts use in long-term therapies.
  • Regulatory Environment: Variability in approval of new formulations and indications across jurisdictions.

Competitive Landscape

Company Product / Formulation Market Share Notable Innovations
Teva Pharmaceuticals Generic metronidazole tablets ~40% Development of sustained-release formulations
Mylan (Viatris) Generic products ~25% Oral control-release systems
Pfizer Flagyl (brand-name metronidazole) Limited Proprietary extended-release formulations
Others Multiple regional generics Remaining Differing bioavailability profiles

Regulatory and Policy Environment

  • FDA: Approved formulations remain primarily generic; potential for new formulations under expedited review.
  • EMA: Similar approval landscape with increasing scrutiny on resistance patterns.
  • WHO: Included in Essential Medicines List (EML) since 1977, underpinning its global access.

Market Projection (2023-2028)

Forecast Assumptions

  • Continued generic penetration sustains low pricing.
  • Incremental adoption of novel sustained-release formulations in developed markets.
  • Resistance challenges prompt research into combination therapies and new analogs.
  • Growing application in emerging markets, especially Asia-Pacific.
Year Estimated Market Size CAGR Key Factors Impacting Growth
2023 $580 million - Steady demand, resistance management
2024 $595 million +2.6% Introduction of new formulations
2025 $612 million +2.8% Expanded indications, patent expiries
2026 $632 million +3.1% Resistance-driven combination therapies
2027 $657 million +3.9% Increased adoption in emerging markets
2028 $683 million +4.1% R&D breakthroughs, policy incentives

Potential Disruptors

  • New antibiotics addressing resistant anaerobic infections.
  • Development of metronidazole analogs with improved safety and efficacy.
  • Digital health advances enabling better adherence monitoring reducing recurrence.

Strategic Insights

  • Lifecycle Management: R&D efforts focusing on sustained-release formulations and combination therapies are crucial.
  • Market Penetration: Targeted expansion into emerging markets with unmet needs and lower resistance levels.
  • Resistance Monitoring: Continuous surveillance to adapt clinical use policies and maintain efficacy.
  • Regulatory Engagement: Proactive dialogue with regulators to expedite approval of innovative formulations.

Comparison with Market Alternatives

Therapy Type Key Attributes Efficacy Resistance Profile Regulatory Status
FLAGYL (Metronidazole) Broad-spectrum, established, low cost High Increasing in some strains Widely approved, generic predominant
Fidaxomicin Narrower spectrum, approved for CDI High Low Patent-protected, premium pricing
Tinidazole Similar to metronidazole, longer half-life High Similar resistance concerns Approved in some regions, generics available
New Formulations Extended-release prototypes Enhanced safety, compliance Pending Under clinical development

FAQs

Q1: What are the main therapeutic indications for FLAGYL?
A1: FLAGYL is mainly used for bacterial vaginosis, trichomoniasis, Giardia, Entamoeba histolytica infections, and Clostridioides difficile-associated diarrhea.

Q2: How is resistance impacting FLAGYL's efficacy?
A2: Resistance in anaerobic bacteria and C. difficile strains has been reported, leading to reduced susceptibility and the need for combination therapies or alternative agents.

Q3: Are there new formulations of FLAGYL under development?
A3: Yes, sustained-release and combination formulations are in clinical trials, aiming to improve compliance and efficacy.

Q4: What are the major safety considerations?
A4: Common adverse effects include nausea, metallic taste, neurotoxicity, especially with prolonged use. Monitoring is essential in long-term treatments.

Q5: How does the market outlook for FLAGYL compare with newer antibiotics?
A5: While generic FLAGYL remains cost-effective and broadly used, its market share is challenged by newer agents with improved resistance profiles, leading to a cautious growth trajectory.

Key Takeaways

  • Clinical trials are focusing on novel formulations and combating resistance, signaling ongoing innovation.
  • The global market remains substantial but faces headwinds from resistance, safety concerns, and competition.
  • The growth trajectory (2023-2028) projects modest but steady expansion driven by emerging markets and formulation improvements.
  • Strategic investments in formulation development and resistance management are critical for maintaining market share.
  • Regulatory collaboration is essential to expedite approval pathways for innovative FLAGYL products.

References

  1. Market Research Future. "Metronidazole Market Analysis & Forecast 2022-2027." Published 2022.
  2. ClinicalTrials.gov. "Database of Clinical Trials." Accessed Q1 2023.
  3. Robinson, J., et al. "Resistance mechanisms in anaerobic bacteria." Clinical Microbiology Reviews, 2022.
  4. WHO, "WHO Model List of Essential Medicines." 2021.

This report offers a strategic overview and actionable insights into FLAGYL's clinical and commercial outlook, equipping stakeholders to navigate evolving market dynamics effectively.

More… ↓

⤷  Get Started Free

Make Better Decisions: Try a trial or see plans & pricing

Drugs may be covered by multiple patents or regulatory protections. All trademarks and applicant names are the property of their respective owners or licensors. Although great care is taken in the proper and correct provision of this service, thinkBiotech LLC does not accept any responsibility for possible consequences of errors or omissions in the provided data. The data presented herein is for information purposes only. There is no warranty that the data contained herein is error free. We do not provide individual investment advice. This service is not registered with any financial regulatory agency. The information we publish is educational only and based on our opinions plus our models. By using DrugPatentWatch you acknowledge that we do not provide personalized recommendations or advice. thinkBiotech performs no independent verification of facts as provided by public sources nor are attempts made to provide legal or investing advice. Any reliance on data provided herein is done solely at the discretion of the user. Users of this service are advised to seek professional advice and independent confirmation before considering acting on any of the provided information. thinkBiotech LLC reserves the right to amend, extend or withdraw any part or all of the offered service without notice.