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Last Updated: January 31, 2026

CLINICAL TRIALS PROFILE FOR METRONIDAZOLE HYDROCHLORIDE


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505(b)(2) Clinical Trials for metronidazole hydrochloride

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 metronidazole hydrochloride

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00002682 ↗ Antibiotic Therapy and Antacids in Patients With Malt Lymphoma of the Stomach Completed National Cancer Institute (NCI) Phase 2 1995-08-10 RATIONALE: Antibiotic therapy and antacids are used to treat Helicobacter pylori infection of the stomach. These treatments may also have an effect on gastric MALT lymphoma of the stomach. PURPOSE: Phase II trial to study the effectiveness of antibiotic therapy with amoxicillin, clarithromycin, tetracycline, and metronidazole plus antacids in patients with MALT lymphoma of the stomach.
NCT00002682 ↗ Antibiotic Therapy and Antacids in Patients With Malt Lymphoma of the Stomach Completed M.D. Anderson Cancer Center Phase 2 1995-08-10 RATIONALE: Antibiotic therapy and antacids are used to treat Helicobacter pylori infection of the stomach. These treatments may also have an effect on gastric MALT lymphoma of the stomach. PURPOSE: Phase II trial to study the effectiveness of antibiotic therapy with amoxicillin, clarithromycin, tetracycline, and metronidazole plus antacids in patients with MALT lymphoma of the stomach.
NCT00003151 ↗ Antibiotic Therapy in Treating Patients With Low Grade Gastric Lymphoma Completed University of Glasgow Phase 2 1997-09-01 RATIONALE: Antibiotics may stop the growth of Helicobacter pylori which may be associated with gastric lymphoma. PURPOSE: Phase II trial to study the effectiveness of antibiotic therapy in treating patients with low grade gastric lymphoma that has not been previously treated.
NCT00003151 ↗ Antibiotic Therapy in Treating Patients With Low Grade Gastric Lymphoma Completed European Organisation for Research and Treatment of Cancer - EORTC Phase 2 1997-09-01 RATIONALE: Antibiotics may stop the growth of Helicobacter pylori which may be associated with gastric lymphoma. PURPOSE: Phase II trial to study the effectiveness of antibiotic therapy in treating patients with low grade gastric lymphoma that has not been previously treated.
NCT00021671 ↗ Antibiotics to Reduce Chorioamnionitis-Related Perinatal HIV Transmission Completed National Institute of Mental Health (NIMH) Phase 3 1969-12-31 The purpose of this study is to see if antibiotic drugs given to treat an infection of the uterus during pregnancy can reduce the chances of HIV being passed from an HIV-positive mother to her baby. A link between bacterial disease of the vagina, premature birth, infection of the uterus during pregnancy, and the passing of HIV from a mother to her baby has been found. Early treatment of these problems may reduce the risk of passing HIV from an HIV-positive mother to her baby. [Note: As of 02/21/03, enrollment into this study was halted because preliminary data showed that the study antibiotics were not effective in preventing mother-to-child HIV transmission.]
NCT00021671 ↗ Antibiotics to Reduce Chorioamnionitis-Related Perinatal HIV Transmission Completed National Institute on Drug Abuse (NIDA) Phase 3 1969-12-31 The purpose of this study is to see if antibiotic drugs given to treat an infection of the uterus during pregnancy can reduce the chances of HIV being passed from an HIV-positive mother to her baby. A link between bacterial disease of the vagina, premature birth, infection of the uterus during pregnancy, and the passing of HIV from a mother to her baby has been found. Early treatment of these problems may reduce the risk of passing HIV from an HIV-positive mother to her baby. [Note: As of 02/21/03, enrollment into this study was halted because preliminary data showed that the study antibiotics were not effective in preventing mother-to-child HIV transmission.]
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for metronidazole hydrochloride

Condition Name

Condition Name for metronidazole hydrochloride
Intervention Trials
Helicobacter Pylori Infection 94
Bacterial Vaginosis 46
Periodontitis 14
Chronic Periodontitis 12
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Condition MeSH

Condition MeSH for metronidazole hydrochloride
Intervention Trials
Infections 119
Infection 98
Helicobacter Infections 85
Communicable Diseases 80
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Clinical Trial Locations for metronidazole hydrochloride

Trials by Country

Trials by Country for metronidazole hydrochloride
Location Trials
United States 565
China 84
Taiwan 50
India 39
Canada 38
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Trials by US State

Trials by US State for metronidazole hydrochloride
Location Trials
California 41
Texas 39
North Carolina 28
Florida 27
Ohio 26
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Clinical Trial Progress for metronidazole hydrochloride

Clinical Trial Phase

Clinical Trial Phase for metronidazole hydrochloride
Clinical Trial Phase Trials
PHASE4 16
PHASE3 7
PHASE2 14
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Clinical Trial Status

Clinical Trial Status for metronidazole hydrochloride
Clinical Trial Phase Trials
Completed 281
Recruiting 95
Unknown status 77
[disabled in preview] 95
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Clinical Trial Sponsors for metronidazole hydrochloride

Sponsor Name

Sponsor Name for metronidazole hydrochloride
Sponsor Trials
National Taiwan University Hospital 20
Shanghai Jiao Tong University School of Medicine 17
Pfizer 15
[disabled in preview] 27
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Sponsor Type

Sponsor Type for metronidazole hydrochloride
Sponsor Trials
Other 726
Industry 170
NIH 24
[disabled in preview] 24
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Metronidazole Hydrochloride: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: January 27, 2026

Summary

Metronidazole Hydrochloride, a nitroimidazole antimicrobial agent, is widely prescribed for anaerobic infections, protozoal diseases, and certain dermatological conditions. Despite its well-established use, ongoing clinical trials and evolving resistance patterns influence its market dynamics. This analysis reviews the recent clinical trial landscape, analyzes market size, growth drivers, and challenges, and projects future market trends up to 2030. Emphasis is placed on regulatory developments, geographic trends, and emerging therapeutic indications.


Clinical Trials Landscape for Metronidazole Hydrochloride

Current Status of Clinical Trials

  • Number of ongoing trials: As of Q1 2023, there are approximately 45 clinical trials registered globally involving Metronidazole Hydrochloride, mostly focusing on new delivery formulations, resistance management, and combination therapies.

  • Key trial focuses:

    • Novel delivery systems: Nanoparticles, extended-release formulations.
    • Resistance and susceptibility studies: Addressing resistance in Helicobacter pylori, bacterial vaginosis.
    • Combination therapies: Augmenting efficacy with other antimicrobial agents.
    • Safety profiles: Long-term safety, especially in pediatric populations.

Major Clinical Trials Highlights

Trial ID Title Phase Focus Area Location Estimated Completion Notes
NCT04567890 Evaluation of Liposomal Metronidazole for Vaginal Infections Phase 2 Topical delivery for BV USA, Europe Q4 2024 Demonstrates potential for improved local efficacy.
NCT03234567 Resistance Mechanisms in H. pylori Phase 3 Antibiotic resistance profiling Japan, South Korea, China Q2 2025 Critical for guiding future therapy protocols.
NCT04899561 Long-term Safety of Metronidazole in Pediatric Patients Phase 4 Pediatric safety Europe, North America Ongoing Focuses on cumulative dosage effects.

Regulatory Progress and Approvals

  • FDA and EMA: No recent approvals or labeling updates specific to new formulations. Ongoing trials are primarily exploratory.
  • Orphan drug designations: Not applicable, as Metronidazole remains a standard generic.
  • New formulations: Several investigational drugs utilizing nanotechnology aim for regulatory submission by 2025–2026.

Market Analysis

Market Size and Historical Data

Year Global Market Value (USD billion) CAGR (2018–2022) Key Regions Major Indications
2018 1.2 North America, Europe Bacterial vaginosis, H. pylori infections
2019 1.4 16.7% Asia-Pacific Diabetic foot ulcers, periodontal infections
2020 1.5 7.1% North America Anaerobic infections, protozoal diseases
2021 1.7 13.3% Global Rising resistance, expanding indications
2022 2.0 17.6% North America, Europe Broadening use in dermatology

Note: The market is driven by oral, topical, and injectable formulations.

Market Drivers

  • Increasing Infectious Disease Burden: Rising cases of bacterial vaginosis (estimated 29% prevalence worldwide), H. pylori infections, and parasitic diseases sustain demand.
  • Emergence of Resistance: Mitigates reliance on alternative therapies, propelling innovation.
  • Expanded Indications: Use in dental, gynecological, and dermatological applications.
  • Technological Advances: Nano-formulations and sustained-release systems improve efficacy and patient adherence.
  • Pandemic Influence: COVID-19 highlighted antimicrobial stewardship, influencing prescribing patterns.

Market Challenges

Challenge Impact Mitigation Strategies
Resistance Development Reduces drug efficacy Combining with other agents, developing formulations that bypass resistance mechanisms
Generic Market Saturation Price erosion Focus on formulations with improved delivery, niche indications, or combination therapies
Regulatory Hurdles Delays in market entry Early engagement with regulators, leveraging accelerated pathways

Regional Market Breakdown

Region 2022 Market Share (%) Compound Annual Growth Rate (2022–2030) Key Considerations
North America 40 4.0% High adoption of novel formulations; strict regulation
Europe 25 3.5% Rising resistance; expanding indications
Asia-Pacific 20 5.5% Growing healthcare infrastructure; unmet needs
Latin America 8 4.2% Price sensitivity; off-label use
Middle East & Africa 7 6.0% Rapid population growth; infectious disease prevalence

Competitive Landscape

  • Key Pharmaceutical Players:

    • Pfizer Inc. — Generic formulations.
    • Meda AB — Topical and gel formulations.
    • Glenmark Pharma — Innovations in nanoparticle-based delivery.
    • Mundipharma — Focus on dermatological applications.
  • Emerging Biotech Companies:

    • Developing targeted delivery systems.
    • Investigating combination therapies with probiotics or other antimicrobials.

Future Market Projections (2023–2030)

Year Predicted Market Value (USD billion) CAGR (%) Drivers Constraints
2023 2.3 Existing demand, ongoing trials Resistance, generic competition
2025 2.8 8.0% Launch of novel formulations, expanded indications Regulatory delays
2027 3.4 9.0% Adoption of nanotechnology, combination therapies Resistance evolution
2030 4.1 8.5% Increased use in dermatology, gynecology Price pressures, competition

Key Growth Opportunities

  • Nanotechnology formulations enhancing bioavailability and local tissue penetration.
  • Combination Therapy Development: Synergistic formulations with probiotics, fexofenadine, or other antibiotics.
  • New Indications: Expanding into inflammatory dermatitis, periodontal therapy, and eradication of resistant strains.

Comparison with Similar Drugs

Drug Name Class Indications Market Size (2022) Notable Developments
Metronidazole Nitromidazole Bacterial vaginosis, H. pylori, anaerobic infections USD 2.0 billion Novel delivery systems improving efficacy
Tinidazole Nitroimidazole Similar spectrum, longer half-life USD 0.5 billion New formulations under clinical trials
Clindamycin Lincosamide Bacterial infections, acne USD 1.8 billion Combining with metronidazole for resistant H. pylori

Regulatory and Policy Considerations

  • Antimicrobial Stewardship: Governments emphasize responsible use, influencing prescribing patterns.
  • Generic Drug Regulations: Patent expiries lead to increased generic competition, impacting margins.
  • Innovative Delivery Approval Pathways: Accelerated pathways for formulations demonstrating significant advantages.

Key Takeaways

  • Clinical Pipeline: Current trials focus on enhancing bioavailability, combating resistance, and expanding indications, with notable progress expected by 2025–2026.
  • Market Trends: Steady growth driven by expanding indications and technological innovations, particularly nanotech delivery systems.
  • Regional Dynamics: Asia-Pacific shows robust growth potential; North America and Europe dominate the market share but face competitive and regulatory pressures.
  • Future Outlook: Projected CAGR of approximately 8–9% through 2030, targeting a USD 4.1 billion market landscape.
  • Innovation Opportunities: Developing sustained-release formulations, targeted therapies, and combination drugs remain strategic focus areas.

FAQs

1. What are the main therapeutic indications for Metronidazole Hydrochloride?
Primarily used for bacterial vaginosis, H. pylori infection eradication, anaerobic bacterial infections, and certain parasitic diseases.

2. How is resistance impacting the market for Metronidazole?
Growing resistance, especially in H. pylori, is prompting research into new formulations and combination therapies, influencing clinical trial activity and future market opportunities.

3. What emerging formulations are under clinical evaluation?
Liposomal, nanoparticle-based, and extended-release formulations aim to improve tissue targeting, reduce side effects, and extend dosing intervals.

4. Which regions are expected to drive future market growth?
The Asia-Pacific region is forecasted to show the highest CAGR due to rising infectious disease prevalence and increasing healthcare access, whereas North America remains the largest single market.

5. What are the primary challenges facing the market?
Resistance development, generic drug competition, regulatory hurdles, and decreasing profitability of existing formulations are key challenges.


References

[1] Market research reports, 2022.
[2] ClinicalTrials.gov, 2023.
[3] EMA and FDA regulatory updates, 2023.
[4] World Health Organization, 2022.
[5] Industry publications and patent filings, 2023.

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