What Is Likmez? Uses, Dosage, and What You Need to Know in 2026

Likmez is a brand-name prescription antibiotic — specifically, a liquid (oral suspension) formulation of the well-known antibiotic metronidazole. It was FDA-approved in September 2023 and is the first and only ready-to-use liquid metronidazole available in the United States. Here's everything you need to know.

What Is Likmez?

Likmez is the brand name for metronidazole oral suspension 500 mg/5 mL. It belongs to the nitroimidazole class of antimicrobial drugs — the same class as Flagyl (the original brand-name metronidazole tablet). The active ingredient in Likmez is metronidazole, which has been used to treat bacterial and parasitic infections since the 1960s.

What makes Likmez unique is its formulation:

• Ready-to-use liquid (no mixing, no refrigeration required)
• Strawberry-peppermint flavor to improve palatability
• Designed specifically for patients with difficulty swallowing tablets (dysphagia) or taste-related adherence issues
• Manufactured by Saptalis Pharmaceuticals (Hauppauge, NY), marketed by Kesin Pharma
• FDA-approved September 25, 2023 under NDA 505(b)(2)

What Is Likmez Used For?

Likmez is FDA-approved to treat three types of infections:

1. Trichomoniasis (adults only)

Trichomoniasis is a sexually transmitted infection (STI) caused by the parasite Trichomonas vaginalis. It affects millions of Americans annually. Likmez treats both symptomatic and asymptomatic trichomoniasis in adult men and women. Because it's an STI, sexual partners should be treated simultaneously to prevent reinfection.

2. Amebiasis (adults and pediatric patients)

Amebiasis is an intestinal infection caused by the parasite Entamoeba histolytica. It can cause acute intestinal amebiasis (amoebic dysentery) with diarrhea, cramping, and bloody stools, or amebic liver abscess — a more serious complication. Likmez is FDA-approved for both forms in adults and pediatric patients.

3. Anaerobic bacterial infections (adults only)

Anaerobic bacteria are organisms that don't require oxygen to survive. Likmez treats serious anaerobic infections including intra-abdominal infections (peritonitis, liver abscess), skin and soft tissue infections, gynecologic infections (endometritis, tubo-ovarian abscess), CNS infections (meningitis, brain abscess), lower respiratory tract infections, endocarditis, and bone/joint infections.

Likmez Dosage Guide

Always follow your doctor's specific dosing instructions. The following are the FDA-approved doses:

Trichomoniasis (adults):

• One-day: 2g (20 mL) as a single dose or two 1g (10 mL) doses on the same day
• Seven-day: 250 mg (2.5 mL) three times daily for 7 days

Amebiasis (adults):

• Acute intestinal (dysentery): 750 mg (7.5 mL) three times daily for 5-10 days
• Liver abscess: 500-750 mg (5-7.5 mL) three times daily for 5-10 days

Amebiasis (pediatric patients):

• 35-50 mg/kg per 24 hours divided into 3 doses, for 10 days (maximum 2250 mg/day, max 750 mg per dose)

Anaerobic bacterial infections (adults):

• 7.5 mg/kg every 6 hours (approximately 500 mg/5 mL for a 70 kg patient), maximum 4g (40 mL)/day, for 7-10 days (longer for some infection types)

How to Take Likmez Correctly

• Shake well before each dose
• Use a calibrated measuring device — never a household spoon
• Can be taken with or without food (take with food to reduce nausea)
• Store at room temperature — do not refrigerate or freeze
• Discard unused portion 10 days after first opening
• Complete the full course even if you feel better
• Avoid all alcohol during treatment and for 3 days after the last dose

Likmez vs. Generic Metronidazole: What's the Difference?

Likmez contains the same active ingredient as generic metronidazole — they are bioequivalent for patients who can use either form. The key differences are:

• Likmez is a liquid suspension; generic metronidazole comes mainly as tablets or capsules
• Likmez costs $207-$246 vs. $5-$10 for generic tablets
• Generic tablets are widely stocked; Likmez must often be ordered or sought at specific pharmacies
• Likmez does not require refrigeration; older compounded liquid versions often did

To learn more about how Likmez works at the cellular level, read: How Does Likmez Work? Mechanism of Action Explained in Plain English.

If you've been prescribed Likmez and are having trouble finding it, medfinder can help locate it at a pharmacy near you.