Comprehensive medication guide to MetroCream including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic on most commercial and Medicare Part D plans (Tier 1–2); brand MetroCream may require prior authorization and may be Tier 3 or higher.
Estimated Cash Pricing
$42–$93 retail for generic metronidazole 0.75% cream (45g); brand MetroCream $618–$801 retail; generic as low as $24–$43 with GoodRx or SingleCare for a 30-day tube.
Medfinder Findability Score
80/100
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MetroCream is the brand name for metronidazole 0.75% topical cream, a prescription medication used to treat rosacea. It was FDA-approved for the treatment of inflammatory papules and pustules of rosacea in September 1997. MetroCream is classified as a nitroimidazole topical antibiotic with anti-inflammatory properties.
Rosacea is a chronic skin condition causing redness, bumps, and visible blood vessels primarily on the nose, cheeks, forehead, and chin. MetroCream helps reduce the inflammatory component of rosacea — specifically the papules (red bumps) and pustules — through its anti-inflammatory mechanism of action.
Generic metronidazole 0.75% topical cream is FDA-approved and bioequivalent to brand MetroCream. It is widely available at major pharmacies and significantly less expensive than the brand name. MetroCream and its generic are available in a 45-gram tube.
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The exact mechanism by which metronidazole reduces rosacea is not fully understood. The FDA's prescribing information states that the mechanisms "appear to include an anti-inflammatory effect." The leading scientific theory involves metronidazole's role as a reactive oxygen species (ROS) scavenger — it neutralizes the unstable molecules produced by neutrophils (white blood cells) during skin inflammation, breaking the cycle of inflammation that drives rosacea flares.
As a nitroimidazole, metronidazole acts as a prodrug that becomes activated in low-oxygen environments. While this antibacterial mechanism is key in treating internal anaerobic infections, it plays a lesser role in rosacea treatment since skin cells have normal oxygen levels. The anti-inflammatory properties account for most of the therapeutic benefit in rosacea.
Systemic absorption from topical application is minimal — blood levels after applying MetroCream to the face are less than 1% of those seen with a single 250mg oral dose. This low systemic exposure is why MetroCream has a much better tolerability profile than oral metronidazole, with fewer systemic side effects.
0.75% — topical cream
Applied once or twice daily to affected facial areas as a thin layer. Available in 45g tubes.
1% — topical cream
Higher-strength formulation; once-daily application. Also available as generic.
As of 2026, the FDA has not declared a shortage of MetroCream or generic metronidazole topical cream. Generic metronidazole 0.75% cream is manufactured by multiple companies and is widely available at major chain pharmacies including CVS, Walgreens, Walmart, and Rite Aid. The generic has a findability score of 80 out of 100 — generally available, with minor stocking gaps at individual pharmacies.
Brand-name MetroCream is less widely stocked than the generic. Many pharmacies carry only the generic equivalent, and the brand can be harder to locate — particularly at smaller chain locations. Insurance may require prior authorization for the brand, adding another layer of access friction for patients who specifically need MetroCream brand.
If you're having trouble locating MetroCream or generic metronidazole cream at a pharmacy near you, medfinder can contact pharmacies in your area to find which ones have it in stock and text you the results — no hold music, no repeated phone calls.
MetroCream is not a controlled substance and has no DEA scheduling requirements. Any licensed prescriber in the United States with prescriptive authority can prescribe MetroCream for appropriate patients with rosacea. No special DEA registration or controlled substance training is required.
Dermatologists — Most common prescribers; specialists in skin conditions including rosacea
Primary care physicians (PCPs) — Family doctors and internists commonly diagnose and treat mild-to-moderate rosacea
Nurse practitioners (NPs) and physician assistants (PAs) — Have prescriptive authority in most states and can independently prescribe MetroCream
Gynecologists — Occasionally prescribe metronidazole topical for other dermatological needs
Telehealth is a convenient option for obtaining a MetroCream prescription. Rosacea is easily evaluated via photo or video consultation, and platforms like Apostrophe, Curology, Teladoc, and MDLive can connect patients with licensed prescribers who can evaluate their rosacea and prescribe metronidazole cream — often with same-day or next-day turnaround.
No. MetroCream (metronidazole 0.75% topical cream) is not a controlled substance. It is not listed on any DEA controlled substance schedule (I–V) and has no abuse or dependency potential. Metronidazole does not require DEA registration to prescribe, and there are no special refill restrictions, written prescription requirements, or monitoring programs associated with its use.
Because MetroCream is a non-controlled prescription medication, any licensed prescriber — including primary care physicians, nurse practitioners, physician assistants, and telehealth providers — can prescribe it without special DEA authorization. Refills can be called in or sent electronically without the restrictions that apply to Schedule II–V medications.
MetroCream is generally well tolerated. In clinical trials, the total incidence of adverse reactions was approximately 10%, and each individual event occurred in less than 3% of patients. Common side effects are application-site reactions:
Burning or stinging at the application site (most common)
Skin dryness
Skin redness (erythema) at application site
Skin irritation
Itching (pruritus)
Worsening of rosacea (rare)
Peripheral neuropathy — Numbness or tingling in extremities; reported in post-approval use; stop use and contact your doctor immediately if this occurs
Allergic or contact dermatitis — Severe redness, swelling, or blistering beyond the application site
Eye irritation — Avoid contact with eyes; can cause tearing and irritation
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Soolantra (ivermectin 1% cream)
FDA-approved for rosacea; superior efficacy to metronidazole in head-to-head trials; once-daily; brand-only (~$400–$600 retail)
Finacea (azelaic acid 15% gel/foam)
FDA-approved; comparable-to-superior efficacy; generic available; applied twice daily; may cause more application-site burning
Oracea (low-dose doxycycline 40 mg)
FDA-approved oral treatment for rosacea; anti-inflammatory dose; ideal for moderate-to-severe disease; avoid in pregnancy
Mirvaso (brimonidine 0.33% gel)
FDA-approved for facial erythema of rosacea; reduces redness via vasoconstriction; does not treat inflammatory bumps
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Warfarin/Coumarin anticoagulants
moderateOral metronidazole significantly potentiates warfarin; topical effect is minimal due to low absorption but monitor INR if on anticoagulants
Disulfiram (Antabuse)
majorConcurrent use with oral metronidazole associated with psychosis/confusion (major interaction); risk with topical is very low but inform your provider
Alcohol
minorOral metronidazole causes disulfiram-like reaction with alcohol; topical risk is minimal but some providers advise caution; alcohol-containing skincare may increase skin irritation
Lithium
moderateOral metronidazole may increase lithium toxicity; theoretical and very low risk with topical formulation; inform provider if taking lithium
MetroCream (metronidazole 0.75% topical cream) remains one of the most established and widely used treatments for papulopustular rosacea, with an FDA-approval history dating back to 1997. While newer agents like ivermectin cream have demonstrated superior efficacy in clinical trials, metronidazole's long safety record, generic availability, and affordability make it a practical first-line choice for many patients.
The key to success with MetroCream is consistency — applying it once or twice daily as directed for at least 8–12 weeks before evaluating response. Patients who struggle with access should ask about generic substitution (metronidazole 0.75% topical cream), which is widely available and dramatically less expensive, with prices as low as $24–$43 using a GoodRx coupon.
If you're having trouble locating MetroCream at a pharmacy near you, medfinder contacts pharmacies in your area to find which ones can fill your prescription and texts you the results. No more hold music, no more repeated calls — just the information you need to get your rosacea treatment.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
Real-time availability
Medfinder is actively checking pharmacy inventory for MetroCream. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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