Comprehensive medication guide to MetroGel 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 metronidazole topical gel on most commercial and Medicare Part D plans (Tier 1–2). Brand-name MetroGel is not typically covered by Medicare Part D.
Estimated Cash Pricing
$78–$186 retail for generic 1% gel (60g); as low as $22–$34 with GoodRx or SingleCare coupons. The 0.75% strength costs $30–$43 retail without a coupon.
Medfinder Findability Score
82/100
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MetroGel is the brand name for metronidazole topical gel, an antibiotic medication applied directly to the skin to treat rosacea. It is manufactured by Galderma and comes in two concentrations: 0.75% gel (applied twice daily) and 1% gel (applied once daily). The 1% formulation is the primary branded MetroGel product.
MetroGel (metronidazole 1% topical gel) is FDA-approved for the treatment of inflammatory lesions (papules and pustules) associated with rosacea — a chronic inflammatory skin condition that causes persistent facial redness, bumps, and visible blood vessels. It belongs to the nitroimidazole class of drugs. Generic versions are FDA-approved and widely available.
MetroGel is not a controlled substance and requires no special DEA authority to prescribe. It is commonly prescribed by dermatologists, primary care physicians, nurse practitioners, and physician assistants. Telehealth prescribers can also prescribe it in most U.S. states.
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The mechanism of action of metronidazole in the treatment of rosacea is not fully established — the FDA labeling states it is "unknown." However, current evidence suggests MetroGel works primarily through anti-inflammatory effects rather than through antibiotic activity. Metronidazole inhibits reactive oxygen species (ROS) and may suppress the inflammatory cascade that causes rosacea flares.
Despite being classified as an antibiotic, minimal metronidazole enters the bloodstream through topical application — peak plasma levels from daily face application are less than 1% of those from a single 250 mg oral dose. This means MetroGel's benefit in rosacea is primarily local (in the skin), with very little systemic antibiotic activity. This is why it is well-tolerated and safe for long-term use.
Most patients see noticeable improvement in 3–4 weeks of consistent use, with maximum results at 10–12 weeks. In pivotal clinical trials, MetroGel 1% reduced inflammatory lesion counts by a mean of 9.4 lesions from baseline over 10 weeks.
1% — topical gel
Applied once daily to affected facial areas. Available in 45g and 60g tubes. Brand-name MetroGel and generic metronidazole 1% gel.
0.75% — topical gel
Applied twice daily (morning and evening) to affected facial areas. Available as generic metronidazole 0.75% gel.
0.75% — topical cream
MetroCream — applied twice daily. Less commonly prescribed than gel formulations.
0.75% — topical lotion
MetroLotion — applied twice daily. Less commonly prescribed.
MetroGel has a findability score of 82 out of 100 — meaning it is generally available, but patients may encounter localized stocking challenges depending on their location and which strength they need. As of 2026, MetroGel is not on any official FDA or ASHP drug shortage list. Generic metronidazole topical gel has multiple manufacturers and is not at supply chain risk.
The main availability challenges are: (1) Brand-name MetroGel is rarely stocked at chain pharmacies, since most have transitioned to generic; (2) The 1% strength generic is not universally stocked — many pharmacies only carry the 0.75% formulation; (3) Some lower-volume pharmacies may occasionally run out of stock between orders.
If you're struggling to find MetroGel at your pharmacy, medfinder can contact pharmacies near you to identify which ones have it in stock. You provide your medication, strength, and location — medfinder handles the calling and texts you results.
MetroGel (metronidazole topical gel) is not a controlled substance and requires no special DEA scheduling authority. Any licensed prescriber in the United States may prescribe it. Providers who commonly prescribe MetroGel for rosacea include:
Dermatologists — skin specialists who most commonly manage rosacea
Primary care physicians (PCPs) — family medicine and internal medicine doctors
Nurse practitioners (NPs) — in dermatology or primary care settings
Physician assistants (PAs) — in dermatology or general practice
MetroGel is widely available through telehealth platforms in 2026. Patients with rosacea can submit photos and a brief history through platforms like Curology, Hims/Hers, Teladoc, or MDLive and receive a prescription without an in-person visit. Telehealth is often the fastest way to get a first MetroGel prescription.
No. MetroGel (metronidazole topical gel) is not a controlled substance and has no DEA scheduling. It does not require any special prescribing authority or DEA registration. Any licensed healthcare provider — including dermatologists, primary care physicians, nurse practitioners, physician assistants, and telehealth providers — can prescribe it without restriction.
There are no limits on how many refills MetroGel can have, and prescriptions can be called in, faxed, or sent electronically without the restrictions that apply to Schedule II–V controlled substances. Patients can also receive 90-day supplies through mail-order pharmacies without restriction.
MetroGel is generally well-tolerated. Most side effects are local skin reactions that tend to improve as the skin adjusts to treatment:
Stinging or burning at the application site
Skin dryness or peeling
Skin irritation or redness
Itchy or scaly skin
Metallic taste in the mouth (occasional despite topical use)
Nausea (rare)
Serious side effects (rare — contact your doctor immediately):
Peripheral neuropathy (numbness, tingling, or weakness in hands/feet)
Allergic contact dermatitis (severe skin reaction — discontinue use)
Eye irritation if product contacts eyes — rinse with water immediately
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Ivermectin cream 1% (Soolantra)
FDA-approved topical rosacea treatment. Studies show superior efficacy to metronidazole in head-to-head trials. Brand-only; more expensive. Once-daily application.
Azelaic acid 15% gel (Finacea) or 20% cream
FDA-approved for rosacea. Generic available. Comparable efficacy to MetroGel. May cause more stinging. Good cost-effective alternative.
Doxycycline (Oracea 40mg)
FDA-approved oral treatment for moderate-to-severe rosacea. Works via anti-inflammatory mechanism. Generic doxycycline is very affordable. Not for pregnant patients.
Minocycline foam 1.5% (Zilxi)
FDA-approved topical rosacea treatment (2020). Once-daily application. Brand-only; expensive; harder to find. Alternative when other topicals are not tolerated.
Prefer MetroGel? We can find it.
Warfarin (Coumadin)
moderateOral metronidazole potentiates warfarin's anticoagulant effect, prolonging prothrombin time. Effect with topical MetroGel is uncertain but inform your prescriber. Monitor INR.
Alcohol
minorOral metronidazole causes disulfiram-like reaction with alcohol. Risk with topical MetroGel is very low due to minimal systemic absorption. Alcohol is also a rosacea trigger.
Lithium
minorOral metronidazole can increase lithium levels. Risk with topical MetroGel is minimal but worth disclosing to your prescriber if you take lithium.
Busulfan
majorOral metronidazole may increase busulfan plasma concentrations to potentially toxic levels. If receiving busulfan chemotherapy, inform your oncologist before using MetroGel.
Cyclosporine
minorOral metronidazole may increase cyclosporine blood levels. Clinical significance with topical MetroGel is very low but worth disclosing.
MetroGel (metronidazole topical gel) remains one of the most established, evidence-backed topical treatments for rosacea. It is safe for long-term use, generally well-tolerated, and available as an affordable generic. While the brand-name version can be expensive and hard to find at most pharmacies, generic metronidazole gel is widely available and typically costs $22–$34 with discount coupons.
Availability challenges with MetroGel are typically due to pharmacy stocking decisions (especially for the 1% strength) and insurance formulary dynamics, not a national drug shortage. Most patients can find it with the right tools and a bit of flexibility about which pharmacy or strength they use.
If you're struggling to fill your MetroGel prescription, medfinder can help. We contact pharmacies near you to find which ones have your specific medication and strength in stock, and text you the results — saving you the time and frustration of calling pharmacy after pharmacy yourself.
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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
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