What is the one day pill for BV?: A guide to single-dose treatment

October 8, 2025 •

3 min read

Bacterial vaginosis (BV) affects millions of women, and non-adherence to multi-day antibiotic regimens can sometimes lead to treatment failure. Fortunately, the one day pill for BV, known as secnidazole, offers a convenient single-dose oral solution for many patients.

Quick Summary

Solosec (secnidazole) is the single-dose oral antibiotic used to treat bacterial vaginosis. It is consumed as granules mixed with soft food. This treatment offers convenience, but requires consideration of cost, side effects, and adherence to specific administration instructions.

Key Points

Secnidazole is the one day pill: The single-dose oral medication for BV is secnidazole, sold under the brand name Solosec.
Method of Administration: The 2-gram dose comes as granules that must be sprinkled on soft food like applesauce and swallowed without chewing.
High Adherence: The primary advantage of this one-day treatment is its ability to improve patient adherence compared to multi-day regimens.
Potential Side Effects: Common side effects include vulvovaginal candidiasis (yeast infection), a metallic taste in the mouth, and nausea.
Alcohol Precaution: Patients must avoid consuming alcohol during and for at least 48 hours after treatment to prevent adverse reactions.
Cost vs. Convenience: While convenient, single-dose secnidazole is considerably more expensive than traditional multi-day generic metronidazole.

Understanding the One Day Pill for BV

Bacterial vaginosis (BV) is a common vaginal infection caused by an imbalance of bacteria in the vagina. While various multi-day treatment options are available, a single-dose oral medication can offer advantages in terms of convenience and adherence. The medication referred to as the one day pill for BV is secnidazole, available under the brand name Solosec. This medication is FDA-approved for treating BV in adult women and provides a complete course of therapy in a single oral dose.

The Pharmacology of Secnidazole

Secnidazole belongs to the nitroimidazole class of antimicrobials. It works by entering bacterial cells and damaging their DNA, which leads to the death of the bacteria causing BV. Its longer half-life compared to similar drugs allows for effective single-dose treatment.

How to Take the Single Dose

Proper administration is essential for the medication's effectiveness. Secnidazole is provided as a single 2-gram packet of granules.

Sprinkle the entire packet onto a soft food like applesauce or yogurt.
Consume the mixture within 30 minutes of preparation.
Do not chew or crunch the granules.
You may drink a glass of water afterward, but do not dissolve the granules in liquid.

Effectiveness and Efficacy

Studies have shown the effectiveness of a single dose of secnidazole for BV. One trial found that a single 2-gram dose was at least as effective as a 7-day course of metronidazole.

Clinical cure rates with secnidazole can be around 50% several weeks post-treatment.
The single-dose approach aims to improve patient adherence, a factor that can contribute to treatment failure and recurring BV.

Potential Side Effects and Precautions

Secnidazole is generally well-tolerated, but it can cause side effects. Being aware of these and taking necessary precautions is important.

Common Side Effects

Commonly reported side effects include a metallic taste, nausea, upset stomach, headache, and vaginal yeast infection. Taking the medication with food can help reduce some gastrointestinal symptoms.

Important Precautions

Alcohol: Avoid alcohol during treatment and for at least 48 hours after the dose to prevent adverse reactions.
Breastfeeding: Breastfeeding is not advised for 96 hours after taking secnidazole.
Allergies: Do not take secnidazole if you are allergic to it or other similar antibiotics.
Carcinogenicity: While the risk with a single dose in humans is unknown, related drugs have shown links to tumors in rodents with chronic use; long-term use should be avoided.

Single-Dose vs. Multi-Dose BV Treatment

The choice between treatment types involves considering factors such as cost, convenience, and individual health history.


Feature	Secnidazole (Solosec) - Single Dose	Metronidazole (Flagyl) - Multi-Dose
Dosing Schedule	One single oral dose of granules.	Oral tablets taken twice daily for 5-7 days.
Convenience & Adherence	High convenience and adherence due to single-dose regimen.	Potential for lower adherence due to extended dosing schedule.
Cost	Considerably more expensive than generic metronidazole.	More affordable, especially for generic versions.
Administration	Granules sprinkled on soft food.	Traditional oral tablets.
Side Effects	Common side effects include yeast infection, metallic taste, nausea.	Common side effects include nausea, metallic taste, headaches.
Patient Profile	Good option for patients concerned about remembering multiple doses.	Preferred by many clinicians and patients for its lower cost and extensive track record.

Conclusion

Secnidazole (Solosec), the one day pill for BV, provides a convenient single-dose treatment option for bacterial vaginosis, potentially improving adherence. However, it is typically more expensive than multi-day treatments and has its own set of potential side effects and precautions. Always consult with a healthcare provider to determine the most appropriate treatment for your individual needs, considering the benefits of convenience against cost and the efficacy of other available therapies. For detailed information, refer to the prescribing information provided by the manufacturer.

Frequently Asked Questions

The single-dose oral medication for bacterial vaginosis (BV) is secnidazole, which is sold under the brand name Solosec.

Secnidazole comes as granules in a packet. You sprinkle the entire contents of the packet onto a small amount of soft food, such as applesauce, yogurt, or pudding, and consume it within 30 minutes without chewing.

Clinical studies have found that a single dose of secnidazole can be comparably effective to a 7-day course of metronidazole for many patients. However, some studies on other single-dose metronidazole regimens have shown lower long-term cure rates compared to multi-dose treatments.

Common side effects of secnidazole include vulvovaginal candidiasis (yeast infection), a metallic taste in the mouth (dysgeusia), nausea, diarrhea, and headache.

No, you must avoid alcohol during and for at least 2 days (48 hours) after taking secnidazole to prevent severe adverse reactions like nausea, vomiting, and flushing.

The safety of secnidazole in pregnancy is not well-established, and breastfeeding is not recommended for 96 hours after taking the dose. Always consult a healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding.

A healthcare provider might prescribe the one-day pill for patients who prefer the convenience of a single dose, have difficulty adhering to multi-day regimens, or have experienced side effects with other BV treatments.

While the antibiotic gets absorbed into the body relatively quickly, it may take several days or up to two weeks for symptoms to start improving significantly as the bacterial balance is restored.