nitazoxanide

nitazoxanide,

an antiprotozoal agent used to treat diarrhea caused by Cryptosporidium parvum or Giardia lamblia.

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nitazoxanide

Alinia

Pharmacologic class: Antiprotozoal

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Impedes pyruvate:ferredoxin oxidoreductase enzyme-dependent electron transfer reaction, which is essential to anaerobic energy metabolism

Availability

Oral suspension: 100 mg/5 ml

Tablets: 500 mg

⊘Indications and dosages

➣ Diarrhea caused by Giardia lamblia or Cryptosporidium parvum

Adults and children ages 12 and older: 500 mg (tablet or 25 ml suspension) P.O. every 12 hours with food for 3 days

Children ages 4 to 11: 200 mg (10 ml suspension) P.O. every 12 hours with food for 3 days

Children ages 1 to 3: 100 mg (5 ml suspension) P.O. every 12 hours with food for 3 days

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• renal, hepatic, or biliary disease or dysfunction; immunodeficiency (including human immunodeficiency virus); diabetes mellitus (suspension)
• concurrent use of warfarin or other highly plasma protein-bound drugs
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 11 (tablets) or age 1 (suspension).

Administration

• Give with food.
• Because a single tablet contains more nitazoxanide than recommended for pediatric dosing, don't give tablets to children younger than age 11.
• Keep suspension container tightly closed and shake well before each use. Suspension may be stored for 7 days; after that, discard unused portion.

Route	Onset	Peak	Duration
P.O.	Unknown	1-4 hr	Unknown

Adverse reactions

CNS: headache

GI: nausea, vomiting, diarrhea, abdominal pain

Interactions

Drug-drug. Warfarin and other highly plasma protein-bound drugs with narrow therapeutic index: competition for binding sites, resulting in increased nitazoxanide blood level and efficacy

Patient monitoring

• Monitor renal and liver function tests frequently in patients with renal, hepatic, or biliary dysfunction.
• Monitor blood glucose levels in diabetic patients taking oral suspension.

Patient teaching

• Instruct patient to take drug with food.
• Inform diabetic patient that oral suspension contains sucrose.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.