nitazoxanide


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nitazoxanide

(nit-a-zox-a-nide) ,

Alinia

(trade name)

Classification

Therapeutic: antiprotozoals
Pharmacologic: benzamides
Pregnancy Category: B

Indications

Treatment of diarrhea due to Cryptosporidium parvum and Giardia lamblia.Not effective for C. Parvum diarrhea in HIV-infected patients.

Action

Interferes with electron transfer reaction necessary for anaerobic energy metabolism of offending organisms.

Therapeutic effects

Antiprotozoal action resulting in decreased diarrhea.

Pharmacokinetics

Absorption: Following oral administration, nitazoxanide is rapidly converted to tizoxanide which is the active metabolite; tizoxanide is further metabolized.
Distribution: Unknown.
Protein Binding: >99%.
Metabolism and Excretion: Tizoxanide—excreted in urine, bile and feces; inactive metabolites excreted in urine, bile and feces.
Half-life: Unknown.

Time/action profile (blood levels)

ROUTEONSETPEAKDURATION
POunknown†1–4 hr12 hr
†Onset of antidiarrheal activity is 24–48 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity.
Use Cautiously in: Hepatic and/or renal impairment; Diabetics (contains 1.48 g sucrose/5 mL); Children <1 pregnancy or lactation (safety not established).

Adverse Reactions/Side Effects

Central nervous system

  • dizziness

Ear, Eye, Nose, Throat

  • yellow eye discoloration

Gastrointestinal

  • abdominal pain
  • diarrhea
  • vomiting

Genitourinary

  • discolored urine

Dermatologic

  • pruritus
  • sweating

Miscellaneous

  • fever

Interactions

Drug-Drug interaction

May interact with other highly protein-bound drugs by competing for binding sites.

Route/Dosage

Oral (Adults and children ≥ 12 yr) 500 mg every 12 hr for 3 days.
Oral (Children 4–11 yr) 200 mg (10 mL) every 12 hr for 3 days.
Oral (Children 1–4 yr) 100 mg (5 mL) every 12 hr for 3 days.

Availability

Tablets: 500 mg
Oral suspensionstrawberry: 100 mg/5 mL in 60 mL bottle

Nursing implications

Nursing assessment

  • Assess frequency and consistency of stools and bowel sounds before and during therapy.
  • Assess fluid and electrolyte balance and skin turgor for dehydration.

Potential Nursing Diagnoses

Diarrhea (Indications)

Implementation

  • Oral: Administer with food. Keep container tightly closed and shake well before each administration. Suspension may be stored at room temperature for 7 days; discard unused portion.
    • Pedi: Tablets contain more than pediatric dose; use solution for patients ≤12 years.

Patient/Family Teaching

  • Explain to parents administration of medication and monitoring of condition.

Evaluation/Desired Outcomes

  • Resolution of symptoms: no watery stools, no more than 2 soft stools within the past 24 hr and no unformed stools within the past 48 hr.

nitazoxanide

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

nitazoxanide

A synthetic salicylamide derivative and antiprotozoal that is active against Cryptosporidium parvum or Giardia lamblia infection, and which appears to also have activity against hepatitis B and hepatitis C.

nitazoxanide

A thiazolide anti-infective drug used to treat diarrhoea caused by Cryptosporidium parvum , Giardia lamblia, Entamoeba histolytica , Blastocystis hominis , Clostridium difficile and rotavirus.
References in periodicals archive ?
The only available medicine for the illness, Nitazoxanide, has demonstrated poor efficacy when used in the treatment of vulnerable infants and immune-compromised patients.
EFFECTIVENESS OF NITAZOXANIDE FOR Giardia spp IN KENNEL OF CALDAS, ANTIOQUIA, COLOMBIA
Fascioliasis and intestinal parasitoses affecting school children in Atlixco, Puebla State, Mexico: epidemiology and treatment with nitazoxanide.
The antimicrobials tested in this study were: metronidazole (Sigma-Aldrich), moxifloxacin (Sigma-Aldrich), nitazoxanide (Farmoquimica), teicoplanin (Sigma-Aldrich), tigecycline (Pfizer), and vancomycin (Sigma-Aldrich).
After some improvement, the patient was discharged home and instructed to complete therapy with nitazoxanide and ciprofloxacin.
Shafi, First- derivative UV-Spectrophotometric Determination of Nitazoxanide in Pharmaceutical Formulations, J.
2003) studied the in vitro parasiticidal effect of nitazoxanide (NTZ) on Echino coccus multilocularis metacestodes using electron microscopy.
Metronidazole, cotrimoxazole or nitazoxanide have been shown to successfully eradicate Blastocystis hominis from stool specimens and also relieve symptoms related to irritable bowel syndrome.
These include praziquantel, ivermectin, pyrantel pamoate, albendazole, nitazoxanide, and iodoquinol.
In one study, the H pylori eradication rate for a 7-day course of LOAD therapy--levofloxacin and doxycydine taken once a day, omeprazole before breakfast, and nitazoxanide twice daily--was 90% vs 73.
Prevalence of intestinal protozoa infection among school-aged children on Pemba Island, Tanzania, and effect of single-dose albendazole, nitazoxanide and albendazole-nitazoxanide.