nitazoxanide
nitazoxanide
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.
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.