Tinidazole: Potent Antimicrobial Therapy for Anaerobic and Protozoal Infections
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Synonyms
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Tinidazole is a second-generation nitroimidazole antimicrobial agent renowned for its broad-spectrum activity against anaerobic bacteria and protozoa. It is a vital therapeutic option in the management of a range of infections, from bacterial vaginosis and giardiasis to amoebiasis and trichomoniasis. Its extended half-life and favorable pharmacokinetic profile often allow for shorter, simpler treatment regimens compared to older agents, potentially improving patient adherence and clinical outcomes.
Features
- Active pharmaceutical ingredient: Tinidazole
- Belongs to the nitroimidazole class of antimicrobials
- Available in oral tablet formulations (commonly 500mg)
- Exhibits broad-spectrum activity against anaerobic bacteria and protozoa
- Possesses a long elimination half-life of approximately 12–14 hours
- Demonstrated efficacy in single-dose or short-course regimens for certain indications
Benefits
- Provides effective and rapid eradication of susceptible anaerobic and protozoal pathogens
- Enables convenient, often single-dose, treatment schedules that support patient compliance
- Reduces the risk of disease transmission in sexually transmitted infections like trichomoniasis
- Helps alleviate distressing symptoms such as diarrhea, abdominal discomfort, and vaginal discharge
- Contributes to decreased incidence of complications from untreated parasitic and anaerobic infections
- Offers a well-tolerated therapeutic alternative with a generally predictable safety profile
Common use
Tinidazole is indicated for the treatment of trichomoniasis caused by Trichomonas vaginalis in both female and male patients. It is also used for the management of giardiasis due to Giardia duodenalis (also known as G. lamblia), amoebiasis (intestinal and extraintestinal) caused by Entamoeba histolytica, and bacterial vaginosis in adult women. Additionally, it may be employed for the treatment of anaerobic bacterial infections, such as those occurring in the abdomen, skin and soft tissues, bones and joints, and central nervous system, when caused by susceptible organisms.
Dosage and direction
Dosage must be individualized based on the infection being treated, patient factors, and clinical response. For trichomoniasis: a single 2g oral dose taken with food. For giardiasis: a single 2g dose. For intestinal amoebiasis: 2g once daily for 3 days; for amoebic liver abscess: 2g once daily for 3–5 days. For bacterial vaginosis: 2g once daily for 2 days, or 1g once daily for 5 days. Tinidazole should be taken with food to minimize gastrointestinal upset. Complete the full course of therapy even if symptoms improve earlier.
Precautions
Use with caution in patients with central or peripheral nervous system diseases, as neurologic adverse effects may occur. Blood dyscrasias have been reported; monitor blood counts if prolonged therapy is used. Avoid alcohol consumption during treatment and for at least 3 days after the last dose due to the risk of a disulfiram-like reaction. Use in pregnancy should be avoided during the first trimester; use in later trimesters only if clearly needed. Tinidazole is secreted in breast milk; interrupt breastfeeding during treatment and for 3 days after the last dose.
Contraindications
Tinidazole is contraindicated in patients with known hypersensitivity to tinidazole, other nitroimidazole derivatives, or any component of the formulation. It should not be administered to patients in the first trimester of pregnancy. Concomitant use with alcohol or products containing propylene glycol is contraindicated. Use is also contraindicated in patients with organic neurological disorders.
Possible side effect
Common adverse reactions may include metallic taste, nausea, vomiting, anorexia, epigastric discomfort, and dizziness. Less frequently, patients may experience headache, fatigue, constipation, or pruritus. Rare but serious side effects include seizures, peripheral neuropathy, leukopenia, and transient elevated liver enzymes. Allergic reactions such as rash, urticaria, and itching may occur.
Drug interaction
Tinidazole may potentiate the anticoagulant effect of warfarin and other coumarin anticoagulants, requiring close monitoring of prothrombin time. Concurrent use with drugs that induce CYP450 enzymes (e.g., phenobarbital, rifampin) may decrease tinidazole levels. It may increase plasma concentrations of lithium, phenytoin, and cyclosporine. Concomitant use with disulfiram should be avoided due to increased risk of psychotic reactions. Cholestyramine may reduce oral absorption of tinidazole.
Missed dose
If a dose is missed, it should be taken as soon as remembered. However, if it is almost time for the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Doubling the dose to make up for a missed dose is not recommended.
Overdose
There is limited experience with tinidazole overdose. Symptoms may include nausea, vomiting, dizziness, and ataxia. There is no specific antidote; treatment should be symptomatic and supportive. Gastric lavage may be considered if performed soon after ingestion. Hemodialysis may accelerate elimination.
Storage
Store at room temperature, between 15–30°C (59–86°F), in a dry place protected from light. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and individual treatment recommendations. The prescribing physician should be consulted regarding any questions about side effects, interactions, or proper use.
Reviews
Clinical studies and post-marketing surveillance have demonstrated tinidazole to be highly effective and generally well-tolerated in the treatment of protozoal and anaerobic bacterial infections. Healthcare providers often note the advantage of its single-dose regimen for several indications, which supports patient adherence. Some patients report a metallic taste and mild gastrointestinal symptoms as the most common drawbacks, though these are typically transient. Overall, it is regarded as a valuable therapeutic option within its approved indications.