Tinidazole
Mechanism :
Tinidazole is an anti-infective drug used mainly in the treatment of infections caused by susceptible organisms, particularly anaerobic bacteria and protozoa. It is responsible for disrupting the DNA helical structure, thus inhibiting nucleic acid synthesis.
Indication :
- Amoebiasis
- Giardiasis
- Trichomonas Vaginalis
Contraindications :
Contraindicated in patients with a prior history of hypersensitivity to tinidazole or other nitroimidazole derivatives and during the first trimester of pregnancy. Use with caution and reduce dose in severe hepatic Impairment.
Dosing :
Use in children more than 2 years of age.
Intestinal amoebiasis:
50 mg/kg/day for 3 days orally. Max: 2 g.
Amoebic liver abscess:
50 mg/kg/day for 5 days orally. Max: 2 g.
Giardiasis/trichomonas:
50 mg/kg single dose orally. Max: 2 g.
Adverse Effect :
Nausea, vomiting, unpleasant taste, darkening of urine, drowsiness, dizziness, headache and ataxia, weakness/fatigue/malaise, skin rashes, urticaria, myalgia and arthralgia. During intensive or prolonged therapy, seizures or peripheral neuropathy have occurred. Mild leukopenia and thrombocytopenia have also been reported rarely.
Interaction :
Warfarin: Potentiates anticoagulant effects.
Lithium: Increased levels of lithium may lead to lithium toxicity.
Phenytoin: Increased levels may occur, and levels should be monitored.
Cimetidine: Reduces hepatic metabolism, leading to increased serum levels and potentially increased incidence of side-effects.
Phenobarbital: May significantly decrease serum levels.
Disulfiram: Reaction may occur with alcohol and the alcohol content of concurrently administered medication should be considered.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
20-50 | Dose as in normal renal function |
10-20 | Dose as in normal renal function |
<10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
CAPD | Unknown dialysability, but likely to be dialysed. Dose as in normal renal function |
HD | Dialysed. Dose as in normal renal function |
HDF/High flux | Dialysed. Dose as in normal renal function |
CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
No data are available on tinidazole pharmacokinetics in patients with hepatic impairment. In several studies, the metabolism of metronidazole, a chemically-related nitroimidazole, has been reported to be reduced in patients with hepatic impairment. Administer tinidazole cautiously to patients with hepatic impairment.