20 . January , 2019 - Sunday
Check todays hot topics or new products

Find a Drug: Advanced

Please Sign in or Register

All about: Nitazoxanide

Big Image Pronouncation: (nye-tah-ZOX-ah-nide)
Class: Antiprotozoal

Trade Names:
- Tablets 500 mg
- Oral suspension 100 mg per 5 mL

Mechanism of Action


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



After ingestion, nitazoxanide is converted to the active metabolites tizoxanide and tizoxanide glucuronide. Bioavailability of the suspension is 70% compared with the tablet. Pharmacokinetics of tizoxanide following administration of nitazoxanide 500 mg tablet with food in adults or children 12 yr of age and older is: C max 10.6 and 9.1 mcg/mL, respectively; T max is 3 and 4 hr, respectively; AUC is 41.9 and 39.5 mcg•hr/mL. For tizoxanide glucuronide, corresponding values are: C max 10.5 and 7.3 mcg/mL, respectively; T max of 4.5 and 4 hr, respectively; AUC of 63 and 46.5 mcg•hr/mL, respectively. Absorption of tizoxanide following administration of the oral suspension with food to children 4 to 11 yr of age or 1 to 3 yr of age is: C max 3 and 3.11 mcg/mL, respectively; T max 2 and 3.5 hr, respectively; AUC 13.5 and 11.7 mcg•hr/mL, respectively. For tizoxanide glucuronide, corresponding values are: C max 2.84 and 3.64 mcg/mL, respectively; T max 4 hr in both age groups; and AUC 16.9 and 19 mcg•hr/mL, respectively.


Tizoxanide is more than 99% protein bound.


Nitazoxanide is rapidly hydrolyzed to an active metabolite, tizoxanide, which then undergoes conjugation, primarily by glucuronidation, to an active metabolite.


Approximately 67% of the oral dose of nitazoxanide is excreted in the feces and 33% in the urine. Tizoxanide is excreted in the urine, bile, and feces, while tizoxanide glucuronide is excreted in the urine and bile.

Indications and Usage

Treatment of diarrhea caused by Giardia lamblia or Cryptosporidium parvum .


Standard considerations.

Dosage and Administration

Diarrhea caused by G. lamblia
Adults and Children 12 yr of age and older

PO 500 mg q 12 hr with food.

Children 4 to 11 yr of age

PO 10 mL (200 mg) q 12 hr with food.

Children 1 to 3 yr of age

PO 5 mL (100 mg) q 12 hr with food.

Diarrhea caused by C. parvum
Children 4 to 11 yr of age

PO 10 mL (200 mg) q 12 hr with food.

Children 1 to 3 yr of age

PO 5 mL (100 mg) q 12 hr with food.

General Advice

  • Nitazoxanide tablets and oral suspension are not bioequivalent. The relative bioavailability of the suspension compared to tablet is 70%.
  • Administer with food to minimize GI side effects and increase absorption.
  • Shake suspension well before measuring dose.


Store tablets, unsuspended powder, and reconstituted oral suspension at controlled room temperature (59° to 86°F). Discard any unused suspension after 7 days.

Drug Interactions

Highly protein-bound drugs (eg, warfarin)

May compete for binding sites, transiently increasing the effects of the displaced drug.

Laboratory Test Interactions

None well documented.

Adverse Reactions


Headache (3%).


Abdominal pain (8%); diarrhea (4%); nausea (3%); vomiting (1%).



Category B .


Not established.


Safety and efficacy not established for treatment of C. parvum in patients 12 yr of age and older.

Oral suspension

Safety and efficacy not established in children younger than 1 yr of age.


Not for use in children 11 yr of age or younger.


Use with caution because of the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant diseases or other drug therapy.

Special Risk Patients

Because nitazoxanide was not studied in patients with impaired hepatic or renal function, use with caution in patients with hepatic, biliary, or renal disease.

Tablet administration

A single tablet contains a greater amount of nitazoxanide than recommended for pediatric dosing and should not be used in patients 11 yr of age or younger.

Patient Information

  • Explain name, dose, action, and potential side effects of drug.
  • Instruct patient to take exactly as prescribed and not to change the dose or discontinue therapy unless advised by health care provider.
  • Advise patient to take prescribed dose with food to minimize GI side effects and increase absorption.
  • Advise patient or caregiver using oral suspension to: shake suspension well before measuring dose; measure and administer prescribed dose using dosing syringe, dosing spoon, or dosing cup; discard any remaining suspension after 7 days.
  • Instruct patient or caregiver to notify health care provider if diarrhea does not improve or worsens.
  • Advise patient to report any other bothersome side effects to health care provider.
  • Advise women to notify health care provider if pregnant, planning to become pregnant, or breastfeeding.
  • Instruct patient not to take any prescription or OTC medications, herbal preparations, or dietary supplements unless advised by health care provider.
  • Advise patient that follow-up visits may be required to monitor therapy and to keep appointments.

Recent Drug Updates at DrugIndexOnline:

Andriol Andriol
Some commonly used brand names are: In the U.S.— Androderm 3 AndroGel 3 Android 2 Android-F 1 Andro L.A. 200 3 Andronate 100 3 Andronate 200 3 Andropository 200 3 Andryl 200 3 Delatest 3 Delatestryl 3 Depotest 3 Depo-Testosterone 3 Everone 200 3 Halotestin 1 ORETON Methyl 2 T-Cypionate 3 more...

Atarax Atarax
Generic Name: Hydroxyzine Capsules and Tablets (hye-DROX-i-zeen) Brand Name: Examples include Atarax and VistarilAtarax is used for:Treating anxiety, for sedation before and after general anesthesia, and to treat itching due to certain allergic conditions, including hives and contact dermatiti more...

Bromatan-DM Suspension Bromatan-DM Suspension
Generic Name: Brompheniramine/Dextromethorphan/Phenylephrine Suspension (brome-fen-IR-a-meen/dex-troe-meth-OR-fan/fen-ill-EF-rin) Brand Name: Bromatan-DM and DuraTan DMBromatan-DM Suspension is used for:Relieving symptoms of sinus congestion, runny nose, sneezing, and cough due to colds, upper more...

Enablex Enablex
Generic Name: darifenacin (dar e fen a sin) Brand Names: Enablex What is darifenacin? Darifenacin relieves spasms of the bladder. Darifenacin is used to treat overactive bladder with the symptoms of urinary frequency, urinary urgency, and urinary incontinence. Darifenacin may also be use more...

Garamycin Ophthalmic Garamycin Ophthalmic
Generic name: Gentamicin sulfate Brand names: Garamycin Ophthalmic Why is Garamycin Ophthalmic prescribed? Garamycin Ophthalmic, an antibiotic, is applied to the eye for treatment of infections such as conjunctivitis (pinkeye) and other eye infections. Most important fact about Garamycin Ophth more...

Isoniazid And Thiacetazone Isoniazid And Thiacetazone
Some commonly used brand names are: INAT Thiazina Thisozide Another commonly used name for isoniazid is INH . Other commonly used names for thiacetazone are thioacetazone and amithiozone . *† Not commercially available in the U.S. and Canada. Description Isoniazid and thiacetazone (e more...

Nutropin Nutropin
Generic Name: somatropin (rDNA origin) Dosage Form: For injection Nutropin Description Nutropin® [somatropin (rDNA origin) for injection] is a human growth hormone (hGH) produced by recombinant DNA technology. Nutropin has 191 amino acid residues and a molecular weight of 22,125 dal more...

Oncovin Oncovin
Generic Name: vincristine (vin CRIH steen) Brand Names: Oncovin, Vincasar PFS What is Oncovin (vincristine)? Vincristine is a cancer (antineoplastic) medication. Vincristine interferes with the growth of cancer cells and slows their growth and spread in the body. Vincristine is used in more...