What is Nitazoxanide?

It is used to treat gastrointestinal illnesses caused by protozoa, helminths, and some viruses.

Nitazoxanide is a broad-spectrum antiparasitic and antiviral agent.

It is especially well known for helping people who have diarrhea from Giardia lamblia and Cryptosporidium parvum.

Nitazoxanide has also been shown to be effective against rotavirus, norovirus, hepatitis B and C, and even influenza and coronaviruses in research settings.

Overview

Description

Nitazoxanide is also known as 2-acetyloxy-N-(5-nitro-2-thiazolyl)benzamide in the chemistry world.

It is a man-made antiparasitic prodrug that is quickly converted in the body into tizoxanide, which is its active form.

Protozoa and some anaerobic species can’t use energy properly when Nitazoxanide is present.

Nitazoxanide is different from many older antiparasitics because it also works against a wide range of viruses.

This makes it a modern therapeutic choice for managing infectious diseases.

Uses / Indications

Treatment of diarrhea induced by Giardia lamblia in patients who are at least one year old

Treatment of diarrhea induced by Cryptosporidium parvum in individuals at least one year of age.

Benefits

Effective against viruses, anaerobic bacteria, and protozoa; broad antibacterial spectrum

Very well-tolerated; less gastrointestinal side effects than previous antiparasitics such as metronidazole

Treatment length is minimal; a three-day regimen is usually enough.

Confirmed safety for use in pediatric patients aged 1 year and elder.

Oral suspension is a convenient dosage form that can be used by both pediatric and geriatric individuals.

Side Effects

How Does Nitazoxanide Work?

Nitazoxanide is a prodrug, which means it is only active after it has been metabolized in the body.

It is promptly hydrolyzed into tizoxanide, the pharmacologically active molecule.

Tizoxanide inhibits the enzyme PFOR (pyruvate: ferredoxin oxidoreductase).

Parasites and certain viruses rely on this enzyme for anaerobic energy metabolism.

This inhibition disrupts electron transfer, halting protozoal and viral energy consumption and development.

How to Use / Dosage Guidelines

Adults and adolescents (≥12 years): Administer 500 mg orally twice a day for 3 days with food.

Children aged 4 to 11 years: Administer 200 mg (10 mL suspension) orally twice daily for 3 days with food.

Children aged 1 to 3 years: Administer 100 mg (5 mL suspension) orally twice daily for 3 days with food.

Thoroughly agitate the suspension before each administration and utilize a measuring instrument.

Ingest pills whole; do not pulverize or masticate.

Always fulfill the entire specified regimen, even if symptoms ameliorate prematurely.

When Not to Use

Documented hypersensitivity or allergy to Nitazoxanide or any excipients

Infants under one year (safety and efficacy not demonstrated)

Patients with significant hepatic impairment

Persons with inherited glucose-6-phosphate dehydrogenase (G6PD) deficiency

Drug Interactions

Nitazoxanide exhibits minimal systemic absorption, rendering significant medication interactions uncommon.

Nonetheless, it may influence the metabolism of certain pharmaceuticals.

Warfarin – May elevate INR (watch prothrombin time meticulously)

Atazanavir / Ritonavir (HIV medications) – Tizoxanide may disrupt metabolic processes.

Immunosuppressants (e.g., cyclosporine) – Assess concentrations

Other medicines metabolized by the liver – Exercise caution and monitor hepatic enzymes

Safety Advice

General Instructions

Please keep the original packaging and keep it out of the light and humid.

Follow the medication’s directions exactly.

Even if you are better, complete the entire course.

When experiencing diarrhea, stay hydrated.

Consult with a doctor if your symptoms worsen or continue.

Special Dietary & Lifestyle Advice

Drink plenty of water while taking Nitazoxanide. This is crucial, especially if you have diarrhea, to avoid dehydration.

Eat bland foods like rice, toast, bananas, and yogurt as part of a light, easy-to-digest diet.

Avoid meals that are spicy, oily, or increased in fiber because they can result in digestive systems feeling even worse.

Good cleanliness, like washing your hands often, can stop infections from spreading or coming back.

Getting enough rest and not drinking booze during treatment can also help you get better faster.

Comparison with Other Antiparasitic Treatments

Nitazoxanide is unique among antiparasitic drugs. It works against both protozoa and viruses.

Nitazoxanide is easier on kids and causes fewer side effects, like a metal kind of taste.

It also works for a shorter time than metronidazole, the usual treatment for protozoal infections such as Giardia and Entamoeba.

For helminthic infections, albendazole is ineffective in front of protozoa and viruses.

Tinidazole, a single-dose option, may produce stomach pain and a bitter taste.

Nitazoxanide works well against Cryptosporidium, a bug that resists standard treatments.

It also shows promise for viral gastroenteritis.

This makes it a versatile and modern option for gut diseases.

Precautions & Warnings

Do not utilize it if you have an allergy to thiazolides.

During prolonged use, maintain a close eye on liver enzymes.

Notice any yellowing of the skin or eyes, as this could indicate liver problems.

With the absence of medical supervision, it is not advised for long-term use.

Immunocompromised patients may require a lengthier course of treatment.

Can It Be Taken With Other Medicines?

Storage

Keep at 20°C to 25°C (68°F to 77°F).

Keep in a dry place, away from sun rays and water.

Keep away from toddlers and pets.

Do not take tablets or suspensions that have expired.