Top 300 Pharmacy Drug Cards


Class: Antiprotozoal

Dosage Forms. Tablet: 500 mg; Suspension: 100 mg/5 mL


Common FDA Label Indication, Dosing, and Titration.

1. Diarrhea caused by Cryptosporidium parvum or Giardia lamblia: Adults: 500 mg po bid × 3 d; Children 1-3 y: 100 mg bid × 3 d; Children 4-11 y: 200 mg bid × 3 d

Off-Label Uses.

1. Clostridium difficile-associated diarrhea: 500 mg po bid

MOA. Interference with the pyruvate ferredoxin oxidoreductase (PFOR) enzyme-dependent electron transfer reaction, which is essential to anaerobic metabolism or protozoans.

Drug Characteristics: Nitazoxanide


Medication Safety Issues: Nitazoxanide


Drug Interactions: Nitazoxanide. None

Adverse Reactions: Nitazoxanide


Efficacy Monitoring Parameters. Resolution of signs and symptoms of infection.

Toxicity Monitoring Parameters. Consider LFTs and CBC prior to therapy.

Key Patient Counseling Points. Complete full course of therapy; take with food.

Clinical Pearls. Suspension bioavailability is 70% of tablet, not interchangeable. Preferred agent for treating Cryptosporidium diarrhea in immunocompetent adults, has not been proven to be superior to placebo in HIV-infected individuals. Equivalent efficacy to metronidazole for C difficile and Giardia, however, based on cost metronidazole remains the treatment of choice.

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