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Nitazoxanide

Trade names Alinia, Nitaxide

Routes are by oral tablets and suspension.

Protein binding by 99%.

Drug is metabolized/hydrolyzed to tizoxanide.

Excretion is renal, biliary and fecal.

A synthetic nitrothiazolyl-salicylamide derivative and an antiprotozoal agent.

Is a prodrug.

The anti-protozoal activity of nitazoxanide is due to interference with the pyruvate:f2242edoxin oxidoreductase (PFOR) enzyme dependent electron transfer reaction, an essential component to anaerobic energy metabolism.

Following oral administration, peak concentrations are observed 1–4 hours.

First-line choice for the treatment of illness caused by Cryptosporidium parvum or Giardia lamblia infection in immunocompetent adults and children.

Should be considered in the treatment of illness caused by other protozoa and/or helminths.

Has activity against influenza A virus, selectively blocking the maturation of the viral hemagglutinin.

It is used for the treatment of infectious diarrhea caused by Cryptosporidium parvum and Giardia lamblia in patients 1 year of age and older.

Has been shown to have efficacy in the treatment of chronic hepatitis B.

Chronic hepatitis C phase II studies with nitazoxanide 500 mg twice daily in 50 adult patients 30% had a virologic end-of-treatment response with undetectable virus, and a sustained virologic response (SVR) with undetectable virus 24 wk after the completion of treatment was observed in 17%.

Adverse effects include: stomach pain, headache, upset stomach, vomiting, discolored urine, skin rash, and itching.

Available in two oral dosage forms – tablet of 500 mg and oral suspension at 100 mg per 5 ml.

A 3-day course of nitazoxanide significantly reduces the duration of rotavirus disease in hospitalized pediatric patients, and is an important treatment option for rotavirus diarrhea.

A safe, effective, inexpensive, and well-tolerated drug for the treatment of niclosamide- and praziquantel-resistant beef tapeworm (Taenia saginata) infection.

No serious adverse events are reported.

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