III. Mechanism

  1. Nitroimidazole antiprotozoal agent
  2. Active against Trichomonas vaginalis, Entamoeba histolytica, and Giardia lamblia
  3. Metabolized to nitrite anions and Metronidazole
    1. Metronidazole in turn disrupts DNA helix, resulting in DNA breakage
    2. Final result is an inhibition of Protein synthesis in susceptible organisms

IV. Medications

  1. Tablets: 250 mg, 500 mg
  2. May be compounded into oral suspension by pharmacist

V. Dosing

  1. Trichomoniasis
    1. Adult: 2 grams orally with food for single dose
  2. Giardiasis
    1. Adult: 2 grams orally with food for single dose
    2. Child (age >3 years): 50 mg/kg (up to 2 grams) orally with food for one dose
  3. Amebiasis
    1. Treatment for Amebic Dysentery or Liver Abscess should also include iodoquinol or Paromomycin
    2. Adult: 2 grams orally with food daily for 3 days
    3. Child (age >3 years): 50 mg/kg (up to 2 grams) orally with food daily for 3 days
  4. Bacterial Vaginosis
    1. Adult: 2 grams orally with food daily for 2 days (or 1 g daily for 5 days)

VI. Safety

  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation
    1. Consider pumping and dumping for first 3 days after a single dose

VII. Drug Interactions

  1. Alcohol
    1. Disulfiram reaction
    2. Avoid Alcohol for at least 3 days after last Tinidazole dose
  2. Tinidazole may increase other drug levels
    1. Cyclosporine
    2. Fluorouracil
    3. Lithium
    4. Phenytoin
    5. Tacrolimus
    6. Warfarin (and increased INR)
  3. Cholestyramine
    1. Separate dosing time from Tinidazole dose

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Related Studies

Cost: Medications

tinidazole (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
TINIDAZOLE 500 MG TABLET Generic $2.60 each