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ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS › ANTIPROTOZOALS › AGENTS AGAINST AMOEBIASIS AND OTHER PROTOZOAL DISEASES › Nitroimidazole derivatives
tinidazole and diloxanide
P01AB53
Forms & Strengths
- Combination tablet: Tinidazole 500 mg + Diloxanide Furoate 500 mg
Adult Dosing
- Amebiasis: 1 tablet (500 mg tinidazole / 500 mg diloxanide furoate) orally three times daily for 5 to 10 days
Pediatric Dosing
- Safety and efficacy in children under 12 years not established for this fixed-dose combination; use individual weight-based components if necessary
Indications
- Treatment of intestinal amebiasis (Entamoeba histolytica) and hepatic amebiasis
Mechanism of Action
- Tinidazole enters the amoebic cell via passive diffusion, where its nitro group is reduced by ferrodoxin to form reactive free radicals that damage DNA and cellular proteins.
- Diloxanide furoate acts primarily in the lumen of the bowel as a direct amoebicide against the trophozoite and cyst forms of Entamoeba histolytica.
Contraindications
- Hypersensitivity to tinidazole, other nitroimidazole derivatives, or diloxanide
- First trimester of pregnancy
- History of blood dyscrasias or active organic neurologic disorders
- Breastfeeding during and for 3 days after tinidazole cessation
Adverse Reactions
- Metallic taste
- Nausea, vomiting, diarrhea, abdominal cramps
- Anorexia
- Headache, dizziness
- Transient leukopenia
- Urticaria, pruritus
Drug Interactions
- Alcohol: Disulfiram-like reaction (flushing, vomiting, tachycardia); avoid alcohol during and 3 days post-treatment
- Warfarin / Coumarin anticoagulants: Potentiation of anticoagulant effect, increasing bleeding risk
- Lithium: Potential for lithium toxicity due to decreased renal clearance
- CYP3A4 inducers (e.g., rifampin, phenytoin): May decrease tinidazole plasma concentrations
Curated Content: Needs Vetting Before Put to Clinical Use