Tinidazole

General

  • Type: Anti-parasitic
  • Dosage Forms: 250, 500
  • Routes of Administration: PO
  • Common Trade Names: Tindamax

Adult Dosing

  • Give with food

Intestinal Amebiasis

  • 2000mg PO daily x 3 days

Amebic liver abscess

  • 2000mg PO daily x 3-5 days

Giardiasis

  • 2000mg PO x 1

Trichamoniasis

  • 2000mg PO x 1
    • Treat partner to avoid re-exposure

Bacterial vaginosis

  • 2000mg PO daily x 2 days OR 1000mg PO daily x 5 days
  • Non-pregnant women only

Urethritis

  • 2000mg PO x 1
  • Give with azithromycin if not treated with azithromycin previously

Pediatric Dosing

  • Approved for age >3 years
  • Give with food

Intestinal Amebiasis

  • 50mg/kg PO daily x 3 days
  • Max 2000mg/dose

Amebic liver abscess

  • 50mg/kg PO daily x 3-5 days
  • Max 2000mg/dose

Giardiasis

  • 50mg/kg PO x 1
  • Max 2000mg/dose

Special Populations

  • Pregnancy Rating: C
  • Lactation risk: Unsafe
  • Renal Dosing
    • Adult: Adjust dose amount; 50% usual dose as supplement if on HD
    • Pediatric: Adjust dose amount; 50% usual dose as supplement if on HD
  • Hepatic Dosing
    • Adult: No defined dose adjustment but can cause hepatic impairment. Use with caution.
    • Pediatric: No defined dose adjustment but can cause hepatic impairment. Use with caution.

Contraindications

  • Allergy to class/drug
  • Pregnancy, 1st trimester
  • Breastfeeding up to 72 hours after treatment
  • Alcohol use up to 72 hours after treatment
  • Hepatic impairment
  • Blood dyscrasia
  • CNS disorder

Adverse Reactions

Serious

  • Seizure
  • Peripheral neuropathy
  • Thrombocytopenia
  • Hypersensitivity reaction
  • Angioedema
  • Stevens-Johnson syndrome
  • Erythema multiforme
  • Bronchospasm

Common

  • nausea and vomiting
  • Anorexia
  • Metallic taste
  • Fatigue/weakness
  • Candidiasis
  • Flatulence
  • UTI
  • Pelvic pain
  • Vulvovaginal discomfort
  • Vaginal odor
  • Menorrhagia
  • URI

Pharmacology

  • Half-life: 12-14 hours
  • Metabolism: Liver; CYP450
  • Excretion: Urine 20-25%, feces 12%
  • Mechanism of Action: Bactericidal; inhibits DNA synthesis

Comments

  • Black box warning: Carcinogenic risk

See Also

References

  • Epocrates