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What is it?

Tinidazole relates to antiprotozoal, antimicrobial. It is active against Trichomonas vaginalis, Entamoeba histolytica, Lamblia; causative agents of anaerobic infections (Bacteroides spp., including B. fragilis, B. Melaninogenicus, Clostridium spp., Eubacterium spp., Fusobacterium spp., Peptococcus spp., Peptostreptococcus spp.).

Being a highly lipophilic substance, it penetrates into Trichomonas and anaerobic microorganisms, where it is restored by nitroreductase, inhibits synthesis and damages the structure of DNA.

Indications

  • Trichomoniasis;
  • Giardiasis;
  • Amebiasis and its hepatic form;
  • Infections caused by anaerobic bacteria, or mixed aerobic-anaerobic infections, usually in combination with antibiotics;
  • Helicobacter pylori infections associated with duodenal or gastric ulcer, as part of combination therapy;
  • Prevention of postoperative anaerobic infections.

Dosage and mode of application

Oral. The drug is taken as prescribed by a doctor.

Trichomoniasis:

  • Adults: 2 g (4 tabs. 500 mg) 1 time per day.
  • Children: 50–75 mg/kg body weight 1 time per day. If necessary, the dose can be repeated.

Giardiasis

  • Adults: 2 g (4 tabs. 500 mg) 1 time per day.
  • Children: 50–75 mg/kg body weight 1 time per day. If necessary, the dose can be repeated.

Intestinal amebiasis

  • Adults: 2 g of tinidazole (4 tabs. 500 mg) 1 time per day, for 2 or 3 days.
  • Children: 50-60 mg/kg body weight 1 time per day for 3 days.

Amoebic liver abscess

  • Adults: depending on the severity of infection, 4.5–12 g of tinidazole per course.
  • Treatment should begin with a dose of 1.5-2 g/day and apply it for 3 days. If necessary, continue treatment for up to 6 days.
  • Children: 50–60 mg/kg body weight per day for 5 days.

Treatment of infections caused by anaerobic bacteria

Adults: on the first day – 2 g (4 tabs of 500 mg) of the drug once, and then – 1 g (2 tabs of 500 mg) once or in 2 doses of 500 mg. Treatment usually continues for 5-6 days.

During the course of treatment, regular clinical and laboratory monitoring of the blood is recommended, especially if treatment continues for more than 7 days.

For children under 12 years of age, dosages are not defined.

Prevention of postoperative infections

  • adults: 2 g of the drug (4 tabs. 500 mg each) once, 12 hours before surgery.
  • children under 12 years of age, dosages are not defined.

Overdose

Cases of a drug overdose have not been described.

Treatment: there is no specific antidote for poisoning with tinidazole, it is necessary to carry out symptomatic and supportive treatment. Gastric lavage may be helpful, tinidazole can be easily removed by dialysis.

Contraindications

  • Hypersensitivity to the components of the drug;
  • Organic diseases of the central nervous system (CNS);
  • Inhibition of bone marrow hematopoiesis;
  • Pregnancy (I term);
  • Lactation (breastfeeding);
  • Children (up to 12 years).

Side effects

  • Digestive system: loss of appetite, dry mucous membranes of the oral cavity, metallic taste in the mouth, nausea, vomiting, diarrhea.
  • Nervous system: headache, dizziness, fatigue, impaired motor coordination (including locomotor ataxia), dysarthria, peripheral neuropathy, rarely – convulsions, weakness.
  • Allergic reactions: urticaria, pruritus, skin rash, angioedema.
  • Other: transient leukopenia.

Pregnancy and breastfeeding

This antibiotic penetrates the placenta, so it is contraindicated in the first trimester of pregnancy. In the II and III trimesters of pregnancy, the drug is used only in case of absolute necessity, since there is a potential risk of its exposure to the fetus.

This drug penetrates into breast milk, therefore during the intake of the drug should be interrupted by breastfeeding. It remains in the breast milk for 72 hours after ingestion.

Interactions

  • It enhances the effect of indirect anticoagulants (to reduce the risk of bleeding, reduce the dose by 50%) and the effect of ethanol.
  • It is compatible with sulfonamides and antibiotics (aminoglycosides, erythromycin, rifampicin, cephalosporins).
  • It is not recommended with ethionamide.
  • Phenobarbital accelerates metabolism.

Safety precautions

In the treatment of genital trichomoniasis, simultaneous treatment of sexual partners should be carried out.

In the process of treatment, it is mandatory to abstain from the use of ethanol (the possibility of disulfiram-like reactions).

It causes dark urine staining. During the period of treatment, it is necessary to abstain from engaging in potentially hazardous activities that require increased concentration of attention and quickness of psychomotor reactions.

The safety and efficacy of use for the treatment and prevention of anaerobic infections in children under 12 years of age have not been established.

If prescribed for more than 6 days, control of the peripheral blood pattern is necessary.

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