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

References

• Epocrates

Authors

Colin Hoff, Ross Donaldson, Neil Young, Daniel Ostermayer