Tinidazole

Indications
 Oral
Bacterial vaginosis
Adult: 2 g as a single dose or 2 g given on 2 consecutive days.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Anaerobic bacterial infections
Adult: 2 g on 1st day, followed by 1 g daily as a single dose or 500 mg bid for 5-6 days.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Endometritis
Adult: 2 g on 1st day, followed by 1 g daily as a single dose or 500 mg bid for 5-6 days.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Lung abscess
Adult: 2 g on 1st day, followed by 1 g daily as a single dose or 500 mg bid for 5-6 days.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Peritonitis
Adult: 2 g on 1st day, followed by 1 g daily as a single dose or 500 mg bid for 5-6 days.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Pneumonia
Adult: 2 g on 1st day, followed by 1 g daily as a single dose or 500 mg bid for 5-6 days.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Skin and soft tissue infections
Adult: 2 g on 1st day, followed by 1 g daily as a single dose or 500 mg bid for 5-6 days.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Prophylaxis of postoperative anaerobic bacterial infections
Adult: 2 g given 12 hr before surgery.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Eradication of H. pylori associated with peptic ulcer disease
Adult: 500 mg bid; given with clarithromycin and omeprazole for 7 days.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Intestinal amoebiasis
Adult: Single daily dose of 2 g for 2 or 3 days. Tinidazole therapy to be followed by a luminal amoebicide (e.g. paromomycin).
Child: A single daily dose of 50-60 mg/kg daily for 3 days. Tinidazole therapy to be followed by a luminal amoebicide (e.g. paromomycin).
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Hepatic amoebiasis
Adult: 1.5-2 g as a single daily dose for 3-6 days. Tinidazole therapy to be followed by a luminal amoebicide (e.g. paromomycin).
Child: A single daily dose of 50-60 mg/kg for 5 days. Tinidazole therapy to be followed by a luminal amoebicide (e.g. paromomycin).
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Giardiasis
Adult: 2 g as a single dose. In trichomoniasis, sexual partners should be treated.
Child: 50-75 mg/kg as a single dose, repeat this dose if necessary.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Trichomoniasis
Adult: 2 g as a single dose. In trichomoniasis, sexual partners should be treated.
Child: 50-75 mg/kg as a single dose, repeat this dose if necessary.
Renal impairment: Haemodialysis: additional dose may be needed.
Oral
Acute necrotising ulcerative gingivitis
Adult: 2 g as a single dose.
Renal impairment: Haemodialysis: additional dose may be needed.
Intravenous
Anaerobic bacterial infections
Adult: Initially, 800 mg/400 ml infused at a rate of 10 ml/min followed by 800 mg daily or 400 mg bid until oral therapy can be substituted.
Renal impairment: Haemodialysis: additional dose may be needed.
Intravenous
Endometritis
Adult: Initially, 800 mg/400 ml infused at a rate of 10 ml/min followed by 800 mg daily or 400 mg bid until oral therapy can be substituted.
Renal impairment: Haemodialysis: additional dose may be needed.
Intravenous
Lung abscess
Adult: Initially, 800 mg/400 ml infused at a rate of 10 ml/min followed by 800 mg daily or 400 mg bid until oral therapy can be substituted.
Renal impairment: Haemodialysis: additional dose may be needed.
Intravenous
Peritonitis
Adult: Initially, 800 mg/400 ml infused at a rate of 10 ml/min followed by 800 mg daily or 400 mg bid until oral therapy can be substituted.
Renal impairment: Haemodialysis: additional dose may be needed.
Intravenous
Pneumonia
Adult: Initially, 800 mg/400 ml infused at a rate of 10 ml/min followed by 800 mg daily or 400 mg bid until oral therapy can be substituted.
Renal impairment: Haemodialysis: additional dose may be needed.
Intravenous
Skin and soft tissue infections
Adult: Initially, 800 mg/400 ml infused at a rate of 10 ml/min followed by 800 mg daily or 400 mg bid until oral therapy can be substituted.
Renal impairment: Haemodialysis: additional dose may be needed.
Intravenous
Prophylaxis of postoperative anaerobic bacterial infections
Adult: 1.6 g given as a single infusion prior to surgery.
Renal impairment: Haemodialysis: additional dose may be needed.
Contraindications
 Blood dyscrasias, organic neurologic disorders, hypersensitivity to 5-nitroimidazole derivatives, porphyria. Lactation, pregnancy (1st trimester).
Warnings / Precautions
 Alcohol should be avoided until 72 hr after stopping therapy. Discontinue if abnormal neurological signs (e.g. dizziness, incoordination, ataxia) develop. CNS diseases, pregnancy (2nd and 3rd trimester).
Adverse Reactions
 Metallic taste, nausea, headache, vomiting, dark urine, flushing, anorexia, diarrhoea, tiredness, transient leucopenia.
Potentially Fatal: Hypersensitivity.
Overdose Reactions
 Treatment is symptomatic and supportive. Gastric lavage and dialysis may be useful.
Drug Interactions
 Possible decrease in absorption with colestyramine. Possible increase in anticoagulant effect of warfarin. Monitor for toxicity if used with ciclosporin, tacrolimus or lithium.
See Below for More tinidazole Drug Interactions
Lab Interactions
 May cause falsely decreased values in tests where determinations are based on the decrease in ultraviolet absorbance that occurs during oxidation of NADH to NAD e.g. alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), triglycerides or glucose.
Food Interactions
 Disulfiram-like reaction with alcohol.
Mechanism of Actions
 Tinidazole, a 5 nitroimidazole derivative with antimicrobial actions similar to metronidazole, is active against both protozoa (e.g.Trichomonas vaginalis, Entamoeba histolytica and Giardia lamblia) and obligate anaerobic bacteria. It damages DNA strands or inhibit DNA synthesis in microorganism.
Absorption: Almost completely absorbed from the GI tract (oral); peak plasma concentrations after 2 hr.
Distribution: Widely distributed; breast milk, CSF, saliva, bile and body tissues (high concentrations similar to plasma), crosses the placenta. Protein-binding: 12%.
Metabolism: Converted to an active hydroxy metabolite. Plasma elimination half-life: 12-14 hr.
Excretion: Via urine (as unchanged drug and metabolites), via faeces (small amounts).
Administration
 Should be taken with food. (Take during or immediately after meals.)
Storage Conditions
 Oral: Store below 25°C.
ATC Classification
 J01XD02 - tinidazole ; Belongs to the class of imidazole derivative antibacterials. Used in the systemic treatment of infections.
P01AB02 - tinidazole ; Belongs to the class of nitroimidazole derivatives antiprotozoals. Used in the treatment amoebiasis and other protozoal diseases.
Storage
 Oral: Store below 25°C.
Available As
  • Tinidazole 1 gm
  • Tinidazole 1 gm (2 tab)
  • Tinidazole 100 mg
  • Tinidazole 1000 mg
  • Tinidazole 1000 mg (2 cap)
  • Tinidazole 1000 mg (2 tab)
  • Tinidazole 150 mg
  • Tinidazole 2 gm
  • Tinidazole 2 mg
  • Tinidazole 2% w/v
  • Tinidazole 200 mg
  • Tinidazole 250 mg
  • Tinidazole 300 mg
  • Tinidazole 400 mg
  • Tinidazole 5% w/w
  • Tinidazole 500 mg
  • Tinidazole 500 mg (2 tab)
  • Tinidazole 500 mg (2 Tablet)
  • Tinidazole 600 mg
  • Tinidazole 75 mg

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