Download N NITAZOXANIDE: Alinia - 2016/2017 Top 300 Pharmacy Drug Cards

NITAZOXANIDE: Alinia
Class: Antiprotozoal
Dosage Forms. Tablet: 500 mg; Suspension: 100 mg/5 mL N
Romark 500 mg pictured
Common FDA Label Indication, Dosing, and Titration.
1. Diarrhea caused by Cryptosporidium parvum or Giardia lamblia: Adults: 500 mg po bid × 3 d; Children 1-3 y: 100 mg bid × 3 d; Children 4-11 y:
200 mg bid × 3 d
Off-Label Uses.
1. Clostridium difficile-associated diarrhea: 500 mg po bid
MOA. Interference with the pyruvate ferredoxin oxidoreductase (PFOR) enzyme-dependent electron transfer reaction, which is essential to anaerobic
metabolism or protozoans.
Drug Characteristics: Nitazoxanide
Dose Adjustment Hepatic
Use with caution
Absorption
F <5%, food enhances absorption by 50%
Dose Adjustment Renal
Use with caution
Distribution
98-99% protein bound
Dialyzable
Not dialyzable
Metabolism
Metabolized to one active metabolite by plasma
esterases
Pregnancy Category
B
Elimination
33% renal, 67% fecal
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Lactation
Weigh risks and benefits
Pharmacogenetics
None known
Contraindications
Hypersensitivity to
nitazoxanide
Black Box Warnings
None
Medication Safety Issues: Nitazoxanide
Suffixes
Tall Man Letters
Do Not Crush
High Alert
Confused Names
No
No
No
No
No
Drug Interactions: Nitazoxanide. None
Adverse Reactions: Nitazoxanide
Common (>10%)
Less Common (1-10%)
Rare but Serious (<1%)
Nausea, vomiting, diarrhea, headaches
Elevated liver function tests
Efficacy Monitoring Parameters. Resolution of signs and symptoms of infection.
Toxicity Monitoring Parameters. Consider LFTs and CBC prior to therapy.
Key Patient Counseling Points. Complete full course of therapy; take with food.
Clinical Pearls. Suspension bioavailability is 70% of tablet, not interchangeable. Preferred agent for treating Cryptosporidium diarrhea in immunocompetent adults, has not been proven to be superior to placebo in HIV-infected individuals. Equivalent efficacy to metronidazole for C difficile and Giardia,
however, based on cost metronidazole remains the treatment of choice.
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