From the Guidelines
Nitazoxanide is primarily used to treat gastrointestinal infections caused by parasites, including Cryptosporidium and Giardia lamblia.
Key Uses
- The medication is approved for the treatment of diarrhea caused by Cryptosporidium and Giardia lamblia in both HIV-uninfected and HIV-infected individuals, with the latter requiring combination with effective antiretroviral therapy (cART) 1.
- It has also been considered for the treatment of other parasitic infections, such as microsporidiosis, although its efficacy in this context is less clear 1.
- Additionally, nitazoxanide has been used in the treatment of rotavirus enteritis in immunocompetent pediatric patients 1.
Dosage
- The recommended dose for children is 100 mg orally twice daily for those aged 1-3 years and 200 mg twice daily for those aged 4-11 years 1.
- For adults, the dosage may vary depending on the specific infection being treated, but it is often administered at a dose of 500 mg twice daily 1.
Efficacy and Safety
- Studies have shown that nitazoxanide can reduce the duration of diarrhea and oocyst shedding in patients with cryptosporidiosis, with clinical response rates ranging from 56% to 88% in different populations 1.
- The medication is generally well-tolerated, with adverse events similar to those reported with placebo in clinical trials 1.
From the FDA Drug Label
The antiprotozoal activity of nitazoxanide is believed to be due to interference with the pyruvate:ferredoxin oxidoreductase (PFOR) enzyme-dependent electron transfer reaction which is essential to anaerobic energy metabolism. Nitazoxanide and its metabolite, tizoxanide, are active in vitro in inhibiting the growth of (i) sporozoites and oocysts of C. parvum and (ii) trophozoites of G. lamblia.
The use of Nitazoxanide is for the treatment of:
- Diarrhea caused by Giardia lamblia (G. lamblia)
- Diarrhea caused by Cryptosporidium parvum (C. parvum) in adults and adolescents 12 years of age or older, as well as in pediatric patients 1 through 11 years of age 2, 2, 2.
From the Research
Uses of Nitazoxanide
- Nitazoxanide is used as an antiprotozoal, anthelmintic, and antiviral agent against various types of Gram-positive and Gram-negative bacteria, parasites, and certain viruses 3, 4.
- It is effective in treating gastrointestinal infections, including those caused by Giardia lamblia/intestinalis, Cryptosporidium parvum, and other gastrointestinal pathogens such as bacteria, roundworms, flatworms, and flukes 5, 6, 7.
- Nitazoxanide has been shown to be effective in treating viral infections, including influenza, respiratory syncytial virus, parainfluenza, coronavirus, rotavirus, norovirus, hepatitis B, hepatitis C, dengue, yellow fever, Japanese encephalitis virus, and human immunodeficiency virus 3, 4.
- It has also been proposed as a potential treatment for coronavirus infection, ovarian cancer, and helicobacter infection 4.
- Nitazoxanide has anti-inflammatory properties and has been investigated for use in Crohn's disease 5.
Specific Indications
- Cryptosporidiosis: Nitazoxanide is the first agent proven to be effective in treating cryptosporidiosis 6.
- Giardiasis: Nitazoxanide has been shown to be effective in treating giardiasis, with fewer side effects compared to metronidazole 6.
- Intestinal helminths: Nitazoxanide is efficacious against intestinal helminths and tapeworms 6.
- Chronic fascioliasis: Nitazoxanide has been shown to be effective in treating chronic fascioliasis 6.
- Clostridium difficile-associated diarrhea: Preliminary reports suggest that nitazoxanide may be an effective treatment for Clostridium difficile-associated diarrhea 7.