Nitazoxanide

Nitazoxanide is a antiprotozoal / antiparasitic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Nitazoxanide is indicated for:

• Giardiasis — diarrhoea caused by Giardia lamblia
• Cryptosporidiosis — diarrhoea caused by Cryptosporidium parvum, including in children
• Amoebiasis and some helminth (worm) infections — as judged appropriate by a doctor
• Persistent or rotavirus-associated diarrhoea — in selected cases under medical guidance

Most short-lived diarrhoea is viral and needs only fluids and zinc (in children) — not antiparasitic medicine. Nitazoxanide should be used when a doctor suspects or confirms a parasitic cause, not routinely for every loose motion.

Usual dosing of Nitazoxanide, always taken with food:

• Adults and children 12 years and older: 500 mg every 12 hours for 3 days
• Children 4-11 years: commonly 200 mg (10 ml suspension) every 12 hours for 3 days
• Children 1-3 years: commonly 100 mg (5 ml suspension) every 12 hours for 3 days

Shake the suspension well before measuring. Complete the full 3-day course even if diarrhoea settles earlier. Children's doses are ultimately weight- and age-based and must follow a registered doctor's prescription; longer courses for special situations are decided by the doctor. Maintain oral rehydration alongside treatment.

Nitazoxanide is generally well tolerated. Possible side effects:

• Common: abdominal pain, nausea, headache, and harmless bright yellow-green discolouration of urine (sometimes of the eyes' sclera appearing yellowish-tinged in reports, and of body fluids)
• Less common: vomiting, diarrhoea, dizziness, loss of appetite
• Rare: allergic reactions with rash, itching or swelling; raised liver enzymes

The yellowish urine is expected with this medicine and disappears after the course ends. Seek medical help for any swelling of the face or throat, breathing difficulty, severe rash, or worsening dehydration despite treatment.

Precautions with Nitazoxanide:

• Take with food — absorption is much better and stomach upset less likely
• Rehydration first: in any diarrhoea, fluids and electrolytes (ORS) remain the priority; the antiparasitic complements, never replaces, them
• Tell your doctor about liver or kidney disease and immune-suppressing conditions such as advanced HIV, where response may differ and longer therapy may be needed
• Diabetic patients should note the suspension contains sugar
• If diarrhoea persists beyond the course, returns, or contains blood, return to the doctor for stool testing rather than repeating courses on your own

Nitazoxanide has relatively few known drug interactions, but note:

• Highly protein-bound drugs: its active form (tizoxanide) binds strongly to blood proteins, so caution with warfarin, phenytoin and similar narrow-margin medicines — monitoring may be advised
• Other antiparasitics: combinations should be doctor-directed to avoid unnecessary duplication
• Alcohol: avoid during treatment of gut infections, as it worsens dehydration and stomach upset

Always give your doctor and pharmacist a complete list of your medicines, including blood thinners and anti-epileptics, before starting Nitazoxanide.

Nitazoxanide should not be used in:

• Known hypersensitivity to nitazoxanide or any component of the
• Children below the age covered by the product's licence (suspension is generally for 1 year and above; tablets for 12 years and above) unless a doctor directs otherwise

Use with caution, under medical supervision, in significant liver or kidney impairment, as safety data in these groups are limited. In severely immunocompromised patients (such as advanced HIV), effectiveness may be reduced and specialist-guided treatment is required rather than standard self-medication.

Pregnancy: Animal studies with nitazoxanide have not shown harm to the foetus, but well-controlled human studies are lacking. It should be used in pregnancy only if a registered doctor judges the benefit to outweigh potential risk — particularly in the first trimester, when most medicines are minimised.

Lactation: It is not known whether nitazoxanide or its active metabolite passes into human breast milk. Breastfeeding mothers should use it only on a doctor's advice, who will weigh the importance of treating the mother's infection against any theoretical risk to the infant.

Store below 30°C in a dry place, protected from light. Keep tablets in the original blister. After reconstitution, the suspension should be kept as directed on the label and used within the stated period (commonly 7 days); shake well before every dose. Keep out of the reach and sight of children and never use after the expiry date.