Nitazoxanide 200 mg is a broad-spectrum antiparasitic and antiviral medication widely used in both children and adults to treat intestinal infections caused by protozoa and certain viruses. Originally developed for the treatment of diarrhea caused by Cryptosporidium parvum and Giardia lamblia, it has since gained recognition for its effectiveness against a range of gastrointestinal pathogens and viral infections.
This comprehensive guide explores the uses, mechanism of action, common side effects, and available formulations of Nitazoxanide to help patients and healthcare providers understand its importance in modern medicine.
What Is Nitazoxanide?
Nitazoxanide is a thiazolide class of anti-infective agents. It works by interfering with the energy metabolism of parasites and certain anaerobic bacteria. Once ingested, Nitazoxanide is rapidly converted in the body to its active form, tizoxanide, which disrupts the function of essential enzymes in the parasite’s mitochondria, leading to cell death.
It is available under various brand names including Alinia, Nizonide, and others depending on the region.
Uses of Nitazoxanide
1. Treatment of Diarrhea Caused by Parasites
Nitazoxanide is FDA-approved for treating:
- Cryptosporidiosis – caused by Cryptosporidium parvum
- Giardiasis – caused by Giardia lamblia
These parasitic infections are common in areas with poor sanitation and can cause severe diarrhea, especially in young children, immunocompromised individuals, and travelers.
2. Rotavirus and Norovirus Infections
Although not FDA-approved for viral gastroenteritis, Nitazoxanide has shown promising results in:
- Reducing the severity and duration of diarrhea
- Helping children recover faster from rotavirus infections
- Providing off-label support in norovirus-related illness
3. Helminthic Infections (Worms)
Nitazoxanide has been studied for effectiveness against:
- Ascaris lumbricoides (roundworm)
- Enterobius vermicularis (pinworm)
- Hymenolepis nana (dwarf tapeworm)
While not the first line of treatment for all helminthic infections, it may be used when other agents fail or are unavailable.
4. Viral Respiratory Infections
Some studies suggest Nitazoxanide’s antiviral potential in combating:
- Influenza A and B
- COVID-19 (investigational use during the pandemic)
- Respiratory syncytial virus (RSV)
Its mechanism inhibits viral maturation, which may reduce replication and spread. However, its use for these conditions is still under research and not officially approved.
5. Clostridium difficile Infections
Nitazoxanide may serve as an alternative therapy in mild to moderate Clostridium difficile–associated diarrhea when standard antibiotics like metronidazole or vancomycin are not suitable.
How to Take Nitazoxanide
Formulations:
- Tablets: 500 mg (usually for adults)
- Oral suspension: 100 mg/5 mL (for children)
General Dosage Guidelines:
| Condition | Age Group | Dose & Duration |
|---|---|---|
| Giardiasis/Cryptosporidiosis | Adults & children ≥12 yrs | 500 mg twice daily for 3 days |
| 1–11 years | Weight-based dose in syrup form | |
| Viral diarrhea | Children | Typically under medical supervision |
| Other infections | Case-specific | As directed by healthcare provider |
It’s important to take Nitazoxanide with food to enhance absorption and reduce gastrointestinal side effects.
Possible Side Effects of Nitazoxanide
Like all medications, Nitazoxanide can cause side effects. However, it is generally well tolerated.
Common Side Effects:
- Nausea
- Vomiting
- Abdominal pain
- Diarrhea
- Headache
These are typically mild and resolve after the course of medication is completed.
Rare or Serious Side Effects:
- Skin rash or allergic reactions
- Discoloration of urine (often yellow-green)
- Fatigue or dizziness
- Liver enzyme elevation (rare)
If any signs of a severe allergic reaction occur—such as difficulty breathing, swelling, or hives—immediate medical attention is necessary.
Precautions and Warnings
1. Pregnancy and Breastfeeding
Nitazoxanide is classified as Pregnancy Category B, meaning that animal studies haven’t shown risk, but human studies are lacking. It should be used during pregnancy only if clearly needed and under doctor supervision.
There is limited data on safety during breastfeeding, so caution is advised.
2. Liver and Kidney Disease
Those with liver or kidney impairment should consult a doctor before use. Dosage adjustments may be necessary.
3. Drug Interactions
Nitazoxanide has minimal known drug interactions. However, it may alter levels of:
- Warfarin (risk of bleeding)
- Antiviral or antiepileptic drugs (rarely)
Always disclose all medications and supplements to your healthcare provider before starting Nitazoxanide.
Available Nitazoxanide Medicines
Nitazoxanide is available globally under various brand names and formulations:
Popular Brands:
- Alinia (U.S. brand, Romark Laboratories)
- Nizonide (commonly used in India and other regions)
- Nitazox / Nitazetol (Latin America)
- Nitax, Nitazid, and others
Form Factors:
- Tablets (usually 500 mg)
- Syrup or oral suspension (100 mg/5 mL, 200 mg/5 mL)
Some products may be combined with other antiparasitic agents to broaden their spectrum or treat mixed infections.
Frequently Asked Questions (FAQs)
Q1: Can Nitazoxanide be used for viral infections like COVID-19?
A: While some studies suggested it might help, Nitazoxanide is not officially approved for COVID-19 treatment. It should only be used under professional guidance.
Q2: Is Nitazoxanide safe for children?
A: Yes, it’s FDA-approved for children as young as 1 year old for certain parasitic infections, in syrup form.
Q3: Can I take Nitazoxanide on an empty stomach?
A: It is best taken with food to enhance absorption and reduce gastrointestinal upset.
Q4: What should I do if I miss a dose?
A: Take the missed dose as soon as you remember. If it’s close to the next dose, skip the missed one. Do not double the dose.
Conclusion
Nitazoxanide is a versatile and effective medication in the fight against parasitic and viral gastrointestinal infections. Its ease of use, broad-spectrum activity, and relatively low side effect profile make it a valuable option in both pediatric and adult patients.
Whether you’re dealing with persistent diarrhea from protozoal infections or exploring options for off-label viral conditions, Nitazoxanide could offer relief. As with any medication, it’s essential to use it under medical supervision, adhere to the correct dosage, and be aware of potential side effects.
For anyone suffering from recurrent intestinal infections or looking for reliable antiparasitic support, Nitazoxanide stands out as a trusted and proven solution.
