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Nitazoxanide is an effective antiprotozoal medication designed to combat infections caused by parasites like Giardia lamblia and Cryptosporidium parvum, which are common causes of diarrhea. Approved by the FDA, it disrupts the energy metabolism of these parasites, hindering their ability to grow and reproduce. This medication is available in 500mg tablets and a 100mg/5mL oral suspension, suitable for both adults and children as young as one-year-old. Treatment typically involves taking the medication every 12 hours for three days, ideally with food, to increase absorption and reduce stomach upset. While generally well-tolerated, Nitazoxanide can cause side effects such as nausea, headache, and abdominal pain. Serious reactions, although rare, include severe allergic responses and liver issues. Following dosage instructions carefully and storing the medication at room temperature is important.

Product Overview

Nitazoxanide is an antiprotozoal medication primarily used to treat diarrhea caused by Giardia lamblia or Cryptosporidium parvum parasites. As an FDA-approved treatment, it interferes with parasites’ cellular machinery, explicitly inhibiting the enzyme pyruvate-ferredoxin oxidoreductase essential for their energy metabolism. This disruption helps halt the growth and replication of these organisms, effectively managing and alleviating symptoms associated with these parasitic infections.

Nitazoxanide is available in two forms: tablets and an oral suspension. The tablet strength is 500mg, suitable for adults and children over 12 years, while the oral suspension, which contains 100mg per 5 mL, is ideal for younger children. The medication is typically taken orally every 12 hours for three days, with food to enhance absorption and minimize gastrointestinal discomfort. Depending on the health condition being treated, this medication can be prescribed to adults and children as young as one year old.

Common side effects of Nitazoxanide include nausea, headache, abdominal pain, diarrhea, and vomiting. More serious side effects might consist of severe allergic reactions, liver problems, and severe diarrhea. Precautions are necessary to prevent adverse reactions, particularly for those with existing health conditions or those on other medications. If a dose is missed, take it as soon as you remember unless it’s almost time for the next dose. In case of an overdose, immediate medical attention is necessary. Store Nitazoxanide at room temperature, keeping it away from moisture and light, and ensure it is out of children’s reach. It is essential to discard expired or unused medication correctly to maintain safety. Always consult healthcare providers for guidance on use, potential interactions, and effective handling of side effects.

Uses of Nitazoxanide

  • Diarrhea

How to Use Nitazoxanide?


Nitazoxanide comes in the following dosage forms and strengths: 


  • 500mg

Oral suspension

  • 100mg/5mL

Recommended Dosage of Nitazoxanide for Different Patients

Adult Dosage for Cryptosporidiosis and Giardiasis:

  • Dose: Take 500 mg orally every 12 hours.
  • Duration: Continue for 3 days.
  • Purpose: Used to treat diarrhea caused by Giardia lamblia or Cryptosporidium parvum parasites.

Children’s Dosage for Cryptosporidiosis and Giardiasis:

  • Ages 1 to 3: Take 100 mg orally every 12 hours.
  • Ages 4 to 11: Take 200 mg orally every 12 hours.
  • Ages 12 and older: Take 500 mg orally every 12 hours.
  • Duration: Continue for 3 days.
  • Purpose: This treats diarrhea caused by Giardia lamblia or Cryptosporidium parvum parasites.

[Note: Dosage recommendations for Nitazoxanide can differ between individuals. Consult your doctor to tailor the dosage to your specific needs.]

How to Take Nitazoxanide?

  • Always follow the dosage instructions for Nitazoxanide given by your healthcare provider. Do not change the dosage strength or frequency without first consulting them.
  • Nitazoxanide is available in tablet form and as an oral suspension. Tablets are typically taken by adults and children over 12 years old, while oral suspension is more commonly prescribed for younger children.
  • Nitazoxanide is usually taken with food. Taking it with a meal can help increase its absorption and reduce stomach upset.
  • Even if you feel better, continue taking Nitazoxanide for the entire prescribed duration to ensure that the infection is completely cleared. Stopping early may allow the infection to return.
  • Shake the oral suspension bottle thoroughly before each use to ensure that Nitazoxanide is evenly mixed.
  • If anything is unclear or needs further explanation, consult your prescription label or ask your pharmacist for detailed instructions specific to your prescription.

[Note: Your doctor will determine the appropriate dosage of Nitazoxanide for you based on your medical condition and in accordance with established guidelines and research on the medication. The dosage may be adjusted over time as necessary.]

How Does Nitazoxanide Work?

Nitazoxanide is an antiprotozoal medication that works by interfering with the cellular machinery of parasites, specifically their ability to produce energy. It does this by inhibiting the enzyme pyruvate-ferredoxin oxidoreductase, which is crucial for anaerobic energy metabolism in various protozoa and anaerobic bacteria. By disrupting this process, Nitazoxanide effectively halts the growth and replication of these organisms. This mechanism helps treat infections caused by protozoa like Giardia lamblia and Cryptosporidium parvum and has shown potential against other microbial infections. However, further research is needed to expand its approved uses.

Important Safety Information

Nitazoxanide Side Effects

Common side effects of Nitazoxanide may include:

  • Nausea
  • Headache
  • Abdominal pain
  • Diarrhea
  • Vomiting
  • Dizziness
  • Fatigue
  • Rash

Serious side effects of Nitazoxanide may include:

  • Severe Allergic Reactions: Signs can include skin rash, itching, swelling in the facial area, including lips and tongue, extreme dizziness, and breathlessness.
  • Liver Problems: Signs might include persistent nausea, vomiting, severe stomach/abdominal pain, yellowing of the skin or eyes (jaundice), and dark urine.
  • Severe Diarrhea: Persistent or worsening diarrhea can lead to dehydration.
  • Unusual Bruising or Bleeding: This can be a sign of a blood disorder.
  • Severe Skin Reactions: Symptoms may include rash, blisters, peeling skin, and severe redness or irritation.
  • Persistent Fever: A high fever that does not disappear might indicate a severe condition.
  • Neurological Issues: Severe headaches, confusion, or abnormal behavior can indicate serious problems.

[Note: This list might not include all potential side effects. Always consult your healthcare expert for medical advice regarding side effects.]

Nitazoxanide Warnings

  • Watch for symptoms of allergic reactions like rashes, itching, swelling, intense dizziness, or difficulty breathing. Inform your doctor if you have known allergies to Nitazoxanide or any of its inactive ingredients.
  • Before starting Nitazoxanide, disclose your complete medical history to your healthcare provider, particularly if you have liver disease, kidney disease, or a compromised immune system.
  • Since the liquid form of Nitazoxanide contains sugar, patients with diabetes should use caution. Discuss with your healthcare provider how this medication might affect your blood sugar levels and what monitoring is necessary.
  • The safety of Nitazoxanide during pregnancy is not fully established. Only use this medication during pregnancy if the potential advantages outweigh the risks to the fetus. It’s unclear if Nitazoxanide is transferred to breast milk, so consult your doctor before breastfeeding.
  • Inform your healthcare specialist about all medications you currently take, including prescription, over-the-counter, and herbal supplements, as Nitazoxanide can interact with other medicines.
  • Patients with pre-existing liver conditions should use Nitazoxanide with caution. Routine liver function tests may be needed to monitor your health condition or check for side effects.
  • Nitazoxanide is not effective in treating all types of infections. It is specifically indicated for certain parasitic infections, and its use should be based on confirmed or strongly suspected parasitic infections.
  • Adhere strictly to the prescribed treatment duration. Never alter it without discussing it with your healthcare provider.

Nitazoxanide Precautions

  • Before taking Nitazoxanide, inform your doctor or pharmacist if you have any allergies, especially to this medication. It may contain inactive ingredients that could trigger allergic reactions or other issues. For more information, consult your pharmacist.
  • Discuss your medical history with your healthcare expert before using Nitazoxanide, particularly if you have a weakened immune system, like from HIV infection.
  • The liquid form of Nitazoxanide includes sugar, so if you have diabetes, use caution and discuss safe usage with your healthcare provider.
  • Use Nitazoxanide during pregnancy only if necessary. It’s important to weigh the potential risks & benefits with your certified medical expert.

Nitazoxanide Contraindications 

  • Allergy to Nitazoxanide or Ingredients: Patients with a known allergy to Nitazoxanide or any of its inactive components should avoid this medication to prevent serious allergic reactions.
  • Severe Liver Disease: Patients with severe liver impairment may need to avoid Nitazoxanide, as it can exacerbate liver conditions or impact the drug’s metabolism and effectiveness.
  • Children Under 1 Year: Nitazoxanide is typically not recommended for use in infants under one year of age due to insufficient data on safety and efficacy in this age group.

Nitazoxanide Missed Dose

Take a missed dose of Nitazoxanide as soon as you remember. If the next dose is due soon, drop the missed one and proceed with your normal schedule. Avoid taking a double dose. Maintaining a regular schedule maximizes the effectiveness of the treatment and prevents missed doses. Always consult your healthcare professional if you frequently miss doses.

[Note: If you miss a dose of Nitazoxanide and are uncertain about when to take the next one, promptly consult your doctor or pharmacist.]

Nitazoxanide Overdose  

If you think you have taken too much nitazoxanide, get medical help right away. Overdose symptoms may include intense headaches, drowsiness, excessive thirst, hyperactivity, vomiting, or restlessness. It is important to stick to the recommended dosage of Nitazoxanide and timing carefully to avoid an overdose. Emergency medical treatment is essential in managing the symptoms and avoiding potential complications from an overdose of nitazoxanide.

[Note: If you take more than the advised dose of Nitazoxanide, seek immediate medical assistance or contact the Poison Help line at 1-800-222-1222.]

Nitazoxanide Storage

  • Keep Nitazoxanide at room temperature, typically between 20°C to 25°C (68°F to 77°F).
  • Protect the medication from excessive heat and moisture. Keep it out of bathrooms and other humid areas.
  • Maintain Nitazoxanide in its original packaging until ready to use to protect it from light and moisture.
  • Keep Nitazoxanide stored in a safe location, out of sight and reach of children to avoid accidental ingestion.
  • Consistently verify the expiration date on the Nitazoxanide packaging and avoid using the medication after this date.
  • Properly dispose of any expired or unused Nitazoxanide by adhering to local disposal guidelines or by returning it to a pharmacy that will safely discard it.

[Note: Consult your healthcare provider about the correct disposal of unused Nitazoxanide and any storage questions you might have.]

Nitazoxanide Interactions

  • Warfarin (Coumadin): Nitazoxanide may increase the effects of warfarin, potentially increasing the risk of bleeding.
  • CYP450 substrates: Nitazoxanide may inhibit certain CYP450 enzymes, potentially affecting the metabolism of drugs that are substrates of these enzymes.
  • Highly protein-bound drugs: As Nitazoxanide is highly protein-bound, it may interact with other highly protein-bound drugs, potentially altering their effectiveness.
  • Alcohol: Consuming alcohol while taking Nitazoxanide may increase the risk of side effects.
  • Oral contraceptives: There’s a theoretical risk of reduced effectiveness of oral contraceptives, though this hasn’t been well-established.
  • Antacids containing aluminum or magnesium: These may decrease the absorption of Nitazoxanide if taken simultaneously.
  • Drugs that can cause QT prolongation: Caution is advised when combining Nitazoxanide with other drugs that can affect heart rhythm.

[Note: This list may not be exhaustive; other drugs could also interact with Nitazoxanide. Inform your doctor about all medications you are taking, including prescription, over-the-counter, and herbal products.]

Nitazoxanide Alternatives

[Note: Your doctor will determine the best treatment option for you. Do not use any alternative medications without first consulting your healthcare provider, as self-medicating could lead to serious side effects.]

Frequently Asked Questions

How quickly does Nitazoxanide begin to take effect?

Nitazoxanide starts acting against diarrhea-inducing pathogens shortly after the initial dose is administered. However, the tangible benefits of the medication, such as reduced diarrhea and stomach pain, may not be immediately noticeable. In clinical trials, the effectiveness of Nitazoxanide was evaluated 7 to 10 days after treatment commenced, with the majority of participants reporting significant improvement in their symptoms by this time.

Is Nitazoxanide considered an antibiotic?

No, Nitazoxanide is not classified as an antibiotic. It is an antiprotozoal medication specifically used to treat infections caused by the parasites Giardia lamblia and Cryptosporidium parvum. While evidence suggests that Nitazoxanide may have effects against certain bacteria, it is not currently approved by the FDA for treating bacterial infections, and additional research is required to explore these potential uses.

Does Nitazoxanide affect beneficial gut bacteria?

Research indicates that Nitazoxanide (Alinia) may alter the composition of gut bacteria, including typical strains such as Clostridium and Bacteroides. If you have concerns about Nitazoxanide’s impact on your gut microbiome, discussing these with your healthcare provider is important.

How long is the recommended duration for taking Nitazoxanide?

Adults & children aged 12 and older should take 25 milliliters (mL) of Nitazoxanide every 12 hours with food for three days. For children aged 4 to 11, the recommended dose is 10 mL every 12 hours with food, also for 3 days. Children aged 1 to 3 should take 5 mL every 12 hours with food for a total duration of 3 days.

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