{"id":55183,"date":"2024-01-10T09:33:08","date_gmt":"2024-01-10T09:33:08","guid":{"rendered":"https:\/\/medsname.com\/nizonide\/"},"modified":"2026-04-30T10:24:50","modified_gmt":"2026-04-30T10:24:50","slug":"nizonide","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/nizonide\/","title":{"rendered":"Nizonide"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div class=\"medsbase-tldr-answer\" style=\"background:#fffbe6;border-left:4px solid #f5a623;padding:14px 18px;margin:14px 0 22px;border-radius:6px;font-size:15px;line-height:1.55;\">\n<h3 style=\"margin:0 0 6px;font-size:17px;color:#8a6d3b;\">\u26a1 Quick Answer \u2014 What is Nizonide?<\/h3>\n<p style=\"margin:0;\">Nizonide is Cipla&#8217;s brand of <strong>nitazoxanide<\/strong> (200 \/ 500 mg) \u2014 a broad-spectrum antiprotozoal and antiviral. First-line for confirmed <em>Giardia lamblia<\/em> a <em>Cryptosporidium parvum<\/em> infections (the only FDA-approved indication), and useful for amoebiasis and selected viral diarrhoeas. Standard adult course is 500 mg twice daily for 3 days, taken with food.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f6f7fb;border:1px solid #e3e5ee;border-radius:8px;padding:14px 18px;margin:18px 0;font-size:14px;line-height:1.55;\"><strong style=\"color:#1f3661;\">Pro\u010d objedn\u00e1vat z MedsBase?<\/strong> Dod\u00e1v\u00e1no od v\u00fdrobce certifikovan\u00e9ho WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Doprava po cel\u00e9m sv\u011bt\u011b \u00b7 <a href=\"\/cs\/reviews\/\" rel=\"noopener\">1 400+ ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a><\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2>What Nizonide is for<\/h2>\n<p>Nizonide is a thiazolide antiprotozoal manufactured by Cipla. The active ingredient nitazoxanide has a uniquely broad spectrum against intracellular and luminal protozoa, certain helminths, anaerobic bacteria, and a number of RNA viruses. In traveller&rsquo;s-diarrhoea and tropical-medicine practice it is most commonly used for:<\/p>\n<ul>\n<li><strong>Giardi\u00f3za<\/strong> \u2014 first-line in many countries; alternative to metronidazole and tinidazole. Better tolerated (no disulfiram-like reaction with alcohol) and shorter 3-day course.<\/li>\n<li><strong>Cryptosporidiosis<\/strong> \u2014 the <em>pouze<\/em> FDA-approved drug for this infection in immunocompetent adults and children. In severe cryptosporidiosis associated with HIV\/AIDS the response is partial \u2014 restoration of CD4 count via ART is the central intervention.<\/li>\n<li><strong>Amoebiasis<\/strong> (intestinal, off-label) \u2014 good activity against <em>Entamoeba histolytica<\/em>; metronidazole or tinidazole remain preferred for invasive disease.<\/li>\n<li><strong>Other protozoa<\/strong> \u2014 <em>Blastocystis hominis<\/em>, <em>Cyclospora<\/em>, <em>Isospora<\/em> in selected contexts.<\/li>\n<li><strong>Helminths<\/strong> (mimo indikaci) \u2014 <em>Hymenolepis nana<\/em> (dwarf tapeworm), <em>Ascaris lumbricoides<\/em>, <em>Trichuris trichiura<\/em>; albendazole\/mebendazole remain preferred first-line.<\/li>\n<li><strong>Viral gastroenteritis<\/strong> \u2014 clinical-trial evidence supports modest reduction in symptom duration in rotavirus and norovirus diarrhoea (Rossignol JAMA 2009; Rossignol Lancet 2006). Not standard of care; consider in severe or prolonged viral illness.<\/li>\n<li><strong>Recurrent <em>Clostridioides difficile<\/em><\/strong> infection (off-label salvage) \u2014 small case series only; vancomycin and fidaxomicin remain first-line.<\/li>\n<\/ul>\n<h2>How Nizonide works<\/h2>\n<p>Nitazoxanide is a prodrug rapidly hydrolysed to its active metabolite tizoxanide in the gut and liver. The mechanism is unique among anti-infectives: it inhibits the <strong>pyruvate:ferredoxin oxidoreductase (PFOR) enzyme<\/strong> required for anaerobic energy metabolism in protozoa, anaerobic bacteria, and certain helminths. Because mammalian cells use aerobic mitochondrial metabolism instead, the drug is selectively toxic to the pathogen. Antiviral activity against rotavirus, norovirus, influenza, and hepatitis B\/C is mediated through different pathways including interference with viral protein maturation.<\/p>\n<h2>D\u00e1vkov\u00e1n\u00ed<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:12px 0;\">\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Indikace<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">D\u00e1vkov\u00e1n\u00ed pro dosp\u011bl\u00e9<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Paediatric (1\u201311 y)<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">D\u00e9lka<\/th>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Giardi\u00f3za<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">500 mg BID<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">1\u20133 y: 100 mg BID \u00b7 4\u201311 y: 200 mg BID<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">3 dny<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Cryptosporidiosis (immunocompetent)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">500 mg BID<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">100 \/ 200 mg BID by age band<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">3 dny<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Cryptosporidiosis (HIV\/CD4 &lt; 200)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">500\u20131000 mg BID<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Specialist guidance<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">14 days minimum<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Amoebiasis (off-label)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">500 mg BID<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">By age band<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">3 dny<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Viral gastroenteritis (off-label)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">500 mg BID<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">By age band<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">3 dny<\/td>\n<\/tr>\n<\/table>\n<div style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:14px 18px;margin:18px 0;border-radius:4px;\"><strong style=\"color:#2e7d32;\">\u2705 U\u017e\u00edvejte s j\u00eddlem<\/strong><br \/>Nitazoxanide is poorly water-soluble. Taking each dose <strong>s j\u00eddlem<\/strong> increases AUC roughly 2\u20133 fold versus fasting. Adherence to this rule is the single biggest predictor of treatment success \u2014 failed courses are most often under-absorbed, not under-dosed.<\/div>\n<h2>Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<ul>\n<li><strong>Bright greenish-yellow urine<\/strong> \u2014 a harmless and characteristic effect of the tizoxanide metabolite. Resolves within 24\u201348 hours of stopping the course.<\/li>\n<li><strong>\u010cast\u00e9 (1\u201310 %)<\/strong> \u2014 abdominal pain, diarrhoea (paradoxically), headache, nausea.<\/li>\n<li><strong>M\u00e9n\u011b \u010dast\u00e9<\/strong> \u2014 vomiting, dyspepsia, skin rash.<\/li>\n<li><strong>Vz\u00e1cn\u00e9<\/strong> \u2014 elevated liver enzymes (usually self-limiting), hypersensitivity reactions.<\/li>\n<\/ul>\n<h2>Interakce l\u00e9k\u016f<\/h2>\n<p>Nitazoxanide and tizoxanide are extensively protein-bound (&gt; 99 %). Caution is warranted with other highly protein-bound drugs in narrow therapeutic windows:<\/p>\n<ul>\n<li><strong>Warfarin<\/strong> \u2014 competition for albumin binding can transiently raise free-warfarin levels; monitor INR closely if co-administered.<\/li>\n<li><strong>Fenytoin<\/strong> \u2014 similar mechanism; consider level monitoring during co-treatment.<\/li>\n<li><strong>Antacids and bile-acid sequestrants<\/strong> \u2014 no clinically significant interaction reported, but separate dosing by 2 hours as a precaution.<\/li>\n<li><strong>CYP enzymes<\/strong> \u2014 nitazoxanide is not a significant CYP substrate or inhibitor at therapeutic doses; CYP-mediated interactions are uncommon.<\/li>\n<\/ul>\n<h2>Kontraindikace a upozorn\u011bn\u00ed<\/h2>\n<ul>\n<li><strong>T\u011bhotenstv\u00ed<\/strong> \u2014 limited human data. FDA Pregnancy Category B (animal data reassuring; no controlled human studies). Avoid in first trimester unless benefit clearly outweighs uncertain risk.<\/li>\n<li><strong>Kojen\u00ed<\/strong> \u2014 limited data on excretion in breast milk. Short courses generally compatible; avoid prolonged dosing where possible.<\/li>\n<li><strong>Children &lt; 1 year<\/strong> \u2014 safety not established; specialist supervision only.<\/li>\n<li><strong>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed<\/strong> \u2014 limited data; specialist supervision.<\/li>\n<li><strong>T\u011b\u017ek\u00e9 po\u0161kozen\u00ed ledvin (CrCl &lt; 30)<\/strong> \u2014 limited data; specialist supervision.<\/li>\n<\/ul>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\"><strong style=\"color:#8a6d3b;\">\ud83d\udca1 Diagnostic confirmation<\/strong><br \/>Symptomatic protozoal infection should ideally be confirmed by stool microscopy, antigen testing, or PCR before treatment, especially for cryptosporidiosis (which has overlapping symptoms with giardia, viral, and bacterial causes). Empirical nitazoxanide for unspecified &#8220;chronic diarrhoea&#8221; without diagnostic workup is not recommended \u2014 chronic diarrhoea after travel can also reflect post-infectious IBS, microscopic colitis, tropical sprue, or coeliac disease, all of which need different management.<\/div>\n<h2>Skladov\u00e1n\u00ed<\/h2>\n<p>Store below 25 \u00b0C in the original blister, away from moisture and direct sunlight. Keep out of reach of children. Do not use after expiry \u2014 antiprotozoal potency degrades.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Is Nizonide first-line for traveller&rsquo;s diarrhoea?<\/h3>\n<p>No. Most acute traveller&rsquo;s diarrhoea is bacterial (ETEC, Campylobacter, Shigella, Salmonella) \u2014 for which a single-dose azithromycin or a 1\u20133 day fluoroquinolone course is first-line. Nizonide becomes appropriate when stool testing identifies a protozoal cause, or in chronic \/ recurrent \/ antibiotic-failed diarrhoea suggestive of cryptosporidium or giardia.<\/p>\n<h3>Why does my urine turn bright yellow-green on Nizonide?<\/h3>\n<p>Tizoxanide, the active metabolite, has an intense yellow chromophore that is excreted renally. The colour is harmless and a normal expected effect \u2014 it does not indicate liver or kidney problems. It clears within 24\u201348 hours of finishing the course.<\/p>\n<h3>Can I take Nizonide if I am pregnant?<\/h3>\n<p>Human pregnancy data are limited. The US FDA classifies nitazoxanide as Pregnancy Category B (no animal evidence of harm, no controlled human studies). For confirmed giardiasis or cryptosporidiosis in pregnancy, paromomycin (non-absorbed aminoglycoside) is often preferred in the first trimester. Nitazoxanide may be used in second\/third trimester after risk-benefit discussion with an obstetrician.<\/p>\n<h3>Does Nizonide cure cryptosporidiosis in HIV\/AIDS?<\/h3>\n<p>Partial response only. In immunocompetent adults nitazoxanide reliably shortens cryptosporidial diarrhoea. In severe immunocompromise (CD4 &lt; 200), response rates are lower and the central intervention is restoration of CD4 count via effective antiretroviral therapy. Higher doses (1000 mg BID) and longer courses (\u2265 14 days) are used in HIV under specialist supervision.<\/p>\n<h3>Does Nizonide work against COVID-19?<\/h3>\n<p>No. Early small studies suggested in-vitro activity but large randomised controlled trials in symptomatic outpatients (PROMINENT-NZX 2022, Rocco 2023) showed no clinically meaningful benefit on viral load, symptom duration, or hospitalisation. Routine use for COVID-19 is not supported.<\/p>\n<h3>How long until symptoms improve?<\/h3>\n<p>For giardiasis and cryptosporidiosis in immunocompetent adults, most patients notice symptom improvement within 24\u201372 hours of starting therapy, with full resolution by the end of the 3-day course or shortly after. Persistent diarrhoea beyond day 5 should prompt re-evaluation \u2014 possible alternative diagnosis, treatment failure (consider drug exposure with food), or co-infection.<\/p>\n<h3>Can I drink alcohol while taking Nizonide?<\/h3>\n<p>Yes. Unlike metronidazole and tinidazole, nitazoxanide does <strong>ne<\/strong> cause a disulfiram-like reaction with alcohol. Modest alcohol intake during a 3-day course is not dangerous, though hydration, gut rest, and avoiding alcohol while diarrhoea is active are sensible regardless.<\/p>\n<h3>Pro\u010d mus\u00edm l\u00e9k u\u017e\u00edvat s j\u00eddlem?<\/h3>\n<p>Nitazoxanide is poorly water-soluble. Taking it on an empty stomach gives roughly half the systemic exposure compared with taking it with food \u2014 particularly fatty food. Sub-therapeutic absorption is the most common reason for treatment failure. Always take both daily doses with a meal, ideally one containing some fat.<\/p>\n<h3>Can I give Nizonide to my child?<\/h3>\n<p>Yes, from age 1. Paediatric dosing is age-banded: 1\u20133 years 100 mg BID; 4\u201311 years 200 mg BID; 12+ years adult 500 mg BID. Cipla also makes nitazoxanide as a paediatric oral suspension at 100 mg \/ 5 ml. Safety in infants &lt; 1 year is not established.<\/p>\n<h3>How does Nizonide compare with metronidazole for giardiasis?<\/h3>\n<p>Comparable cure rates (around 75\u201385 %) in head-to-head trials. Nitazoxanide advantages: shorter 3-day course (vs 5\u20137 days for metronidazole), no disulfiram-like alcohol reaction, no metallic taste, generally better tolerated. Metronidazole advantages: more market familiarity, lower cost, available in most healthcare settings. Either is reasonable first-line.<\/p>\n<h3>Can Nizonide treat amoebiasis?<\/h3>\n<p>Yes for intestinal\/luminal amoebiasis (3-day course), with cure rates comparable to metronidazole. For invasive disease (amoebic dysentery, hepatic abscess), metronidazole or tinidazole \u2014 followed by a luminal agent like paromomycin to clear cysts \u2014 remain the preferred regimen. Always investigate suspected amoebiasis with stool antigen or PCR plus serology when liver involvement is possible.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3>Dal\u0161\u00ed mo\u017enosti p\u0159i cestovatelsk\u00e9m pr\u016fjmu a antibiotika<\/h3>\n<ul>\n<li><a href=\"\/cs\/althrocin\/\">Althrocin (erythromycin 250\/500 mg) \u2014 alternative for Campylobacter coverage<\/a><\/li>\n<li><a href=\"\/cs\/augmentin\/\">Augmentin (amoxicillin + clavulanate) \u2014 for selected bacterial GI infections<\/a><\/li>\n<li><a href=\"\/cs\/cendox\/\">Cendox (doxycycline 100 mg) \u2014 broad-spectrum traveller-medicine antibiotic<\/a><\/li>\n<li><a href=\"\/cs\/medical-emergency-kit\/\">Medical Emergency Kit \u2014 8-drug travel pack<\/a><\/li>\n<li><a href=\"\/cs\/metrogyl\/\">Metrogyl (metronidazole 200\/400 mg) \u2014 alternative for giardia \/ amoebiasis<\/a><\/li>\n<li><a href=\"\/cs\/tiniba\/\">Tiniba (tinidazole 500\/1000 mg) \u2014 single-dose option for giardia<\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:24px 0;border-radius:4px;font-size:13.5px;line-height:1.55;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed.<\/strong> Tyto informace maj\u00ed vzd\u011bl\u00e1vac\u00ed charakter a nenahrazuj\u00ed individu\u00e1ln\u00ed l\u00e9ka\u0159skou radu. Krvav\u00fd pr\u016fjem, hore\u010dka &gt; 39 \u00b0C, p\u0159etrv\u00e1vaj\u00edc\u00ed zvracen\u00ed, p\u0159\u00edznaky dehydratace nebo p\u0159\u00edznaky trvaj\u00edc\u00ed &gt; 5\u20137 dn\u00ed vy\u017eaduj\u00ed neodkladn\u00e9 l\u00e9ka\u0159sk\u00e9 vy\u0161et\u0159en\u00ed \u2014 zvl\u00e1\u0161t\u011b po cest\u011b do rizikov\u00fdch oblast\u00ed (zva\u017ete parazitologick\u00e9 vy\u0161et\u0159en\u00ed a kultivaci stolice). T\u011bhotn\u00e9 \u017eeny, kojenci, senio\u0159i a pacienti s oslabenou imunitou by se m\u011bli p\u0159ed samol\u00e9\u010dbou poradit s l\u00e9ka\u0159em.<\/div>","protected":false},"excerpt":{"rendered":"<p>\u2705 Treats parasitic infections<br \/>\n\u2705 Fights viral gastroenteritis<br \/>\n\u2705 Reduces diarrhea symptoms<br \/>\n\u2705 Fast-acting relief<br \/>\n\u2705 Broad antiparasitic action<\/p>\n<p>Nizonide contains <strong>Nitazoxanide<\/strong>.<\/p>","protected":false},"featured_media":55184,"comment_status":"open","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[3583,3342,3448,3489],"product_tag":[3083,3084],"class_list":{"0":"post-55183","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-diarrhoea-treatment","7":"product_cat-general-health","8":"product_cat-travel-health-category-overview","9":"product_cat-travellers-diarrhea-treatment","10":"product_tag-nitazoxanide","11":"product_tag-nizonide","13":"first","14":"instock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/55183","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=55183"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/55184"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=55183"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=55183"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=55183"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=55183"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}