AlternativeAlinia

Nitazoxanide

Thiazolide antiprotozoal

Cryptosporidium and giardia in immunocompetent women.

Oral

First-line for

  • Cryptosporidiosis
  • Giardiasis (metronidazole alternative)

Mechanism

Inhibits pyruvate:ferredoxin oxidoreductase (PFOR) — anaerobic energy metabolism.

“Cryptosporidium with diarrhoea? Think nitazoxanide”

  • No specific Crypto treatment otherwise
  • Supportive rehydration mainstay

Dosing

Adult
500 mg BD x 3 d

Contraindications

  • AbsoluteHypersensitivity
  • CautionHepatic impairment

Side effects

  • Abdominal pain
  • Greenish discoloration of urine
  • Headache

Fetal & maternal notes

  • Limited human data — use only if benefit > risk
  • Avoid breastfeeding during treatment

Key interactions

  • Warfarin

    Caution

    ↑ INR (highly bound)

Clinical pearls

  • 💡 Useful in HIV-positive women with chronic crypto
  • 💡 Hydration is the cornerstone

Content last reviewed: REPLACE_ME (e.g. 2026-07)

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For educational use only

Not medical advice. Verify dosing against the BNF and your local trust guidelines before prescribing.