Rx Update: February 2005
Joan Murhammer, R.Ph., Mary Ross, R.Ph., M.B.A., Kevin Bebout,
R.Ph.
Peer Review Status: Internally Reviewed
Tinidazole
Tinidazole (Tindamax®) is an antiprotozoal agent. It is FDA-approved for use in the treatment of trichomoniasis infections caused by Trichomonas vaginalis, giardiasis caused by Giardia duodenalis, and intestinal amebiasis and amebic liver abscess causes by Entamoeba histolytica. Although it is in the same therapeutic class as metronidazole, it is not approved for use for anaerobic bacterial infections.
Tinidazole is contraindicated in people with hypersensitivity to tinidazole or metronidazole. Alcohol should not be taken concurrently with tinidazole or for 3 days following the last dose of tinidazole because of the potential to cause a disulfiram-like reaction (e.g., abdominal cramps, nausea, vomiting, headaches, and flushing).
The most commonly reported adverse effects with tinidazole therapy include metallic/bitter taste, nausea, weakness, fatigue, malaise, anorexia, dyspepsia, cramps, epigastric discomfort, vomiting, headache, dizziness, and constipation. Convulsions and transient peripheral neuropathy have also been reported rarely. If abnormal neurological symptoms develop, tinidazole should be discontinued. It should be used with caution in patients with central nervous system diseases.
The recommended adult dose of tinidazole for the treatment of trichomoniasis or giardiasis is a single 2 gm dose. For the treatment of intestinal amebiasis, the dose is 2 gm daily for 3 days. The dose for amebic liver abscess is 2 gm daily for 3 to 5 days. Tinidazole should be taken with food to minimize the incidence of gastrointestinal side effects. No dosage adjustments are required in patients with renal dysfunction. A supplemental dose is required in patients on hemodialysis. Tinidazole should be used cautiously in patients with hepatic dysfunction. Tinidazole is commercially available in 250 and 500 mg tablets and is significantly more expensive than metronidazole tablets.
Pharmacy will no longer be providing aromatic oils (e.g., peppermint, cinnamon, spearmint oils) for use on patient care areas as room deodorizers. These oils were previously used on areas by placing the oil on a gauze pad or pouring it into containers to help freshen rooms. These oils are very caustic and can cause damage to plastic equipment or to skin it may come in contact with.
Only products that are manufactured specifically for use as room deodorizers should be utilized for this purpose. Room deodorizers can be obtained through Hospital Stores and include: deodorant air freshener pump spray (MH03056); Solidaire stick (MH07019); or Solidaire stick for very strong odors (MH07020).