Warfarin
Severe
Database
Nitroimidazoles potentiate warfarin → raised INR/bleeding
Monitor INR; adjust warfarin
Source: Kimi deep-research + Cla
Drug reference
Secnidazole
Second-generation nitroimidazole antimicrobial · Antiprotozoal, Anti-infective
Also known as Secnil, Seczol, Secro, Solosec
START
Single 2 g oral dose (granules on soft food); treat partner for trichomoniasis
TYPICAL MAX
2 g single dose
STOP IF
Hypersensitivity reaction; neurologic symptoms (rare)
WATCH
Counsel alcohol avoidance (class caution), breastfeeding interruption ~96 h, candidiasis after BV treatment
CDSCO approvedATC P01AB07
KDIGO 2024 + manufacturer label
- ONSET
- 4h · absorption
- PEAK
- 4h · Cmax
- t½
- 22h · plasma t½
- DURATION
- 1d · single-dose (prolonged effect)
EXCRETION
Hepatic metabolism; ~15% renal unchanged
route + CYP
INTERACTIONS
1 major
SEVERE in our sources
PREGNANCY
Avoid first trimester; later only if clearly needed (limited data; nitroimidazole class)
FDA category + note
Top interactionssee all 4 →
- WarfarinSevereDatabaseKimi deep-research + Cla
Available in India
22 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Nitro group reduced intracellularly in anaerobes/protozoa to reactive species causing DNA strand breakage and cell death; long half-life enables single-dose therapy.
Indications
Bacterial vaginosis (single-dose, oral granules)TrichomoniasisAmoebiasis and giardiasis (region-dependent)
Dosing
- Adult
- Bacterial vaginosis/trichomoniasis: single 2 g oral dose (granules sprinkled on food). Amoebiasis/giardiasis: 2 g single dose (or per regional regimen).
- Pediatric
- 30 mg/kg single dose (max 2 g) where indicated (region-dependent).
- Renal adjustment
- No specific adjustment (single dose; caution ESRD).
- Hepatic adjustment
- Caution in significant hepatic impairment (reduced clearance).
- Geriatric
- No specific adjustment.
- Max dose
- 2 g single dose
Pharmacokinetics
Onset
Antimicrobial over the days following single dose
Peak effect
Cmax ~4 h
Duration
Prolonged (single-dose efficacy)
Half-life
~17–29 h (long — basis for single dosing)
Bioavailability
Well absorbed orally
Protein binding
<15%
Metabolism
Hepatic
Excretion
Renal (≈15% unchanged) and metabolites
Contraindications
- Hypersensitivity to nitroimidazoles
- Caution: blood dyscrasias, CNS disease; alcohol (disulfiram-like — class caution)
Side effects
Common
Nausea/dysgeusia (metallic taste)HeadacheVulvovaginal candidiasis (BV treatment)Abdominal discomfort/diarrhoeaVomiting
Serious
- Hypersensitivity reactions
- CNS effects (rare — peripheral neuropathy/seizures, class, with prolonged/high exposure)
- Possible disulfiram-like reaction with alcohol (nitroimidazole class)
Pregnancy & lactation
Pregnancy
Avoid first trimester; later only if clearly needed (limited data; nitroimidazole class)
Lactation
Avoid breastfeeding during and for ~96 h (long half-life) after the single dose
Drug interactions
Disulfiram
Moderate
Database
Acute psychosis/confusion reported with nitroimidazoles
Avoid combination
Source: Kimi deep-research + Cla
Alcohol
Moderate
Database
Possible disulfiram-like reaction (nitroimidazole class)
Avoid alcohol during and for ~3 days after
Source: Kimi deep-research + Cla
Lithium
Moderate
Database
Possible raised lithium levels (class)
Monitor lithium
Source: Kimi deep-research + Cla
8 additional unreviewed or low-confidence interactions hidden because their provenance or source detail is insufficient.
Related guidelines
Empirical antimicrobial use in common syndromes
ICMR · Infectious Diseases · 2019
Antimicrobial resistance — clinical roadmap
MOHFW · Infectious Diseases · 2012
Stroke and TIA — secondary prevention
AHA · Neurology · 2021
Infective endocarditis prevention
ADA_DENTAL · Dentistry · 2015
Infective endocarditis prevention
NICE · Cardiology / Dentistry · 2008
Ask House about Secnidazole
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Textbook-sourced·Sources: KD Tripathi 7e, Harrison 22e·Updated: 2026-05-19·Cockpit curated: 2026-05-19