Disulfiram
Contraindicated
Database
Psychotic reactions reported; both drugs affect alcohol metabolism
Do not use within 2 weeks of disulfiram
Source: Kimi deep-research + Cla
Drug reference
Tinidazole
Nitroimidazole antimicrobial / antiprotozoal · Antibiotic
Also known as Tinidazole Hydrochloride
START
2 g single dose for BV, trichomoniasis, giardiasis; 2 g OD x 3-6 days for amoebiasis/anaerobic infections; take with food to reduce GI upset
TYPICAL MAX
2 g/day
STOP IF
Signs of peripheral neuropathy, severe allergic reaction, persistent vomiting
WATCH
Response to treatment (symptom resolution), CNS symptoms with prolonged use
CDSCO approvedSchedule HJan AushadhiATC P01AB02
KDIGO 2024 + manufacturer label
- ONSET
- 26min · absorption onset
- PEAK
- 1.8h · Peak plasma concentration
- t½
- 13h · Long half-life (12-14 hours)
- DURATION
- 2d · Single dose effective for 48+ hours
EXCRETION
Urine and fecal
route + CYP
INTERACTIONS
2 major
incl. contraindicated
PREGNANCY
Avoid in first trimester; use with caution in second and third trimesters
FDA category + note
Top interactionssee all 6 →
- DisulfiramContraindicatedDatabaseKimi deep-research + Cla
- AmprenavirSevereDatabaseDDInter
Available in India
40 branded formulations and 280 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
The nitro group is reduced by ferredoxin (or ferredoxin-linked redox system) within anaerobic organisms, forming toxic radical intermediates that damage DNA helix structure and inhibit nucleic acid synthesis. Selectively taken up by anaerobic bacteria and protozoa
Indications
Bacterial vaginosisTrichomoniasisGiardiasisAmoebiasis (intestinal and extraintestinal)Anaerobic bacterial infections (including dental, intra-abdominal)Helicobacter pylori eradication (as part of combination therapy)
Dosing
- Adult
- BV: 2 g single dose; Trichomoniasis: 2 g single dose (treat partner); Giardiasis: 2 g single dose; Amoebiasis: 2 g OD for 3 days; Anaerobic infections: 2 g OD for 5-6 days
- Pediatric
- >12 years: adult dosing; 6-12 years: 50-60 mg/kg single dose (max 2 g)
- Renal adjustment
- No dose adjustment in renal impairment incl. severe (FDA §8.6 — PK not significantly different). Hemodialysis: give an additional ½ dose after the session.
- Hepatic adjustment
- No adjustment in mild-moderate; caution in severe hepatic impairment
- Geriatric
- Standard dosing
- Max dose
- 2 g/day
Pharmacokinetics
Onset
Rapid (antimicrobial effect)
Peak effect
1.5-2 hours (Tmax)
Duration
24-48 hours
Half-life
12-14 hours
Bioavailability
~100% (oral)
Protein binding
12%
Metabolism
Hepatic oxidation, hydroxylation, and conjugation
Excretion
Urine (20-25% unchanged); feces (12%)
Contraindications
- First trimester pregnancy
- Breastfeeding (during treatment and for 3 days after)
- Previous hypersensitivity to nitroimidazoles
- Concurrent disulfiram use (within last 2 weeks)
Side effects
Common
Metallic tasteNauseaVomitingAnorexiaEpigastric discomfortDark urine (harmless)HeadacheDry mouth
Serious
- Peripheral neuropathy (with prolonged use)
- Seizures (rare)
- Leukopenia
- Severe allergic reactions
- Pancreatitis (rare)
- Drug reaction with eosinophilia and systemic symptoms (DRESS)
Pregnancy & lactation
Pregnancy
Avoid in first trimester; use with caution in second and third trimesters
Lactation
Excreted in breast milk; breastfeeding should be interrupted during treatment and for 3 days after last dose
Drug interactions
Amprenavir
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Alcohol
Moderate
Database
Disulfiram-like reaction (flushing, vomiting, headache, abdominal cramps)
Avoid alcohol during treatment and for 3 days after last dose
Source: Kimi deep-research + Cla · p948
Lithium
Moderate
Database
Increased serum lithium levels
Monitor lithium levels
Source: Kimi deep-research + Cla · p948
Phenytoin
Moderate
Database
Hepatic enzyme induction reduces tinidazole levels; may also increase phenytoin levels
Monitor levels and clinical response
Source: Kimi deep-research + Cla
Warfarin
Moderate
Database
Increased anticoagulant effect; enhanced hypoprothrombinemia
Monitor INR closely; may need warfarin dose reduction
Source: Kimi deep-research + Cla
6 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.
Related guidelines
Helicobacter pylori infection
ICMR · Gastroenterology · 2021
Acute dental pain and intraoral swelling
ADA_DENTAL · Dentistry · 2019
Skin and soft tissue infections
IDSA · Infectious Diseases · 2010
Empirical antimicrobial use in common syndromes
ICMR · Infectious Diseases · 2019
Intra-abdominal infection
WSES · Surgery · 2017
Ask House about Tinidazole
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19