Secnidal

Indications

Secnidazole is an antimicrobial used to treat infections caused by certain parasites and anaerobic bacteria (bacteria that live without oxygen). Common uses include intestinal amoebiasis (amoebic dysentery), giardiasis, trichomoniasis (a sexually transmitted infection) and bacterial vaginosis.

How It Works

Secnidazole belongs to the nitroimidazole group, like Metronidazole. Inside the germ it is changed into a reactive form that damages the germ's DNA, so the germ dies. It stays in the body for a long time, which allows treatment with a single dose or a short course.

Dosage and Administration

For adults, a single dose of 2 g by mouth is usually used for trichomoniasis, bacterial vaginosis, giardiasis and acute intestinal amoebiasis. Some infections, such as amoebiasis of the liver, need a longer course as prescribed by a doctor. It is best taken with or just before a meal. Granules can be mixed into soft food such as yoghurt and eaten without chewing. For trichomoniasis, the sexual partner should also be treated at the same time. Children's doses are based on weight and should be given as prescribed.

Interactions

• Alcohol: avoid alcohol during treatment and for at least 2 to 3 days after, as it can cause flushing, vomiting, headache and a fast heartbeat.
• Warfarin: the blood thinning effect may increase; INR should be checked.
• Disulfiram: may cause confusion or psychotic reactions; do not use together.
• Lithium: blood levels may rise.

Contraindications

• Allergy to Secnidazole or other nitroimidazoles such as Metronidazole or Tinidazole.
• First trimester of pregnancy.
• Breastfeeding, unless milk is expressed and discarded for the advised time.
• A history of blood disorders.

Side Effects

Common side effects include nausea, a metallic or bitter taste, stomach pain, diarrhoea, headache and dizziness. Vaginal yeast infection (itching and white discharge) can occur after treatment for vaginal infections. Rarely, skin rash, itching or a lowered white blood cell count may occur.

Get urgent medical help if you have signs of a serious allergic reaction (swelling of the face, lips or throat, difficulty breathing, widespread rash), numbness or tingling in the hands or feet, fits, or severe confusion.

Pregnancy and Lactation

Secnidazole should not be used in the first three months of pregnancy and should be used later in pregnancy only if a doctor decides it is clearly needed. It passes into breast milk; breastfeeding should be stopped during treatment and for a few days afterwards as advised by your doctor.

Precautions and Warnings

• Do not drink alcohol during treatment and for at least 2 to 3 days afterwards.
• Use with care if you have nerve or brain disorders.
• Dizziness may occur; take care when driving.
• Complete the full prescribed course.

Overdose

Overdose may cause nausea, vomiting, dizziness and, rarely, nerve symptoms. Contact a doctor or hospital straight away. Treatment is supportive.

Therapeutic Class

Antiprotozoal and antibacterial medicine; nitroimidazole.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.