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Indications
Intestinal amoebiasis, hepatic amoebiasis, urethritis and vaginitis caused by Trichomonas vaginalis, and Giardiasis are all treated with secnidazole.
Pharmacology
Secnidazole is the first nitroimidazole to provide antiprotozoal activity for three days after just one dose. Secnidazole provides an efficient treatment with a long half-life, which ensures enhanced patient compliance due to the short treatment duration and high therapeutic efficacy.
Entamoeba histolytica, Giardia lamblia, and Trichomonas vaginalis are anaerobic protozoa that Secnidazole can kill. Following oral treatment, secnidazole is readily absorbed. After 3 hours of oral administration of 2 gm secnidazole, the maximal serum level is attained.
The half-life of plasma elimination is approximately 20 hours. The majority of Secnidazole is excreted in the urine (50 percent of the ingested dose is excreted within 120 hours). Secnidazole has the longest half-life of all the second-generation nitroimidazoles, ensuring 72-hour therapeutic blood levels from a 2 gm single dose, thanks to its pharmacokinetic characteristics.
Dosage & Administration
Secnidazole tablet should be administered orally. The dosage schedule of Secnidazole tablet is mentioned below:
Secnidazole Tablet:
Amoebiasis:
Acute intestinal amoebiasis:
Adults: 2 gm single dose (2x1000 mg tablet), taken preferably just before meal.
Children: 30 mg/kg single dose, taken preferably just before meal.
Asymptomatic amoebiasis (minute & cystic form):
Adults: 2 gm once daily (2x1000 mg tablet) for only 3 days, taken preferably just before meal.
Children: 30 mg/kg once daily for only 3 days, taken preferably just before meal.
Hepatic amoebiasis :
Adults: 1.50 gm/day, in a single or divided dose, just before meal for 5 days.
Children: 30 mg/kg/day, in a single or divided dose, just before meal for 5 days.
N.B.: Evacuation of pus must be performed simultaneously with Secnidazole treatment at the suppurative stage of hepatic amoebiasis.
Giardiasis :
Adults: 2 gm single dose (2x1000 mg tablet), taken preferably just before meal.
Children: 35-50 mg/kg single dose, taken preferably just before meal.
Trichomoniasis :
Adults: 2 gm single dose (2x1000 mg tablet), taken preferably just before meal.
Children: 30 mg/kg single dose, taken preferably just before meal. The partner should also receive the same treatment concomitantly.
Secnidazole Suspension:
Suspension should be administered orally. The dosage schedule of Secnidazole suspension is mentioned below:
Children of 10 to 15 kg body weight: 1 bottle of Secnidazole 500 mg suspension.
Children of 16 to 25 kg body weight: 1½ bottle of Secnidazole 500 mg suspension.
Children of 26 kg or more body weight: 2 bottles of Secnidazole 500 mg suspension.
Interaction
Secnidazole should not be taken with disulfiram since it may cause disorientation and a delusional reaction.
The use of secnidazole with warfarin necessitates continuous monitoring since oral anticoagulants' effects and hemorrhagic risk are likely to be enhanced.
Contraindications
Patients who are hypersensitive to imidazole derivatives should not take secnidazole.
Side Effects
Secnidazole has proved to have a high level of tolerance in clinical trials, with no significant adverse effects documented to far. Secnidazole, like all nitroimidazole derivatives, can cause the following side effects, which are rarely significant.
Gastrointestinal disturbances, nausea, epigastric pain, metallic taste, glossitis, and stomatitis are the most common adverse effects.
Urticaria and mild leukopenia are rare adverse effects that can be reversed when the medication is stopped.
Vertigo, ataxia and motor incoordination, paresthesia, and peripheral neuropathy are all rare adverse effects. GI problems, such as nausea, vomiting, and epigastric pain, have been described in very uncommon cases with secnidazole.
Pregnancy & Lactation
After the first trimester, secnidazole may be prescribed to a pregnant woman. Secnidazole, like other comparable medications, should not be used during the first trimester of pregnancy or breastfeeding because it is detected in the placenta and breast milk.
Precautions & Warnings
Patients should be told not to drink alcohol when using secnidazole (because of possibility of antabuse effect). Secnidazole should not be given to patients who have a history of blood dyscrasia.
Therapeutic Class
Amoebicides, Anti-diarrhoeal Antiprotozoal
Storage Conditions
Store in a cool, dry location away from direct sunlight.
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