Indications

Secnidazole is indicated in Intestinal Amoebiasis, Hepatic Amoebiasis, Urethritis and Vaginitis due to Trichomonas vaginalis, Giardiasis

Therapeutic Class

Amoebicides, Anti-diarrhoeal Antiprotozoal

Pharmacology

Secnidazole is the first nitroimidazole to offer a 3 day antiprotozoal activity from one single dose. With its prolonged half life, Secnidazole offers an effective treatment and thus ensures improved patient compliance because of the short duration of treatment with excellent therapeutic efficacy.

Secnidazole exhibits activity against anaerobic protozoa Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis. Secnidazole is rapidly absorbed following oral administration. The maximum serum level is obtained after 3 hours following oral administration of 2 gm secnidazole.

The plasma elimination half life is about 20 hours. The majority of Secnidazole is eliminated via urine (50% of the ingested dose is excreted within 120 hours). The pharmacokinetic profile of Secnidazole gives it the longest half-life of all the second generation nitroimidazoles, ensuring 72-hour therapeutic blood levels from a 2 gm single dose.

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 (2×1000 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 (2×1000 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 (2×1000 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 (2×1000 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

Administration of secnidazole with disulfiram is not recommended: confusional state & paranoid reaction may occur.

Use of secnidazole simultaneously with warfarin requires close monitoring: increased effect of oral anticoagulants and of the hemorrhagic risk is likely.

Contraindications

Secnidazole is contraindicated for those patients who are hypersensitive to imidazole derivatives.

Side Effects

The clinical studies have shown that secnidazole is characterized by very good tolerance and no serious adverse reactions have been reported to date. The following side-effects may be observed with secnidazole as with all nitroimidazole derivatives & are rarely serious

Most frequent side-effects: Gastrointestinal disturbances, nausea, epigastric pain, metallic taste, glossitis, and stomatitis.

Occasional side-effects: Urticaria, moderate leukopenia which is reversible on treatment discontinuation.

Rare side-effects: Vertigo, ataxia and motor incoordination, paresthesia, and peripheral neuropathy. With secnidazole, gastrointestinal disorders e.g. nausea, vomiting, epigastric pain, etc. have been reported in very rare cases.

Pregnancy & Lactation

Secnidazole may be prescribed in pregnancy after the first trimester. As with other similar drugs, secnidazole should not be administered during the first trimester of pregnancy or during lactation because secnidazole is found in placenta and breast milk.

Precautions & Warnings

Patients should be advised not to take alcohol during treatment with secnidazole (because of possibility of antabuse effect). Administration of secnidazole should be avoided to patients with a history of blood dyscrasia.

Storage Conditions

Store in a cool dry place, protected from heat.