Adults

Not typically used in suspension form for adults; tablets are preferred. If suspension is used, consult a physician for specific dosage (e.g., 500 mg every 12 hours for 3 days).

Elderly

Not typically used in suspension form for elderly; tablets are preferred. Consult a physician for specific dosage. No specific dosage adjustment required based solely on age.

Renal_impairment

No dosage adjustment needed for mild to moderate renal impairment. Caution with severe impairment due to limited data.

Onset

Clinical improvement often seen within 2-3 days of treatment.

Excretion

Excreted in urine, feces, and bile as tizoxanide and tizoxanide glucuronide.

Half life

Tizoxanide: approximately 1-1.6 hours (for the active metabolite).

Absorption

Rapidly absorbed from the gastrointestinal tract and rapidly hydrolyzed to its active metabolite, tizoxanide. Food increases absorption significantly.

Metabolism

Undergoes rapid hydrolysis to tizoxanide, which is then glucuronidated.

Highly protein-bound drugs

Potential for displacement interactions, although specific clinical significance is not well-established.

Coumarin anticoagulants (e.g., Warfarin)

Nitazoxanide may displace coumarin anticoagulants from plasma protein binding sites, leading to an increased prothrombin time and International Normalized Ratio (INR). Monitor INR closely when co-administered.