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Nitazoxanide is a thiazolide antimicrobial that treats protozoal diarrhea such as cryptosporidiosis and giardiasis in children.
Only antiparasitic approved for cryptosporidiosis in immunocompetent children; efficacy in severe immunodeficiency is limited.
Administer with food every 12 hours for 3 days to enhance absorption and tolerance.
Reconstituted suspension expires after 7 days; counsel families on storage and discard date.
Common adverse effects include nausea, abdominal pain, headache, and yellow-green urine; reassure families these are usually mild.
Limited data exist in severe hepatic or renal impairment—monitor closely and consider alternative therapy if function worsens.
Nitazoxanide targets protozoal diarrhea and select viral infections.
Only FDA-approved therapy for pediatric cryptosporidiosis and widely used for giardiasis.
| Condition | Age Range | First Line? | Notes |
|---|---|---|---|
| Cryptosporidiosis in immunocompetent children | Children 1–11 years | Yes | Administer 100–200 mg twice daily with food for 3 days; longer courses may be needed in persistent symptoms. |
| Giardiasis | Children ≥1 year | Yes | Three-day course provides cure rates comparable to metronidazole and offers better palatability for some families. |
| Adjunct therapy for persistent viral gastroenteritis (investigational) | Children | No | Evidence remains limited; consider only in clinical trials or specialist-directed care. |
| Refractory Clostridioides difficile infection | Adolescents | No | May be combined with vancomycin for recalcitrant disease under infectious disease consultation. |
FDA-approved primary uses with Level A evidence
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Nitazoxanide side effects are usually mild and self-limited.
Gastrointestinal symptoms, headache, and urine discoloration are most common.
Nausea
Common • mild
Abdominal pain
Common • mild
Headache
Common • mild
Yellow sclera or discoloration
Uncommon • mild
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Administration tips for nitazoxanide in children.
Shake the oral suspension well. Measure each dose with the provided dosing cup or syringe. Give with food, such as breakfast and dinner.
Reconstituted suspension expires after 7 days; store at room temperature. Mark the discard date on the bottle.
Emergency contact: Seek care for severe abdominal pain, yellowing eyes or skin, dark urine, or symptoms of dehydration such as minimal urine or dizziness.
Keeping your child hydrated and dosing with meals helps nitazoxanide clear the infection quickly.
Different formulations and concentrations
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The active metabolite tizoxanide inhibits the pyruvate ferredoxin oxidoreductase enzyme system.
Nitazoxanide disrupts anaerobic energy metabolism and may modulate viral replication.
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Receptors, enzymes, and cellular targets
Absorption, metabolism, and elimination
Age-related differences and special populations
Practical pearls for nitazoxanide therapy.
Focus on adherence, hydration, and follow-up.
Administer with meals to improve absorption and minimize nausea.
Reconstituted suspension expires in 7 days; write the discard date on the bottle.
Recommend oral rehydration solutions if diarrhea is moderate to severe.
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Understanding your child's medication is important. We've created comprehensive guides to help you safely administer Nitazoxanide and monitor your child's response to treatment.
Once water is added, the suspension is stable for only 7 days at room temperature. Discard any remaining medicine after that time.
It can. Bright yellow or green urine is harmless and expected.
Call your clinician. Some infections need another evaluation, stool testing, or additional treatment.
Taking it with food improves absorption and reduces stomach upset, so pair each dose with a meal.