Screen for allergy, pregnancy status, and hematologic history before tinidazole.
Absolute: hypersensitivity to tinidazole or nitroimidazoles. Relative: first trimester pregnancy, breastfeeding, blood dyscrasias, hepatic impairment, prolonged QT, and existing neurologic disease.
Cross-reactivity with metronidazole can trigger severe dermatologic or anaphylactic reactions; avoid the class entirely.
Embryotoxicity signals from animal data drive a first-trimester contraindication; postpone therapy or select a safer alternative.
Tinidazole persists in milk; interrupt nursing for 72 hours after a dose or use a different antimicrobial.
Extensive hepatic metabolism warrants dose reduction and close monitoring for cumulative toxicity.
Tinidazole has been associated with leukopenia in predisposed patients; obtain baseline counts and repeat if therapy exceeds the usual single course.
Tinidazole can increase QT interval when combined with other offenders; review cardiac history and cautious ECG monitoring is advised.