tinidazole
Tinidazole (Tindamax) is an oral antibiotic. It's used to treat certain bacterial and parasitic infections, including bacterial vaginosis and trichomoniasis, in adults and children. Tinidazole (Tindamax) is taken by mouth, typically once a day. It can also be crushed and added into cherry syrup for those with trouble swallowing. Some common side effects of this medication include bitter taste in the mouth and nausea. Avoid drinking alcohol while taking and for 3 days after stopping tinidazole (Tindamax) because doing so can cause flushing, headache, and nausea.
What is Tinidazole (Tindamax)?
What is Tinidazole (Tindamax) used for?
Trichomoniasis ("trich")
Giardiasis (parasitic gut infection)
Amebiasis (parasitic gut infection)
Bacterial vaginosis (BV)
How Tinidazole (Tindamax) works
Tinidazole (Tindamax) is a nitroimidazole antibiotic. It kills bacteria and parasites by damaging their genetic material.
Drug Facts
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What are the side effects of Tinidazole (Tindamax)?
Common Side Effects
- Metallic or bitter taste (4-6%)
- Nausea (3-5%)
- Poor appetite (2-3%)
- Belly cramps (1-2%)
- Vomiting (1-2%)
- Weakness (1-2%)
- Constipation (1%)
- Dizziness (1%)
- Headache (1%)
Other Side Effects
- Trouble sleeping
- Feeling drowsy
- Darkened urine
- Chest palpitations
- Joint pain
- Muscle pain
- Thrush
- Tongue discoloration
- Vaginal discharge
- Excess gas
- Painful urination
- Trouble urinating
- Pelvic pain
- Heavy periods
- Upper respiratory tract infections, such as coughing, sore throat
Serious Side Effects
- Brain and nerve problems: seizures, numbness in the feet and hands, headache, dizziness, vertigo, impaired coordination, slurred speech, easily irritable, depression, weakness, trouble sleeping
- Severe allergic or skin reaction: rash, blistering or peeling of skin, hives, painful sores in your mouth or around your eyes, fever, trouble breathing, swollen lymph nodes
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Black, tarry stools
bleeding gums
blood in urine or stools
burning, numbness, tingling, or painful sensations
chills
difficulty swallowing
fast, irregular, pounding, or racing heartbeat or pulse
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
lower back or side pain
painful or difficult urination
pale skin
pinpoint red spots on the skin
reddening of the skin, especially around ears
seizures
sores, ulcers, or white spots on the lips or in the mouth
swelling of eyes, face, or inside of the nose
swollen glands
ulcers
unsteadiness or awkwardness
unusual bleeding or bruising
unusual tiredness or weakness
weakness in the arms, hands, legs, or feet
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Bitter taste
metallic taste
Less common
Acid or sour stomach
belching
cramps
difficulty having a bowel movement
dizziness
general feeling of discomfort or illness
headache
indigestion
loss of appetite
pain or discomfort in the chest, upper stomach, or throat
vomiting
Rare
Body aches or pain
coating on tongue
hoarseness
mood or mental changes
tender, swollen glands in the neck
voice changes
Incidence not known
Darkened urine
difficulty in moving
feeling of constant movement of self or surroundings
giddiness
lightheadedness
muscle pain or stiffness
pain, swelling, or redness in joints
sensation of spinning
shakiness and unsteady walk
sleepiness
swelling of the mouth
tongue discoloration
trembling, or other problems with muscle control or coordination
trouble sleeping
unable to sleep
white or brownish vaginal discharge
white patches in the mouth or throat or on the tongue
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Tinidazole (Tindamax)
Pros
Available as a lower-cost generic medication
Can be used to treat different types of bacterial and parasitic infections
Only taken once a day or as an one-time dose
Cons
Serious interaction with alcohol
Can cause metallic or bitter taste in mouth
Not recommended to breastfeed during treatment and for 3 days after your last dose
Pharmacist tips for Tinidazole (Tindamax)
Take tinidazole (Tindamax) with food to lower the risk of stomach side effects such as bloating, heartburn, nausea, and vomiting.
Don't drink alcohol or eat large amounts of food containing ethanol or propylene glycol while taking tinidazole (Tindamax) and for at least 3 days after. Doing so might cause belly cramps, nausea, vomiting, headaches, and flushing.
If you have trouble swallowing, some pharmacies can create tinidazole (Tindamax) oral suspension for you from the tablets. Make sure to shake the bottle before each use. Be aware that oral suspension is only good for a week. Throw away any leftover tinidazole (Tindamax) that you have at the end of your treatment.
Tinidazole (Tindamax) might get into breastmilk. If you're nursing, you might want to consider feeding your baby previously stored breast milk or infant formula while taking tinidazole (Tindamax) and for 3 days after treatment ends.
If you're taking tinidazole (Tindamax) for trich, make sure that your sexual partner(s) also get treated to avoid getting reinfected. Don't have sex until you or your sexual partner(s) have finished treatment and have no more symptoms.
Your primary care provider (PCP) might also test you for human immunodeficiency virus (HIV) and other STIs if you tested positive for bacterial vaginosis (BV) or trich. Having BV or trich can raise your risk for other STIs as well.
Tinidazole (Tindamax) can interact with many medications, such as warfarin (Coumadin). Let your care team know what medications you're taking, including over-the-counter products and supplements, before you start tinidazole (Tindamax). Talk with your care team if you have any questions about interactions with this medication.
Frequently asked questions about Tinidazole (Tindamax)
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What are the risks and warnings for Tinidazole (Tindamax)?
Tinidazole (Tindamax) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Possible risk of cancer
Risk factor: Taking tinidazole (Tindamax) for a long time
Animal studies of a medication similar to tinidazole (Tindamax) throughout their lifetime were at higher risk for tumors in the liver, lung, and different organs. But it's unclear that taking a short course of tinidazole (Tindamax) carries the same risks. If you're taking tinidazole (Tindamax), don't take this medication more often than what your primary care provider (PCP) has directed.
Brain and nerve problems
Rarely, people who take tinidazole (Tindamax) can develop serious brain and nerve problems, such as seizures. Get medical attention right away if you experience convulsions, problems with speech, coordination, clear thinking, headache, nausea, and vomiting. These are symptoms of brain damage and your care team might ask you to stop taking tinidazole (Tindamax) to prevent further injury.
In addition, people who take tinidazole (Tindamax) might also experience different nerve problems. Let your PCP know if you experience numbness in the hands and feet. Your PCP will discuss with you whether tinidazole (Tindamax) is a good option for you.
Risk of fungal infection
Taking tinidazole (Tindamax) can raise your risk of getting a fungal infection, including a vaginal yeast infection. It's important to let your care team know if your symptoms don't go away or get worse after starting treatment. Your PCP might prescribe an antifungal medication for you if symptoms develop. Please talk with your care team if you notice your vagina is red and itchy, you have thick white vaginal fluid, or if you have fever or chills.
Lower blood cell counts
Risk factors: Current or history of blood problems | Taking medications that lower white blood cell counts
Though extremely rare, some people developed lower blood cell count while taking tinidazole (Tindamax). While this typically doesn't cause side effects in normal people, the effect can be severe in those with current or history of blood problems. Depending on your medical history, your PCP might require lab work before and while you're taking this medication to make sure it's safe for you. Let your care team know if you have symptoms of low blood cell counts, such as fatigue, weakness, frequent bleeding, unexplained bruising, and fever.
Risk of drug resistance
Risk factor: Taking tinidazole (Tindamax) more often or differently than prescribed
Taking tinidazole (Tindamax) more often or differently than prescribed can put you at risk for infections that are harder to treat in the future. To make sure that this medication will work well to fight future infections, follow your care team's instruction on when and how long to take tinidazole (Tindamax).
Interaction with other medications
Tinidazole (Tindamax) can interfere with how your body gets rid of other medications. For example, taking certain medications like disulfiram with tinidazole (Tindamax) might cause delusions and hallucinations. Avoid taking tinidazole (Tindamax) within 2 weeks of disulfiram.
When tinidazole (Tindamax) is taken with lithium (Lithobid), it might raise the amount of lithium in your body. This can lead to higher risk of lithium toxicity and side effects, such as confusion, tremors, and uncontrolled eye movements. Your PCP will monitor your bloodwork during treatment with both of these medications.
Tinidazole (Tindamax) can also raise the risk of bleeding when it's taken with certain blood thinners, such as warfarin (Coumadin). Make sure to get your routine blood tests done on time during treatment so your PCP can adjust your dose of warfarin (Coumadin) as needed.
Let your care team know what other medications you’re taking before and while taking tinidazole (Tindamax).
Tinidazole (Tindamax) dosage forms
Typical dosing for Tinidazole (Tindamax)
Adults
Trichomoniasis: The typical dose is 2 grams by mouth as a single dose. Because trich is a STI, sexual partners should be treated with medication at the same time as well.
Giardiasis: The typical dose is 2 grams by mouth as a single dose.
Amebiasis: The typical dose is 2 grams by mouth once a day for 3-5 days.
Bacterial vaginosis: The typical dose is 2 grams by mouth once a day for 2 days, or 1 gram by mouth once a day for 5 days.
Children
Giardiasis (children older than 3 years): Your child's pediatrician will determine the dose based on your child's body weight. The typical dose is 50 mg/kg of body weight (up to 2 grams) by mouth as a single dose.
Amebiasis (children older than 3 years): Your child's pediatrician will determine the dose based on your child's body weight. The typical dose is 50 mg/kg of body weight (up to 2 grams) by mouth once a day for 3-5 days.
Interactions between Tinidazole (Tindamax) and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Capecitabine
- Disulfiram
- Doxifluridine
- Fluorouracil
- Tegafur
How much does Tinidazole (Tindamax) cost?
Tinidazole (Tindamax) contraindications
Allergy to other nitroimidazole medications (e.g., metronidazole (Flagyl))
What are alternatives to Tinidazole (Tindamax)?
Trichomoniasis ("trich")
Giardiasis (parasitic gut infection)
Amebiasis (parasitic gut infection)
Bacterial vaginosis (BV)
Bacterial vaginosis (BV) (a vaginal bacterial infection)
Trichomoniasis or Trich (a type of sexually transmitted infection (STI))
Amebiasis (parasitic gut infection)
Serious bacterial infections, such as:
What is the latest news about Tinidazole (Tindamax)?
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References
Best studies we foundAgency for Toxic Substances and Disease Registry. (2014). Public Health Statement for propylene glycol.
Centers for Disease Control and Prevention. (2021). Bacterial vaginosis.
Centers for Disease Control and Prevention. (2022). Trichomoniasis.
Centers for Disease Control and Prevention. (2024). About Giardia.
Gülmezoglu, A. M., et al. (2000). Interventions for treating trichomoniasis in women. The Cochrane Database of Systematic Reviews.
Hedya, S. A., et al. (2023). Lithium toxicity. StatPearls.
Rising Pharma Holdings, Inc. (2023). Tindazole- tinidazole tablet, film coated [package insert]. DailyMed.
Schwebke, J. R., et al. (2011). Tinidazole vs metronidazole for the treatment of bacterial vaginosis. American Journal of Obstetrics and Gynecology.
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