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Nitozoxanida en Oxiuros ??
Uso de la Nitozoxanida.
revisando un poco de terapeutica antiparasitaria, existen paginas de internet donde colegas recomiendan su uso para casi todo tipo de parasitos incluido los oxiuros o enterobiasis.
Simpre tenemos que buscar fuentes fidedignas y revistas medicas que cuenten con rigurosidad academica para publicar un estudio o un articulo, prefiero mil veces un nivel de evidencia I-A que un nivel IV, asi mismo prefiero una Recomendacion A que una D
Prefiero usar la nitozoxanida para casos de:
criptoporosdiosis y giardiasis
Ver Articulos
UpToDaTe 19.3
PD: Si alguien tiene otro criterio o goza con algun articulo a favor de la nitozoxanida para oxiuros favor de compartirlo.
revisando un poco de terapeutica antiparasitaria, existen paginas de internet donde colegas recomiendan su uso para casi todo tipo de parasitos incluido los oxiuros o enterobiasis.
Simpre tenemos que buscar fuentes fidedignas y revistas medicas que cuenten con rigurosidad academica para publicar un estudio o un articulo, prefiero mil veces un nivel de evidencia I-A que un nivel IV, asi mismo prefiero una Recomendacion A que una D
Nivel de evidencia
Ia: La evidencia proviene de metaanálisis de ensayos controlados, aleatorizados, bien diseñados.
Ib: La evidencia proviene de, al menos, un ensayo controlado aleatorizado.
IIa: La evidencia proviene de, al menos, un estudio controlado bien diseñado sin aleatorizar.
IIb: La evidencia proviene de, al menos, un estudio no completamente experimental, bien diseñado, como los estudios de cohortes. Se refiere a la situación en la que la aplicación de una intervención está fuera del control de los investigadores, pero cuyo efecto puede evaluarse.
III: La evidencia proviene de estudios descriptivos no experimentales bien diseñados, como los estudios comparativos, estudios de correlación o estudios de casos y controles.
IV: La evidencia proviene de documentos u opiniones de comités de expertos o experiencias clínicas de autoridades de prestigio o los estudios de series de casos.
[editar] Grado de la recomendación
A: Basada en una categoría de evidencia I. Extremadamente recomendable.
B: Basada en una categoría de evidencia II. Recomendación favorable
C: Basada en una categoría de evidencia III. Recomendación favorable pero no concluyente.
D: Basada en una categoría de evidencia IV. Consenso de expertos, sin evidencia adecuada de investigación
Ia: La evidencia proviene de metaanálisis de ensayos controlados, aleatorizados, bien diseñados.
Ib: La evidencia proviene de, al menos, un ensayo controlado aleatorizado.
IIa: La evidencia proviene de, al menos, un estudio controlado bien diseñado sin aleatorizar.
IIb: La evidencia proviene de, al menos, un estudio no completamente experimental, bien diseñado, como los estudios de cohortes. Se refiere a la situación en la que la aplicación de una intervención está fuera del control de los investigadores, pero cuyo efecto puede evaluarse.
III: La evidencia proviene de estudios descriptivos no experimentales bien diseñados, como los estudios comparativos, estudios de correlación o estudios de casos y controles.
IV: La evidencia proviene de documentos u opiniones de comités de expertos o experiencias clínicas de autoridades de prestigio o los estudios de series de casos.
[editar] Grado de la recomendación
A: Basada en una categoría de evidencia I. Extremadamente recomendable.
B: Basada en una categoría de evidencia II. Recomendación favorable
C: Basada en una categoría de evidencia III. Recomendación favorable pero no concluyente.
D: Basada en una categoría de evidencia IV. Consenso de expertos, sin evidencia adecuada de investigación
criptoporosdiosis y giardiasis
Ver Articulos
UpToDaTe 19.3
Nitazoxanide: Drug information
Copyright 1978-2012 Lexicomp, Inc. All rights reserved.
(For additional information see "Nitazoxanide: Patient drug information" and see "Nitazoxanide: Pediatric drug information")
Brand Names: U.S.
Pharmacologic Category
Dosing: Adult Diarrhea caused by Cryptosporidium parvum or Giardia lamblia: Oral: 500 mg every 12 hours for 3 days Clostridium difficile -associated diarrhea (unlabeled use): Oral: 500 mg every 12 hours for 10 days (Musher, 2009)
Dosing: Pediatric(For additional information see "Nitazoxanide: Pediatric drug information")
Diarrhea caused by Cryptosporidium parvum or Giardia lamblia: Oral: Note: May consider increasing duration up to 14 days in HIV-exposed/-infected patients with crypotosporidiosis (CDC, 2009): Children 1-3 years: 100 mg every 12 hours for 3 days; may consider increasing duration up to 14 days in HIV-exposed/-infected patients with crypotosporidiosis (CDC, 2009) Children 4-11 years: 200 mg every 12 hours for 3 days; may consider increasing duration up to 14 days in HIV-exposed/-infected patients with crypotosporidiosis (CDC, 2009) Children ≥12 years: Refer to adult dosing.
Dosing: Geriatric Refer to adult dosing.
Dosing: Renal Impairment Specific recommendations are not available; use with caution.
Dosing: Hepatic Impairment Specific recommendations are not available; use with caution.
Dosage Forms: U.S. Excipient information presented when available (limited, particularly for generics); consult specific product labeling. Powder for suspension, oral: Alinia®: 100 mg/5 mL (60 mL) [contains sodium benzoate, sucrose 1.48 g/5 mL; strawberry flavor] Tablet, oral: Alinia®: 500 mg [contains soy lecithin]
Generic Equivalent Available: U.S. No
Administration Administer with food. Shake suspension well prior to administration.
Use Treatment of diarrhea caused by Cryptosporidium parvum or Giardia lamblia
Use - Unlabeled/Investigational Alternative treatment for Clostridium difficile-associated diarrhea (CDAD)
Adverse Reactions Significant Rates of adverse effects were similar to those reported with placebo.
1% to 10%: Central nervous system: Headache (1% to 3%) Gastrointestinal: Abdominal pain (7% to 8%), diarrhea (2% to 4%), nausea (3%), vomiting (1%) <1% (Limited to important or life-threatening): Allergic reaction, ALT increased, anemia, anorexia, appetite increased, creatinine increased, diaphoresis, dizziness, eye discoloration (pale yellow), fever, flatulence, hypertension, infection, malaise, nausea, pruritus, rhinitis, salivary glands enlarged, tachycardia, urine discoloration
Contraindications Hypersensitivity to nitazoxanide or any component of the formulation
Warnings/Precautions Disease-related concerns: • Hepatic impairment: Use with caution in patients with hepatic impairment. • HIV: Safety and efficacy have not been established in patients with HIV infection. • Renal impairment: Use with caution in patients with renal impairment. Special populations: • Immunocompromised patients: Safety and efficacy have not been established in patients with immunodeficiency. • Pediatrics: Oral suspension: Safety and efficacy have not been established in children <1 year of age. Tablet: Safety and efficacy have not been established in children <12 years of age.
Drug Interactions
(For additional information: Launch Lexi-Interact™ Drug Interactions Program )
There are no known significant interactions.
Ethanol/Nutrition/Herb Interactions Food: Food increases AUC.
Pregnancy Risk Factor B (show table)
Pregnancy Implications Teratogenic effects were not observed in animal studies. There are no adequate and well-controlled studies in pregnant women.
Lactation Excretion in breast milk unknown/use caution
Dietary Considerations Should be taken with food.
Pricing: U.S. (www.drugstore.com) Tablets (Alinia) 500 mg (60): $1360.01
International Brand Names
Mechanism of Action Nitazoxanide is rapidly metabolized to the active metabolite tizoxanide in vivo. Activity may be due to interference with the pyruvate:ferredoxin oxidoreductase (PFOR) enzyme-dependent electron transfer reaction which is essential to anaerobic metabolism. In vitro, nitazoxanide and tizoxanide inhibit the growth of sporozoites and oocysts of Cryptosporidium parvum and trophozoites of Giardia lamblia.
Pharmacodynamics/Kinetics Protein binding: Tizoxanide: >99% Bioavailability: Relative bioavailability of suspension compared to tablet: 70% Metabolism: Hepatic, to an active metabolite, tizoxanide. Tizoxanide undergoes conjugation to form tizoxanide glucuronide. Nitazoxanide is not detectable in the serum following oral administration. Time to peak, plasma: Tizoxanide and tizoxanide glucuronide: 1-4 hours Excretion: Tizoxanide: Urine, bile, and feces; Tizoxanide glucuronide: Urine and bile
Copyright 1978-2012 Lexicomp, Inc. All rights reserved.
(For additional information see "Nitazoxanide: Patient drug information" and see "Nitazoxanide: Pediatric drug information")
Brand Names: U.S.
- Alinia®
Pharmacologic Category
- Antiprotozoal
Dosing: Adult Diarrhea caused by Cryptosporidium parvum or Giardia lamblia: Oral: 500 mg every 12 hours for 3 days Clostridium difficile -associated diarrhea (unlabeled use): Oral: 500 mg every 12 hours for 10 days (Musher, 2009)
Dosing: Pediatric(For additional information see "Nitazoxanide: Pediatric drug information")
Diarrhea caused by Cryptosporidium parvum or Giardia lamblia: Oral: Note: May consider increasing duration up to 14 days in HIV-exposed/-infected patients with crypotosporidiosis (CDC, 2009): Children 1-3 years: 100 mg every 12 hours for 3 days; may consider increasing duration up to 14 days in HIV-exposed/-infected patients with crypotosporidiosis (CDC, 2009) Children 4-11 years: 200 mg every 12 hours for 3 days; may consider increasing duration up to 14 days in HIV-exposed/-infected patients with crypotosporidiosis (CDC, 2009) Children ≥12 years: Refer to adult dosing.
Dosing: Geriatric Refer to adult dosing.
Dosing: Renal Impairment Specific recommendations are not available; use with caution.
Dosing: Hepatic Impairment Specific recommendations are not available; use with caution.
Dosage Forms: U.S. Excipient information presented when available (limited, particularly for generics); consult specific product labeling. Powder for suspension, oral: Alinia®: 100 mg/5 mL (60 mL) [contains sodium benzoate, sucrose 1.48 g/5 mL; strawberry flavor] Tablet, oral: Alinia®: 500 mg [contains soy lecithin]
Generic Equivalent Available: U.S. No
Administration Administer with food. Shake suspension well prior to administration.
Use Treatment of diarrhea caused by Cryptosporidium parvum or Giardia lamblia
Use - Unlabeled/Investigational Alternative treatment for Clostridium difficile-associated diarrhea (CDAD)
Adverse Reactions Significant Rates of adverse effects were similar to those reported with placebo.
1% to 10%: Central nervous system: Headache (1% to 3%) Gastrointestinal: Abdominal pain (7% to 8%), diarrhea (2% to 4%), nausea (3%), vomiting (1%) <1% (Limited to important or life-threatening): Allergic reaction, ALT increased, anemia, anorexia, appetite increased, creatinine increased, diaphoresis, dizziness, eye discoloration (pale yellow), fever, flatulence, hypertension, infection, malaise, nausea, pruritus, rhinitis, salivary glands enlarged, tachycardia, urine discoloration
Contraindications Hypersensitivity to nitazoxanide or any component of the formulation
Warnings/Precautions Disease-related concerns: • Hepatic impairment: Use with caution in patients with hepatic impairment. • HIV: Safety and efficacy have not been established in patients with HIV infection. • Renal impairment: Use with caution in patients with renal impairment. Special populations: • Immunocompromised patients: Safety and efficacy have not been established in patients with immunodeficiency. • Pediatrics: Oral suspension: Safety and efficacy have not been established in children <1 year of age. Tablet: Safety and efficacy have not been established in children <12 years of age.
Drug Interactions
(For additional information: Launch Lexi-Interact™ Drug Interactions Program )
There are no known significant interactions.
Ethanol/Nutrition/Herb Interactions Food: Food increases AUC.
Pregnancy Risk Factor B (show table)
Pregnancy Implications Teratogenic effects were not observed in animal studies. There are no adequate and well-controlled studies in pregnant women.
Lactation Excretion in breast milk unknown/use caution
Dietary Considerations Should be taken with food.
Pricing: U.S. (www.drugstore.com) Tablets (Alinia) 500 mg (60): $1360.01
International Brand Names
- Anelmin (PY);
- Annita (BR);
- Celectan (CO, EC, VE);
- Colufase (PE);
- Coluquim (PE);
- Daxon (MX);
- Dexidex (MX);
- Heliton (AR);
- Kidonax (MX);
- Nodik (GT);
- Pacovanton (MX);
- Paramix (MX);
- Plantassel (GT, HN, NI, PA, SV);
- Repinox (CR, DO);
- Zoxanid (GT, HN, NI, PA, SV)
Mechanism of Action Nitazoxanide is rapidly metabolized to the active metabolite tizoxanide in vivo. Activity may be due to interference with the pyruvate:ferredoxin oxidoreductase (PFOR) enzyme-dependent electron transfer reaction which is essential to anaerobic metabolism. In vitro, nitazoxanide and tizoxanide inhibit the growth of sporozoites and oocysts of Cryptosporidium parvum and trophozoites of Giardia lamblia.
Pharmacodynamics/Kinetics Protein binding: Tizoxanide: >99% Bioavailability: Relative bioavailability of suspension compared to tablet: 70% Metabolism: Hepatic, to an active metabolite, tizoxanide. Tizoxanide undergoes conjugation to form tizoxanide glucuronide. Nitazoxanide is not detectable in the serum following oral administration. Time to peak, plasma: Tizoxanide and tizoxanide glucuronide: 1-4 hours Excretion: Tizoxanide: Urine, bile, and feces; Tizoxanide glucuronide: Urine and bile
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