Secnidazole is indicated for the treatment of

• intestinal amoebiasis,
• hepatic amoebiasis,
• urethritis and vaginitis caused by Trichomonas vaginalis,
• and giardiasis.

Secnidazole is rapidly absorbed after oral administration. After a 2 g oral dose, the maximum serum concentration is reached within approximately 3 hours. The plasma elimination half-life is about 20 hours. Around 50% of the administered dose is excreted in urine within 120 hours. Its pharmacokinetic profile gives secnidazole the longest half-life among second-generation nitroimidazoles, allowing therapeutic blood levels to be maintained for up to 72 hours following a single 2 g dose.

Secnidazole tablet should be administered orally. The dosage schedule of is mentioned below:

Acute Intestinal Amoebiasis:

• Adults: 2 gm single dose, taken preferably just before meal.
• Children: 30 mg/kg single dose, taken preferably just before meal.

Asymptomatic Amoebiasis (minute & cystic form):

• Adults: 2 gm once daily for only 3 days, taken preferably just before meal.
• Children: 30 mg/kg once daily for only 3 days, taken preferably just before meal.

Hepatic Amoebiasis: Evacuation of pus must be performed simultaneously with Secnidazole treatment at the suppurative stage of hepatic amoebiasis.

• Adults: 1.50 gm/day in a single or divided doses, just before meal, for 5 days.
• Children: 30 mg/kg/day, in a single or divided dose, just before meal, for 5 days.

Giardiasis:

• Adults: 2 gm single dose, taken preferably just before meal.
• Children: 35-50 mg/kg single dose, taken preferably just before meal.

Trichomoniasis:

• Adults: 2 gm single dose, taken preferably just before meal. The partner should also receive the same treatment concomitantly.

Concomitant use of secnidazole with disulfiram is not recommended, as it may cause confusion and paranoid reactions.

Concurrent use with warfarin requires close monitoring due to a possible increase in the effect of oral anticoagulants and an increased risk of bleeding.

Secnidazole is contraindicated in patients with known hypersensitivity to imidazole derivatives.

Clinical studies indicate that secnidazole is generally well tolerated, and no serious adverse reactions have been reported so far. However, as with other nitroimidazole derivatives, the following side effects may occur:

• Most common: Gastrointestinal disturbances, nausea, epigastric pain, metallic taste, glossitis, stomatitis.
• Occasional: Urticaria and mild reversible leukopenia after discontinuation of treatment.
• Rare: Vertigo, ataxia, motor incoordination, paresthesia, peripheral neuropathy. In very rare cases, gastrointestinal symptoms such as nausea, vomiting, and epigastric pain may also occur.

Secnidazole may be used during pregnancy after the first trimester. However, it should not be used during the first trimester or during lactation, as it passes through the placenta and is excreted in breast milk.

Patients should be advised to avoid alcohol during treatment due to the possibility of a disulfiram-like (antabuse) reaction. Secnidazole should be avoided in patients with a history of blood dyscrasia.

Amoebicides, Anti-diarrhoeal Antiprotozoal

Store in a cool, dry place, protected from heat.