Nitazoxanide

What it is used for

• Cryptosporidia-associated diarrhea
• Equine protozoal myeloencephalitis (EPM) caused by Sarcocystis neurona
• Relapsing EPM

How it is given

Possible side effects

• Horses: Fever, anorexia, lethargy/depression, decreased gut sounds, diarrhea/enterocolitis, colic, laminitis, head/limb edema
• Horses: 'Treatment crisis' (CNS inflammation secondary to dying protozoa)
• Dogs: Excessive salivation, vomiting, diarrhea (often therapy-limiting)
• Humans: Yellow discoloration of sclera (rare, reversible)

Cautions & contraindications

• Horses less than 1 year of age
• Horses that are sick or debilitated for reasons other than EPM
• Use with extreme caution in stallions and horses predisposed to laminitis
• Animals with compromised renal or hepatic function (safety not established)
• Use with caution in animals with compromised renal or hepatic function. In horses, monitor closely for signs of enterocolitis (disruption of normal flora) and laminitis (stallions may be more prone). A 'treatment crisis' may occur in horses during the first two weeks of EPM therapy due to CNS inflammation from dying protozoa, which may require anti-inflammatory therapy. Not evaluated in horses weighing > 1200 lbs.

Drug interactions

• Highly protein-bound drugs with narrow therapeutic index: Use with caution; tizoxanide is >99% protein bound and may displace or be displaced by other highly bound drugs, potentially altering free drug concentrations.

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