Adverse Reactions

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Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Among 3669 patients treated with a single 2 g dose of tinidazole, in both controlled and uncontrolled trichomoniasis and giardiasis clinical studies, adverse reactions were reported by 11.0% of patients. For multi-day dosing in controlled and uncontrolled amebiasis studies, adverse reactions were reported by 13.8% of 1765 patients. Common (≥ 1% incidence) adverse reactions reported by body system are as follows. (Note: Data described in Table 1 below are pooled from studies with variable designs and safety evaluations.)

Adverse reactions summary of published reports
  Adverse reaction 2 g single dose Multi-day dose
GI Metallic/bitter taste 3.7% 6.3%
Nausea 3.2% 4.5%
Anorexia 1.5% 2.5%
Dyspepsia / cramps / epigastric discomfort 1.8% 1.4%
Vomiting 1.5% 0.9%
Constipation 0.4% 1.4%
CNS Weakness / fatigue / malaise 2.1% 1.1%
Dizziness 1.1% 0.5%
Other Headache 1.3% 0.7%
Total patients with
adverse reactions
11.0%
(403/3669)
13.8%
(244/1765)
Table 1

Other adverse reactions reported with tinidazole

  • Central Nervous System: Two serious adverse reactions reported include convulsions and transient peripheral neuropathy including numbness and paresthesia (see Warnings and Precautions).
  • Other CNS reports include vertigo, ataxia, giddiness, insomnia, drowsiness.
  • Gastrointestinal: tongue discoloration, stomatitis, diarrhea
  • Hypersensitivity: urticaria, pruritis, rash, flushing, sweating, dryness of mouth, fever, burning sensation, thirst, salivation, angioedema
  • Renal: darkened urine
  • Cardiovascular: palpitations
  • Hematopoietic: transient neutropenia, transient leukopenia
  • Other: Candida overgrowth, increased vaginal discharge, oral candidiasis, hepatic abnormalities including raised transaminase level, arthralgias, myalgias, and arthritis.

Rare reported adverse reactions include bronchospasm, dyspnea, coma, confusion, depression, furry tongue, pharyngitis and reversible thrombocytopenia.

Adverse reactions in pediatric patients

In pooled pediatric studies, adverse reactions reported in pediatric patients taking tinidazole were similar in nature and frequency to adult findings including nausea, vomiting, diarrhea, taste change, anorexia, and abdominal pain.

Bacterial vaginosis

The most common adverse reactions in treated patients (incidence > 2%), which were not identified in the trichomoniasis, giardiasis and amebiasis studies, are gastrointestinal: decreased appetite, and flatulence; renal: urinary tract infection, painful urination, and urine abnormality; and other reactions including pelvic pain, vulvo-vaginal discomfort, vaginal odor, menorrhagia, and upper respiratory tract infection (See Clinical Studies).

Postmarketing experience

The following adverse reactions have been identified and reported during post-approval use of Tindamax. Because the reports of these reactions are voluntary and the population is of uncertain size, it is not always possible to reliably estimate the frequency of the reaction or establish a causal relationship to drug exposure.

Severe acute hypersensitivity reactions have been reported on initial or subsequent exposure to tinidazole. Hypersensitivity reactions may include urticaria, pruritis, angioedema, Stevens-Johnson syndrome and erythema multiforme.

Important Safety Information

WARNING: POTENTIAL RISK FOR CARCINOGENICITY

Carcinogenicity has been seen in mice and rats treated chronically with metronidazole, another nitroimidazole agent. Although such data have not been reported for tinidazole, the two drugs are structurally related and have similar biologic effects. Its use should be reserved for the conditions described in INDICATIONS AND USAGE.

Contraindications

  • Prior history of hypersensitivity to tinidazole or other nitroimidazole derivatives
  • First trimester of pregnancy
  • Nursing mothers, unless breast-feeding is interrupted during tinidazole therapy and for 3 days following the last dose

Warnings and Precautions

  • Seizures and neuropathy have been reported. Discontinue Tindamax if abnormal neurologic signs develop
  • Vaginal candidiasis may develop with Tindamax and require treatment with an antifungal agent
  • Use Tindamax with caution in patients with blood dyscrasias. Tindamax may produce transient leukopenia and neutropenia

Adverse Reactions

Most common adverse reactions for a single 2 g dose of tinidazole (incidence >1%) are metallic/bitter taste, nausea, weakness/fatigue/malaise, dyspepsia/cramps/epigastric discomfort, vomiting, anorexia, headache, dizziness and constipation. To report SUSPECTED ADVERSE REACTIONS, contact Mission Pharmacal Company at 1-800-298-1087 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch

This material is intended to provide basic information. Patients should discuss all medical advice, diagnosis, and treatment with their healthcare provider.

Please see full Prescribing Information


Only Tindamax® is approved to treat both bacterial vaginosis and trichomoniasis (TV).

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Tindamax® may be prescribed for other infections including: