Secnidazole

DAE Class; Secnidazole Rx

Common Brand Names; Solosec

• Nitroimidazoles

Secnidazole is a nitroimidazole derivative; 5-nitroimidazoles enters the bacterial cell as an inactive prodrug where the nitro group is reduced by bacterial enzymes to radical anions

It is believed that these radical anions interfere with bacterial DNA synthesis of susceptible isolates

Indicated for bacterial vaginosis in females

Indicated for treatment of trichomoniasis caused by Trichomonas vaginalis

Because trichomoniasis is transmitted sexually with potentially serious sequelae, treat partners of infected patients simultaneously in order to prevent reinfection

Hypersensitivity to secnidazole, excipients of the formulation, or other nitroimidazole derivatives

Patients with Cockayne syndrome

Vulvovaginal candidiasis (8.4-9.6%)

Nausea (3.6-5.3%)

Headache (3.6%)

Dysgeusia (3.4%)

Diarrhea (2.5%)

Vomiting (2.5%)

Abdominal pain (2%)

Vulvovaginal pruritus (2%)

Vulvovaginal candidiasis may occur; symptomatic vulvovaginal candidiasis may require treatment with an antifungal agent

Carcinogenicity has been seen in mice and rats treated long term with nitroimidazole derivatives, which are structurally related to secnidazole; avoid long-term use of secnidazole

Prescribing secnidazole in the absence of proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria

Avoid chronic use; carcinogenicity reported in mice and rats treated chronically with nitroimidazole derivatives, structurally related to secnidazole; significance unclear

Severe irreversible hepatotoxicity/acute liver failure with fatal outcomes reported after initiation of metronidazole in patients with Cockayne syndrome

Drug interaction overview

• Alcohol

  • Avoid alcoholic beverages and preparations containing ethanol or propylene glycol during secnidazole therapy and for 2 days after treatment is stopped
  • Nausea, vomiting, diarrhea, abdominal pain, dizziness, and headache reported when coadministered

Pregnancy

Data with secnidazole use in pregnant women are insufficient to inform a drug-associated risk of adverse developmental outcomes

Lactation

There is no information on the presence of secnidazole in human milk, the effects on the breastfed child, or the effects on milk production

Bacterial Vaginosis

Indicated for bacterial vaginosis in females

1 packet (2 grams) of granules PO once as a single dose, without regard to timing of meals

Trichomoniasis

Indicated for treatment of trichomoniasis caused by Trichomonas vaginalis

Because trichomoniasis is transmitted sexually with potentially serious sequelae, treat partners of infected patients simultaneously in order to prevent reinfection

1 packet (2 grams) of granules PO once as single dose, without regard to timing of meals

Secnidazole