Details of the Drug

General Information of Drug (ID: DMOWLVG)

• Drug Name: Nitazoxanide
• Synonyms: Alinia; Colufase; Cryptaz; Daxon; Heliton; Nitazoxanid; Nitazoxanida; Nitazoxanidum; Taenitaz; Tizoxanide glucuronide; AZT + Nitazoxanide; Alinia (TN); Annita (TN); Azt+ nitazoxanide; Daxon (TN); Dexidex (TN); Kidonax (TN); Nitax (TN); Nitazox (TN); Nitazoxanida [INN-Spanish]; Nitazoxanide [USAN:INN]; Nitazoxanidum [INN-Latin]; Pacovanton (TN); Paramix (TN); Phavic-1; Zox (TN); Nitazoxanide (USAN/INN); Daxon, Dexidex, Kidonax, Pacovanton, Paramix, Nitax, Zox, Nitazoxanide

Indication

Disease Entry	ICD 11	Status	REF
Clostridioides difficile infection	1A04	Approved	[1]
Cryptosporidium infection	1A32	Approved	[1]
Diarrhea	DA90	Approved	[2]
Coronavirus Disease 2019 (COVID-19)	1D6Y	Phase 3	[3]
Giardiasis	N.A.	Investigative	[1]

• Therapeutic Class: Antiparasitic Agents
• Drug Type: Small molecular drug
• #Ro5 Violations (Lipinski): 0:
  Molecular Weight (mw); 307.28
  Logarithm of the Partition Coefficient (xlogp); 2
  Rotatable Bond Count (rotbonds); 4
  Hydrogen Bond Donor Count (hbonddonor); 1
  Hydrogen Bond Acceptor Count (hbondacc); 7
• ADMET Property:
  Bioavailability: 70% of drug becomes completely available to its intended biological destination(s) [4]
  MRTD: The Maximum Recommended Therapeutic Dose (MRTD) of drug that ensured maximising efficacy and moderate side effect is 46.49 micromolar/kg/day [5]
• Chemical Identifiers:
  Formula: C12H9N3O5S
  IUPAC Name: [2-[(5-nitro-1,3-thiazol-2-yl)carbamoyl]phenyl] acetate
  Canonical SMILES: CC(=O)OC1=CC=CC=C1C(=O)NC2=NC=C(S2)[N+](=O)[O-]
  InChI: InChI=1S/C12H9N3O5S/c1-7(16)20-9-5-3-2-4-8(9)11(17)14-12-13-6-10(21-12)15(18)19/h2-6H,1H3,(H,13,14,17)
  InChIKey: YQNQNVDNTFHQSW-UHFFFAOYSA-N
• Cross-matching ID:
  PubChem CID: 41684
  ChEBI ID: CHEBI:94807
  CAS Number: 55981-09-4
  DrugBank ID: DB00507
  TTD ID: D08EBN
  ACDINA ID: D00473
• Repurposed Drugs (RPD): Click to Jump to the Detailed RPD Information of This Drug

Molecular Interaction Atlas of This Drug

Drug Therapeutic Target (DTT)

DTT Name	DTT ID	UniProt ID	MOA	REF
Cryptosporidium Pyruvate:ferredoxin oxidoreductase (Crypto CpPNO)	TT0F5P8	PNO_CRYPV	Modulator	[6]

Drug Off-Target (DOT)

DOT Name	DOT ID	UniProt ID	Interaction	REF
Cyclic AMP-dependent transcription factor ATF-4 (ATF4)	OTRFV19J	ATF4_HUMAN	Gene/Protein Processing	[7]
Dedicator of cytokinesis protein 8 (DOCK8)	OTNQLL21	DOCK8_HUMAN	Drug Response	[8]
Eukaryotic translation initiation factor 2A (EIF2A)	OTWXELQP	EIF2A_HUMAN	Post-Translational Modifications	[7]
Multidrug resistance-associated protein 1 (ABCC1)	OTGUN89S	MRP1_HUMAN	Drug Response	[8]
Nuclear receptor subfamily 1 group I member 3 (NR1I3)	OTS3SGH7	NR1I3_HUMAN	Gene/Protein Processing	[9]
Slit homolog 3 protein (SLIT3)	OTU8MKEU	SLIT3_HUMAN	Drug Response	[8]
Sushi domain-containing protein 6 (SUSD6)	OTZS4SKF	SUSD6_HUMAN	Drug Response	[8]

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Disease Different from Nitazoxanide (Comorbidity)

DDI Drug Name	DDI Drug ID	Severity	Mechanism	Comorbidity	REF
Glibenclamide	DM8JXPZ	Moderate	Increased plasma concentration of Nitazoxanide and Glibenclamide due to competitive binding of plasma proteins.	Acute diabete complication [5A2Y]	[10]
Tolazamide	DMIHRNA	Moderate	Increased plasma concentration of Nitazoxanide and Tolazamide due to competitive binding of plasma proteins.	Acute diabete complication [5A2Y]	[10]
Glipizide	DMZA5PQ	Moderate	Increased plasma concentration of Nitazoxanide and Glipizide due to competitive binding of plasma proteins.	Acute diabete complication [5A2Y]	[10]
Clorazepate	DMC3JST	Moderate	Increased plasma concentration of Nitazoxanide and Clorazepate due to competitive binding of plasma proteins.	Anxiety disorder [6B00-6B0Z]	[11]
Oxazepam	DMXNZM4	Moderate	Increased plasma concentration of Nitazoxanide and Oxazepam due to competitive binding of plasma proteins.	Anxiety disorder [6B00-6B0Z]	[10]
Diazepam	DM08E9O	Moderate	Increased plasma concentration of Nitazoxanide and Diazepam due to competitive binding of plasma proteins.	Epilepsy/seizure [8A61-8A6Z]	[10]
Flurazepam	DMAL4G0	Moderate	Increased plasma concentration of Nitazoxanide and Flurazepam due to competitive binding of plasma proteins.	Insomnia [7A00-7A0Z]	[10]
Quazepam	DMY4D87	Moderate	Increased plasma concentration of Nitazoxanide and Quazepam due to competitive binding of plasma proteins.	Insomnia [7A00-7A0Z]	[10]
Estazolam	DMZGXUM	Moderate	Increased plasma concentration of Nitazoxanide and Estazolam due to competitive binding of plasma proteins.	Insomnia [7A00-7A0Z]	[10]
Methotrexate	DM2TEOL	Moderate	Increased plasma concentration of Nitazoxanide and Methotrexate due to competitive binding of plasma proteins.	Leukaemia [2A60-2B33]	[10]
Midazolam	DMXOELT	Moderate	Increased plasma concentration of Nitazoxanide and Midazolam due to competitive binding of plasma proteins.	Mood/affect symptom [MB24]	[10]
Warfarin	DMJYCVW	Moderate	Increased plasma concentration of Nitazoxanide and Warfarin due to competitive binding of plasma proteins.	Supraventricular tachyarrhythmia [BC81]	[10]
Tolbutamide	DM02AWV	Moderate	Increased plasma concentration of Nitazoxanide and Tolbutamide due to competitive binding of plasma proteins.	Type 2 diabetes mellitus [5A11]	[10]
Chlorpropamide	DMPHZQE	Moderate	Increased plasma concentration of Nitazoxanide and Chlorpropamide due to competitive binding of plasma proteins.	Type 2 diabetes mellitus [5A11]	[10]

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG

DIG Name	DIG ID	PubChem CID	Functional Classification
FD&C blue no. 2	E00446	2723854	Colorant
Quinoline yellow WS	E00309	24671	Colorant
Sunset yellow FCF	E00255	17730	Colorant
Magnesium stearate	E00208	11177	lubricant
Polyvinyl alcohol	E00666	Not Available	Coating agent; Emulsion stabilizing agent; Film/Membrane-forming agent
Saccharose	E00091	5988	Binding agent; Coating agent; Cryoprotectant; Diluent; Flavoring agent; Suspending agent; Viscosity-controlling agent
Soybean lecithin	E00637	Not Available	Other agent
Talc	E00520	16211421	Anticaking agent; Diluent; Glidant; lubricant
Titanium dioxide	E00322	26042	Coating agent; Colorant; Opacifying agent

Pharmaceutical Formulation

Formulation Name	Drug Dosage	Dosage Form	Route
Nitazoxanide 500 mg tablet	500 mg	Oral Tablet	Oral

Jump to Detail Pharmaceutical Formulation Page of This Drug

References

• [1] Nitazoxanide FDA Label
• [2] Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
• [3] ClinicalTrials.gov (NCT04382846) Novel Regimens in COVID-19 Treatment. U.S. National Institutes of Health.
• [4] Critical Evaluation of Human Oral Bioavailability for Pharmaceutical Drugs by Using Various Cheminformatics Approaches
• [5] Estimating the safe starting dose in phase I clinical trials and no observed effect level based on QSAR modeling of the human maximum recommended daily dose
• [6] Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services.
• [7] The anti-hepatitis C agent nitazoxanide induces phosphorylation of eukaryotic initiation factor 2alpha via protein kinase activated by double-stranded RNA activation. Gastroenterology. 2009 Nov;137(5):1827-35. doi: 10.1053/j.gastro.2009.07.056. Epub 2009 Aug 4.
• [8] Population-based in vitro hazard and concentration-response assessment of chemicals: the 1000 genomes high-throughput screening study. Environ Health Perspect. 2015 May;123(5):458-66. doi: 10.1289/ehp.1408775. Epub 2015 Jan 13.
• [9] Identification of Modulators That Activate the Constitutive Androstane Receptor From the Tox21 10K Compound Library. Toxicol Sci. 2019 Jan 1;167(1):282-292. doi: 10.1093/toxsci/kfy242.
• [10] Product Information. Alinia (nitazoxanide). Romark Laboratories L.C., Tampa, FL.
• [11] Guo LQ, Yamazoe Y "Inhibition of cytochrome P450 by furanocoumarins in grapefruit juice and herbal medicines." Acta Pharmacol Sin 25 (2004): 129-36. [PMID: 14769198]