A fixed-dose combination therapy primarily used for the treatment of intestinal amoebiasis and giardiasis, with adjunctive relief from associated gas and bloating. Diloxanide is a luminal amoebicide, Tinidazole is a nitroimidazole antimicrobial effective against both luminal and tissue-invasive forms, and Simethicone is an anti-flatulent that provides symptomatic relief.
Adult: For Intestinal Amoebiasis/Giardiasis: One tablet (Diloxanide 250mg + Tinidazole 300mg + Simethicone 25mg) three times daily for 5-7 days. For Trichomoniasis (Tinidazole indication): 2g single dose (requires separate Tinidazole-only formulation).
Note: Take after meals to minimize GI upset and improve Diloxanide absorption. Swallow whole with a full glass of water. Do not crush or chew. Avoid alcohol during and for at least 72 hours after the last dose.
Diloxanide furoate is hydrolyzed in the intestinal lumen to diloxanide, which acts directly as a luminal amoebicide, likely by disrupting protein synthesis in Entamoeba histolytica cysts and trophozoites. Tinidazole enters microbial cells and undergoes nitro-reduction, generating cytotoxic intermediates that damage DNA and inhibit nucleic acid synthesis, effective against trophozoites in tissues and lumen. Simethicone is a surfactant that lowers surface tension of gas bubbles in the GI tract, causing them to coalesce and be expelled more easily.
Pregnancy: Category C (Tinidazole). Contraindicated in the first trimester. Use in second/third trimester only if potential benefit justifies potential fetal risk. Diloxanide data is limited.
Driving: May cause dizziness, vertigo, or confusion. Patients should be cautioned about operating machinery or driving until their response is known.
| Alcohol | Disulfiram-like reaction (flushing, vomiting, tachycardia) | Major |
| Warfarin | Tinidazole may inhibit warfarin metabolism, increasing INR and bleeding risk | Major |
| Phenytoin, Phenobarbital | May increase Tinidazole metabolism, reducing efficacy | Moderate |
| Lithium | Tinidazole may increase lithium levels, risk of toxicity | Moderate |
| Cyclosporine | Tinidazole may increase cyclosporine levels | Moderate |
| Oral Contraceptives | Potential for reduced efficacy; advise backup barrier method | Moderate |
Same composition (Diloxanide (250mg) + Tinidazole (300mg) + Simethicone (25mg)), different brands: