Drug interactions
Fexinidazole + Tinidazole
Severity: Major
Fexinidazole and Tinidazole: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both are nitroimidazoles, and fexinidazole can inhibit CYP3A4, but tinidazole is only partly CYP3A4-dependent. Fexinidazole also carries QT-prolonging risk and neuropsychiatric effects, and combining two nitroimidazoles offers no therapeutic benefit and adds to toxicity.
What this interaction means in plain words
Fexinidazole and Tinidazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Possible CYP3A4 inhibition by fexinidazole raising tinidazole levels, with overlapping nitroimidazole toxicity.
What to do
Avoid using the two together. If unavoidable, monitor ECG and neuropsychiatric status.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Tinidazole
- Disulfiram + Tinidazole Contraindicated
- Ethanol + Tinidazole Major
- Lopinavir + Tinidazole Major
- Nilotinib + Tinidazole Major
- Ritonavir + Tinidazole Major
- Amiodarone + Tinidazole Moderate
Frequently asked questions
Can I take Fexinidazole with Tinidazole?
MediHelp rates the interaction as major. Fexinidazole and Tinidazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both are nitroimidazoles, and fexinidazole can inhibit CYP3A4, but tinidazole is only partly CYP3A4-dependent. Fexinidazole also carries QT-prolonging risk and neuropsychiatric effects, and combining two nitroimidazoles offers no therapeutic benefit and adds to toxicity.
How serious is the interaction between Fexinidazole and Tinidazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using the two together. If unavoidable, monitor ECG and neuropsychiatric status.
What other medicines interact with Tinidazole?
MediHelp also lists interactions of Tinidazole with, for example, Disulfiram, Ethanol, Lopinavir. The full list is on the Tinidazole page.
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