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Secnidazole

[Secnidazole photo]

KEY POINTS

  • Secnidazole (Solosec) is a 5-nitroimidazole antimicrobial drug that enters bacterial cells, where it is then reduced to radical anions by bacterial enzymes, which interferes with DNA synthesis in susceptible organisms
  • FDA-approved September 17, 2017 for treatment of bacterial vaginosis in adult women
    • Has activity versus most organisms known to cause bacterial vaginosis, such as:
      • Bacteroides sp.
      • Gardnerella vaginalis
      • Prevotella sp.
      • Mobiluncus sp.
      • Megasphera-like type I/II
    • Isolates with reduced susceptibility to metronidazole (another introimidazole) also show reduced susceptibility to secnidazole
  • Typical dose is one 2-gram packet taken orally once
    • Is to be sprinkled onto applesauce, pudding, or yogurt then consumed orally within 30 minutes without chewing or crushing the granules
    • Not meant to be dissolved in any liquid
    • Chronic use is not recommended, beware possible carcinogenicity risk
  • People allergic to metronidazole may also be allergic to secnidazole
  • Some of the more common side effects to beware are: vulvovaginal candidiasis, nausea, headache, dysgeusia, diarrhea, vomiting, abdominal pain, and vulvovaginal pruritus
    • No serious adverse events reported in clinical trials

RESOURCES

  • Secnidazole Package Insert
  • Secnidazole FDA Approval Notice
  • Sexually Transmitted Diseases Guidelines [CDC, 2015]
  • Secnidazole treatment of bacterial vaginosis: a randomized controlled trial [2017]
  • A phase-3, double-blind, placebo-controlled study of the effectiveness and safety of single oral doses of secnidazole 2 g for the treatment of women with bacterial vaginosis [2016]
  • Secnidazole. A review of its antimicrobial activity, pharmacokinetic properties and therapeutic use in the management of protozoal infections and bacterial vaginosis [1996]

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