Which medications are used to treat trichomoniasis?

Updated: Jan 02, 2020
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

5-Nitroimidazole drugs are the only widely used pharmacological treatment for trichomoniasis. In the United States, two of these drugs, metronidazole and tinidazole, are FDA-approved. The CDC recommends the following drug schedules in the treatment of trichomoniasis: [11]

  • A single 2-g dose of metronidazole
  • A single 2-g dose of tinidazole
  • A schedule of 500 mg of metronidazole, taken twice daily for 7 days

Each drug schedule has advantages and disadvantages, but, ultimately, they yield similar cure rates. In a 2003 Cochrane review, metronidazole and tinidazole had comparable efficacy in treating trichomoniasis. [1] Randomized clinical trials comparing single 2-g doses have also shown metronidazole and tinidazole to be equally effective. [11] With recommended dosages, the expected cure rate of trichomoniasis is 95%. Tinidazole is generally more expensive than metronidazole but also seems to persist in serum longer. [11] Some research suggests that tinidazole has fewer side effects than metronidazole, but not all studies have found this result. [1, 113, 114]

The advantages of single-dose therapy with metronidazole or tinidazole over the week-long metronidazole schedule include better patient compliance and a lower total dose. The week-long metronidazole schedule may be more effective in treating trichomoniasis in HIV-infected women. [109]


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