Metronidazole and Tinidazole interaction

Metronidazole and Tinidazole: the Tinidazole prescribing label flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Tinidazole label · effective 2025-12-01

Major

WARNING: POTENTIAL RISK FOR CARCINOGENICITY WARNING: POTENTIAL RISK FOR CARCINOGENICITY Carcinogenicity has been seen in mice and rats treated chronically with metronidazole, another nitroimidazole agent [see Nonclinical Toxicology (13.1)].

Boxed warningnames MetronidazoleView label on DailyMed
Major

Carcinogenicity has been seen in mice and rats treated chronically with metronidazole, another nitroimidazole agent (13.1).

Boxed warningnames MetronidazoleView label on DailyMed
Major

Severe irreversible hepatotoxicity/acute liver failure with fatal outcomes have been reported after initiation of metronidazole, another nitroimidazole drug, structurally related to tinidazole, in patients with Cockayne syndrome [see Adverse Reactions (6.2)] Prior history of hypersensitivity to tinidazole or other nitroimidazole derivatives (4, 6.1, 6.2)

Contraindicationsnames MetronidazoleView label on DailyMed
Moderate

The following drug interactions were reported for metronidazole, a chemically-related nitroimidazole and may therefore occur with tinidazole: Warfarin and other oral coumarin anticoagulants: Anticoagulant dosage may need adjustment during and up to 8 days after tinidazole therapy ( 7.1 )

Drug interactionsnames MetronidazoleView label on DailyMed
Moderate

Potential Effects of Tinidazole on Other Drugs Warfarin and Other Oral Coumarin Anticoagulants: As with metronidazole, tinidazole may enhance the effect of warfarin and other coumarin anticoagulants, resulting in a prolongation of prothrombin time.

Drug interactionsnames MetronidazoleView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.