Comprehensive medication guide to Secnidazole including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$25–$75 copay with commercial insurance and the manufacturer savings card; many plans require prior authorization or step therapy before covering Solosec.
Estimated Cash Pricing
$290–$550 retail for brand-name Solosec (no generic available); as low as $179 with a GoodRx coupon or $75 with the manufacturer savings card for a single 2-gram packet.
Medfinder Findability Score
62/100
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Secnidazole is a nitroimidazole antimicrobial antibiotic sold under the brand name Solosec. It was FDA-approved on September 15, 2017, and is manufactured by Lupin Pharmaceuticals. Solosec is the only FDA-approved single-dose oral treatment for bacterial vaginosis in the United States.
Secnidazole is FDA-approved for two conditions: bacterial vaginosis (BV) in females aged 12 and older, and trichomoniasis in patients aged 12 and older. It comes as oral granules in a single-dose foil packet containing 2 grams of secnidazole, sprinkled onto soft food and consumed in one sitting.
Secnidazole is closely related to metronidazole (Flagyl) and tinidazole (Tindamax) — all members of the nitroimidazole drug class. Its longer half-life of approximately 17 hours is what allows a single 2-gram dose to deliver a complete course of therapy. No FDA-approved generic secnidazole is available in the United States as of 2026.
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Secnidazole is a nitroimidazole prodrug — it enters bacterial and parasitic cells in an inactive form and becomes activated once inside. Anaerobic bacteria and parasites contain enzymes that reduce the drug's nitro group, generating highly reactive radical anions. These radical anions directly damage the cell's DNA, disrupting its ability to replicate and repair, ultimately killing the organism.
This mechanism is selective: the activation only occurs efficiently in anaerobic environments — meaning the drug is preferentially toxic to bacteria and parasites associated with BV and trichomoniasis, with less impact on the patient's own aerobic cells. Secnidazole's plasma half-life of approximately 17 hours — longer than metronidazole's ~8 hours — is what makes a single 2-gram dose therapeutically sufficient.
For bacterial vaginosis, secnidazole targets anaerobic organisms associated with BV including Bacteroides spp., Prevotella spp., and Mobiluncus spp. For trichomoniasis, it targets the parasitic protozoan Trichomonas vaginalis through the same DNA-damaging mechanism, with clinical cure rates of 91.7% to 100% in trials.
2 g — oral granules
Single-dose foil packet. Sprinkle entire contents onto applesauce, yogurt, or pudding and consume within 30 minutes. Do not chew/crush granules or dissolve in liquid.
Secnidazole (Solosec) is not on the FDA's Drug Shortage Database as of 2026, but patients commonly experience difficulty filling their prescriptions. Because there is no generic version, only one manufacturer (Lupin Pharmaceuticals) supplies the entire U.S. market. Many pharmacies keep limited quantities on hand, and a local spike in demand can quickly deplete stock.
Cost also creates a practical access barrier. Retail prices range from $290 to $550 per packet without insurance. Many commercial insurance plans require step therapy — patients must try metronidazole or clindamycin first — before Solosec is covered. This adds paperwork and delay. Rural patients and those without commercial insurance face the most difficulty accessing this medication.
If you're struggling to find Solosec at your pharmacy, medfinder contacts pharmacies near you to check which ones have it in stock, so you don't have to make the calls yourself.
Secnidazole (Solosec) is not a controlled substance and does not require any DEA scheduling authority to prescribe. Any licensed healthcare provider with standard prescriptive authority can prescribe it. The following types of providers routinely prescribe Solosec:
OB/GYNs (Obstetrician-Gynecologists) — most common prescribers for bacterial vaginosis
Primary care physicians (PCPs) — family medicine and internal medicine doctors
Nurse practitioners (NPs) and physician assistants (PAs) — with prescriptive authority in their state
Urgent care providers — for same-day diagnosis and treatment of BV or trichomoniasis
Infectious disease specialists — for complicated, recurrent, or treatment-resistant cases
Telehealth is widely available for Solosec prescriptions. Platforms like Wisp, Nurx, and Planned Parenthood Direct specialize in women's and sexual health and can diagnose and prescribe treatment via virtual visit. Since secnidazole is not controlled, it can be prescribed and transmitted electronically through standard telehealth workflows.
No. Secnidazole (Solosec) is not a controlled substance and is not scheduled by the DEA. It can be prescribed by any licensed healthcare provider — including primary care physicians, OB/GYNs, nurse practitioners, physician assistants, and telehealth providers — without any special DEA registration or controlled substance authority. No state-specific prescribing restrictions apply based on scheduling.
As a standard prescription antibiotic, secnidazole does not require PDMP (Prescription Drug Monitoring Program) reporting, has no refill limitations related to scheduling, and can be transmitted electronically without controlled substance e-prescribing credentials. This makes it straightforward to prescribe through telehealth platforms as well.
The following side effects were reported in at least 2% of patients in clinical trials:
Nausea
Dysgeusia (metallic or bitter taste)
Headache
Vomiting
Diarrhea
Abdominal pain
Vulvovaginal candidiasis (yeast infection) — in approximately 10% of patients
Vulvovaginal pruritus (vaginal itching)
Allergic reaction: Hives, difficulty breathing, swelling of face/lips/tongue/throat — seek emergency care immediately
Severe hepatotoxicity (Cockayne syndrome patients only): Secnidazole is contraindicated in Cockayne syndrome — fatal liver failure has been reported with related nitroimidazoles in these patients
Disulfiram-like reaction with alcohol: Nausea, vomiting, dizziness, and abdominal pain when alcohol is consumed within 48 hours of the dose
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Metronidazole (Flagyl)
First-line CDC treatment for BV and trichomoniasis. Generic available for $4–$15 for a 7-day course. Oral (500 mg BID × 7 days) or vaginal gel (0.75% × 5 days for BV). Multi-day regimen required.
Tinidazole (Tindamax)
Nitroimidazole in the same class as secnidazole. Generic available for $15–$50. Single-dose option for trichomoniasis (2 g); 2-day or 5-day regimens for BV. Fewer GI side effects than metronidazole.
Clindamycin
Lincosamide antibiotic for BV only (not trichomoniasis). Available oral (300 mg BID × 7 days) or vaginal cream (2% × 7 days). Preferred CDC alternative for nitroimidazole-intolerant patients.
Metronidazole Vaginal Gel (MetroGel)
Topical formulation for BV. Applied intravaginally once daily for 5 days. Less systemic absorption than oral metronidazole. Not effective for trichomoniasis.
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Alcohol / Ethanol
majorAvoid alcohol during treatment and for 48 hours after. Can cause nausea, vomiting, abdominal pain, dizziness, and headache. Includes beverages, mouthwash, and foods/medications containing ethanol or propylene glycol.
Warfarin (Coumadin)
moderateNitroimidazoles may enhance anticoagulant effect of warfarin. Monitor INR more closely after treatment. Dose adjustment may be required.
Disulfiram (Antabuse)
majorCombination may cause severe CNS reactions including psychosis and confusion. Avoid concurrent use.
Lithium
moderateNitroimidazoles may potentially affect lithium levels. Inform prescriber; monitoring of lithium levels and renal function may be warranted.
Oral Contraceptives
minorClinical studies showed no significant effect on oral contraceptive hormone levels. Discuss with prescriber; some recommend backup contraception for 7 days after any antibiotic course.
Secnidazole (Solosec) is a clinically valuable medication — the only single-dose oral antibiotic approved for bacterial vaginosis in the U.S. Its convenience makes it especially useful for patients who struggle with multi-day regimens, and its effectiveness against both BV and trichomoniasis makes it a versatile option in gynecologic and sexual health care.
The main practical challenges in 2026 are availability and cost. With no generic, retail prices range from $290 to $550 per packet — though the manufacturer savings card can reduce this to $25 for commercially insured patients and $75 for cash-pay patients. Finding it at a local pharmacy may require checking multiple locations.
If you need help finding Solosec at a pharmacy near you, medfinder contacts pharmacies in your area to check stock so you don't have to. Simply provide your medication, dosage, and location, and results are texted directly to your phone.
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Real-time availability
Medfinder is actively checking pharmacy inventory for Secnidazole. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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