Comprehensive medication guide to Tinidazole including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$30 copay for generic tinidazole on most commercial insurance and Medicare Part D plans (Tier 1–2); some plans require prior authorization if metronidazole has not been tried first.
Estimated Cash Pricing
$60–$70 retail for generic tinidazole 500 mg (4-8 tablets); as low as $26–$28 with GoodRx or SingleCare coupons for a short course. Brand Tindamax costs $847+ and should be avoided.
Medfinder Findability Score
75/100
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Tinidazole is a prescription antibiotic and antiprotozoal agent belonging to the nitroimidazole drug class. It is sold under the brand name Tindamax in the United States and was FDA-approved in 2004. Generic tinidazole is manufactured by several companies including Hikma Pharmaceuticals, Edenbridge Pharmaceuticals, and Novel Laboratories. Internationally, it is also known by the brand name Fasigyn.
Tinidazole is FDA-approved for four conditions: trichomoniasis (a sexually transmitted infection caused by Trichomonas vaginalis), giardiasis (a small intestinal parasitic infection caused by Giardia lamblia), amebiasis—both intestinal and extraintestinal (amebic liver abscess) caused by Entamoeba histolytica—and bacterial vaginosis (an overgrowth of anaerobic bacteria in the vagina). It is approved for adults for all indications, and for children older than 3 years for the parasitic infections.
Available in 250 mg and 500 mg oral tablets, tinidazole is notable for its convenient dosing—many of its indications can be treated with a single 2 gram dose (four 500 mg tablets taken at one time). Treatment courses range from a single dose to a maximum of 5 days, depending on the infection type. Tinidazole is not a controlled substance and requires no special prescribing credentials.
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Tinidazole works through selective reductive activation. Its nitro group (-NO₂) remains inert in human cells but is chemically reduced inside anaerobic microorganisms—bacteria and protozoa that do not use oxygen for energy metabolism. These organisms contain low-redox-potential electron-carrying proteins (such as ferredoxin) that reduce tinidazole's nitro group into a highly reactive nitro-radical anion.
This reactive nitro-radical attacks and breaks the organism's DNA double helix structure, causing irreparable DNA strand breaks and disrupting nucleic acid synthesis. The result is cell death—tinidazole is bactericidal and protozoicidal, meaning it kills the target organisms rather than merely slowing their growth. Human aerobic cells lack the required reduction pathways, making tinidazole selectively toxic to the targeted pathogens.
After oral ingestion, tinidazole is rapidly and completely absorbed. It distributes into virtually all body tissues and fluids, including crossing the blood-brain barrier. With a plasma half-life of 12-14 hours—longer than metronidazole's 6-8 hours—tinidazole achieves sustained tissue concentrations that allow for once-daily or single-dose treatment regimens. It is metabolized primarily by the liver enzyme CYP3A4 and excreted via urine and feces.
500 mg — tablet
Most commonly prescribed strength; used for all adult indications
250 mg — tablet
Less commonly stocked; used for pediatric dosing and some adult regimens
Tinidazole is not on the FDA's official drug shortage list as of 2026, and generic versions are manufactured by multiple suppliers. However, its relatively low prescription volume compared to more common antibiotics means that many pharmacies—particularly smaller independent locations and rural pharmacies—do not routinely stock it. Many pharmacies order tinidazole only when a prescription is presented, which can create a 24-48 hour wait.
Large chain pharmacies (CVS, Walgreens, Walmart Pharmacy, Kroger) are most likely to carry generic tinidazole 500 mg in stock. The 250 mg strength is significantly harder to find. Brand-name Tindamax is rarely stocked due to its high cost ($847+ for 60 tablets). Always request generic tinidazole 500 mg for the best combination of availability and affordability.
If you're struggling to locate tinidazole near you, medfinder calls pharmacies in your area to check which ones have tinidazole in stock and can fill your prescription—results are texted directly to you.
Tinidazole is not a controlled substance and carries no DEA scheduling requirements. Any licensed prescriber with prescribing authority can write a tinidazole prescription—no specialist referral or special DEA certification is needed.
Primary care physicians (family medicine, internal medicine)
OB/GYNs and women's health providers (midwives, certified nurse midwives)
Urgent care providers
Infectious disease specialists (for complex, recurrent, or resistant cases)
Gastroenterologists (for giardiasis or intestinal amebiasis)
Nurse practitioners (NPs) and physician assistants (PAs) with prescribing authority
Sexual health and STI clinic providers (Planned Parenthood, public health clinics)
Telehealth providers can also prescribe tinidazole after a virtual consultation. Platforms like Wisp, Nurx, Plushcare, Teladoc, and MDLive can evaluate and prescribe for bacterial vaginosis, trichomoniasis, and giardiasis online. Since tinidazole is not a controlled substance, telehealth prescribing is available in all states without restriction.
No. Tinidazole is not a DEA-controlled substance and is not assigned any DEA schedule (Schedule I-V). This means it can be prescribed by any licensed healthcare provider with prescribing authority—including primary care physicians, OB/GYNs, urgent care providers, nurse practitioners, and physician assistants—without special DEA prescribing registration.
Because tinidazole is not controlled, it can also be prescribed via telehealth platforms without the restrictions that apply to controlled substances. Prescriptions can be transferred between pharmacies freely (unlike controlled substances which have transfer restrictions). Refills are permitted as clinically appropriate, though tinidazole is typically prescribed as a short, acute course rather than a chronic medication requiring regular refills.
In clinical studies, approximately 9-11% of patients taking tinidazole reported adverse effects. Most were mild to moderate gastrointestinal symptoms:
Metallic or bitter taste in the mouth (most common)
Nausea (reduced significantly by taking with food)
Vomiting
Headache and dizziness
Weakness, fatigue, or malaise
Dark or discolored urine (harmless metabolite effect)
Serious side effects (seek medical attention):
Peripheral neuropathy: numbness, tingling, or pain in hands or feet (stop medication)
Seizures or severe neurological symptoms (seek emergency care)
Severe allergic reactions: hives, facial swelling, difficulty breathing, anaphylaxis (seek emergency care)
Disulfiram-like reaction with alcohol: severe flushing, nausea, vomiting, tachycardia (avoid all alcohol during treatment and 3 days after)
Vaginal candidiasis (yeast infection) — approximately 4.7% of women treated for BV
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Metronidazole (Flagyl)
Same nitroimidazole class; treats identical infections; much less expensive (under $5 with GoodRx); requires multi-day dosing vs. tinidazole's single-dose convenience; universally available
Secnidazole (Solosec)
Third-generation nitroimidazole; single-dose 2g granule packet for BV and trichomoniasis; brand-only ($300+); not approved for giardiasis or amebiasis in US
Clindamycin
Lincosamide antibiotic; effective for bacterial vaginosis (not parasitic infections); oral or vaginal cream; preferred alternative for nitroimidazole-allergic patients
Nitazoxanide (Alinia)
Alternative for giardiasis; different mechanism; 500 mg twice daily for 3 days; not used for BV or trichomoniasis
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Alcohol
majorDisulfiram-like reaction: severe nausea, vomiting, flushing, tachycardia. Avoid all alcohol during treatment and for 3 days after last dose.
Warfarin
majorTinidazole may enhance anticoagulant effect, prolonging INR. Monitor INR closely during treatment and for up to 8 days after stopping.
Disulfiram (Antabuse)
majorPsychotic reactions reported with metronidazole combination; avoid tinidazole within 2 weeks of disulfiram use.
Lithium
moderateMay increase serum lithium levels; monitor serum lithium and creatinine after several days of concurrent use.
Fluorouracil (5-FU)
moderateMay decrease fluorouracil clearance, increasing toxicity; monitor for 5-FU-associated adverse effects.
Cyclosporine / Tacrolimus
moderateMay increase calcineurin inhibitor levels; monitor for signs of toxicity in transplant patients.
CYP3A4 inducers (rifampin, phenobarbital, phenytoin)
moderateAccelerate tinidazole metabolism, reducing plasma levels and potentially reducing efficacy.
CYP3A4 inhibitors (ketoconazole, cimetidine)
moderateSlow tinidazole metabolism, potentially increasing blood levels and side effects.
Tinidazole is a well-established, effective antibiotic for bacterial vaginosis, trichomoniasis, giardiasis, and amebiasis. Its key advantages include convenient single-dose or short-course treatment, broad activity across both bacterial and protozoal infections, and retained efficacy in some metronidazole-resistant cases. Generic tinidazole is affordable—especially with GoodRx or SingleCare coupons (as low as $26-$28 for a typical course)—and covered by most insurance plans as a Tier 1-2 generic.
The main practical challenge with tinidazole is locating it at a pharmacy, since its lower prescription volume compared to metronidazole means many smaller pharmacies don't keep it routinely stocked. Large chain pharmacies are your best first stop. Always remember: avoid all alcohol during treatment and for 3 full days after your last dose to prevent the disulfiram-like reaction.
If you're having trouble filling your tinidazole prescription, medfinder can call pharmacies near you to check which ones have your medication in stock and can fill your prescription—results delivered by text, so you can skip the hold music.
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