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Tindamax Side Effects

Generic Name: tinidazole

Note: This page contains side effects data for the generic drug tinidazole. It is possible that some of the dosage forms included below may not apply to the brand name Tindamax.

For the Consumer

Applies to tinidazole: oral tablet

As well as its needed effects, tinidazole (the active ingredient contained in Tindamax) may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking tinidazole, check with your doctor immediately:

  • Change in consciousness
  • cough
  • difficulty breathing
  • loss of consciousness
  • noisy breathing
  • shortness of breath
  • tightness in chest
  • wheezing
Incidence unknown
  • Black, tarry stools
  • bleeding gums
  • blood in urine or stools
  • burning, numbness, tingling, or painful sensations
  • chest pain
  • chills
  • difficulty swallowing
  • fast, irregular, pounding, or racing heartbeat or pulse
  • fever
  • hives
  • increased transaminase levels
  • large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • lower back or side pain
  • nausea
  • painful or difficult urination
  • pale skin
  • pinpoint red spots on skin
  • reddening of the skin, especially around ears
  • seizures
  • sore throat
  • sores, ulcers, or white spots on lips or in mouth
  • swelling of eyes, face, or inside of nose
  • swollen glands
  • ulcers
  • unsteadiness or awkwardness
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • weakness in arms, hands, legs, or feet

Minor Side Effects

Some tinidazole side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Bitter taste
  • metallic taste
Less common:
  • Acid or sour stomach
  • belching
  • cramps
  • difficulty having a bowel movement (stool)
  • dizziness
  • general feeling of discomfort or illness
  • headache
  • heartburn
  • indigestion
  • loss of appetite
  • pain or discomfort in chest, upper stomach, or throat
  • vomiting
  • weight loss
  • Body aches or pain
  • coating on tongue
  • congestion
  • depression
  • dryness or soreness of throat
  • hoarseness
  • mood or mental changes
  • runny nose
  • tender, swollen glands in neck
  • voice changes
Incidence unknown
  • Abnormal liver
  • darkened urine
  • diarrhea
  • difficulty in moving
  • feeling of constant movement of self or surroundings
  • giddiness
  • lightheadedness
  • muscle pain or stiffness
  • pain, swelling, or redness in joints
  • sensation of spinning
  • shakiness and unsteady walk
  • sleepiness
  • sleeplessness
  • swelling or inflammation of the mouth
  • tongue discoloration
  • trembling, or other problems with muscle control or coordination
  • trouble sleeping
  • unable to sleep
  • white or brownish vaginal discharge
  • white patches in the mouth or throat or on the tongue

For Healthcare Professionals

Applies to tinidazole: compounding powder, oral tablet


Gastrointestinal side effects have included metallic/bitter taste (3.7% following a 2 g single dose and 6.3% following multi-day dosing), nausea (3.2% following a 2 g single dose and 4.5% following multi-day dosing), anorexia (1.5% following a 2 g single dose and 2.5% following multi-day dosing), dyspepsia/cramps/epigastric discomfort (1.8% following a 2 g single dose and 1.4% following multi-day dosing), vomiting (1.5% following a 2 g single dose and 0.9% following multi-day dosing), constipation (0.4% following a 2 g single dose and 1.4% following multi-day dosing), tongue discoloration, stomatitis, diarrhea, decreased appetite, and flatulence. Furry tongue and pharyngitis have been reported rarely.[Ref]

Nervous system

Nervous system side effects have included weakness/fatigue/malaise (2.1% following 2 g single dose and 1.1% following multi-day dosing), dizziness (1.1% following 2 g single dose and 0.5% following multi-day dosing), convulsions, transient peripheral neuropathy (including numbness and paresthesia), vertigo, ataxia, giddiness, insomnia, and drowsiness.[Ref]


Oncologic side effects have included mutagenicity in animal studies. Tinidazole (the active ingredient contained in Tindamax) has tested positive for genotoxicity in in vivo studies.[Ref]


Hepatic side effects have included raised transaminase levels and at least one case report of possible hepatitis.[Ref]

A possible case of hepatitis was reported in a 4-year-old girl after receiving tinidazole 625 mg orally as a single dose treatment for Giardia. The patient returned to the clinic 6 days following tinidazole therapy with concerns of a 3-day history of progressive ankle swelling. Upon examination she was found to have a 3 g weight gain, marked edema of legs (up to knees), periorbital edema, abdominal distension, ejection flow murmur, liver palpable 6 cm below right coastal margin, no palpable spleen, and clinical evidence of ascites. Laboratory results, upon this admission, were hemoglobin 112 g/L, white cell count 5.2 x 10(9)/L, ESR 14 mm in one hour, sodium 145 mmol/L, potassium 2.6 mmol/L, urea 2.2 mmol/L, total protein 55 g/L, albumin 31 g/L, bilirubin 8 micromoles/L, gamma-glutamyltransferase (GGT) 50 units/L, aspartate aminotransferase (AST) 231 units/L, and creatine phosphokinase 1498 units/L. A chest X-ray, abdominal X-ray, and electrocardiogram showed no abnormalities. Tests for hepatitis A, hepatitis B, leptospirosis, cytomegalovirus, and Epstein-Barr virus were all negative. The patient's parents denied any known contact with infectious hepatitis. The patient was treated with potassium and spironolactone. The patient never became jaundiced. Two weeks later, all serum electrolyte levels and laboratory tests had returned to normal values, edema was absent, liver was palpable 2 cm below right costal margin, and the spleen could just be felt.[Ref]


Musculoskeletal side effects have included arthralgias, myalgias, and arthritis.[Ref]


Hypersensitivity side effects have included urticaria, pruritus, rash, flushing, sweating, dryness of mouth, fever, burning sensation, thirst, salivation, and angioedema. Severe acute hypersensitivity reactions (including urticaria, pruritus, angioedema, Stevens-Johnson syndrome, and erythema multiforme) during initial or subsequent tinidazole (the active ingredient contained in Tindamax) exposure have been reported during postmarketing experience.[Ref]

Ten patients were reported to have hypersensitivity reactions occurring on the same day of oral tinidazole administration. Nine patients were adults receiving 2 g as a single-dose. One patient was a 5-year-old girl receiving 500 mg as a single-dose. Nine reactions were severe and atropine was administered as part of the treatment. The reactions were characterized by urticaria; facial, periorbital, or laryngeal edema; hypotension; bronchospasm; and dyspnea. All patients recovered without further incidence. Note, at the time of these reactions the oral tablets contained tartrazine. It has been hypothesized that the tartrazine was the causative agent for these reactions. However, none of the patients had a history of asthma, atopy, or sensitivity to aspirin or aspirin-like products.[Ref]


Renal side effects have included darkened urine and urine abnormality.[Ref]


Cardiovascular side effects have included palpitations.[Ref]


Hematologic side effects have included transient neutropenia and transient leukopenia. Reversible thrombocytopenia has been reported rarely.[Ref]


Genitourinary side effects have included increased vaginal discharge, urinary tract infection, dysuria, vulvovaginal discomfort, vaginal odor, menorrhagia, female genital pruritus, and Candida vaginitis.[Ref]


Respiratory side effects have included upper respiratory tract infection. Bronchospasm and dyspnea have been reported rarely.[Ref]


Psychiatric sides effects have included rare reports of depression.[Ref]


Other side effects have included headache (1.3% following a 2 g single dose and 0.7% following multi-day dosing), Candida overgrowth, oral candidiasis, and pelvic pain. Confusion and coma have been reported rarely.[Ref]


In a study involving 450 patients with fixed drug eruptions, 8 patients were found to have oral tinidazole (the active ingredient contained in Tindamax) as the probable causative agent. The fixed drug eruptions varied as to duration, shape and size, symptoms, number of lesions, and body site(s) affected. The study did not break these factors down for each individual causative agent.[Ref]

Dermatologic side effects have included reports of fixed drug eruption.[Ref]


A 44-year-old man experienced a severe toxic reaction following administration of tinidazole (the active ingredient contained in Tindamax) 1600 mg intravenously over 80 minutes. Within 15 minutes following end of the infusion he fainted and was unconscious for about 10 seconds. The patient experienced some spasms of his left arm, without generalized convulsions, while resuming consciousness. Pharmacologic treatment was not necessary during or following the attack. Low blood pressure, intense nausea, sleepiness, and exhaustion followed the attack and lasted for several hours. The patient's condition gradually improved and he was completely recovered 6 hours after start of attack. Blood samples following infusion showed serum tinidazole level of 35.4 mg/L, normal immunoglobulin E level, and a transient fall in the concentration of complement factor C3.[Ref]

General side effects have included severe toxic reaction (1 case report) following intravenous administration of tinidazole.[Ref]


1. "Tinidazole (Tindamax)--a new option for treatment of bacterial vaginosis." Med Lett Drugs Ther 49 (2007): 73-4

2. Livengood CH 3rd, Ferris DG, Wiesenfeld HC, et al. "Effectiveness of Two Tinidazole Regimens in Treatment of Bacterial Vaginosis: A Randomized Controlled Trial." Obstet Gynecol 110 (2007): 302-309

3. "Tinidazole (tindamax) a new option for treatment of bacterial vaginosis." Obstet Gynecol 111 (2008): 208-9

4. "Product Information. Tindamax (tinidazole)." Presutti Laboratories Inc, Arlington Heights, IL.

5. Howard K "Tinidazole and hepatitis." Med J Aust 142 (1985): 513

6. McEwen J "Hypersensitivity reactions to tinidazole (Fasigyn)" Med J Aust 1 (1983): 498-9

7. Mahboob A, Haroon TS "Drugs causing fixed eruptions: a study of 450 cases." Int J Dermatol 37 (1998): 833-8

8. Aase S, Olsen AK, Roland M, et al. "Severe toxic reaction to tinidazole." Eur J Clin Pharmacol 24 (1983): 425-7

It is possible that some side effects of Tindamax may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

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