Drug General Information (ID: DDIWS38PZ0)
Drug Name			Nitazoxanide		Drug Info		Clorazepic acid		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antiparasitic Agents				Anxiolytics/Sedatives/Hypnotics
Structure

Mechanism of Nitazoxanide-Clorazepic acid Interaction (Severity Level: Moderate)
Competitive binding of plasma proteins Click to Show/Hide Mechanism Graph
Drug Name		Nitazoxanide				Clorazepic acid
Mechanism		Competition for plasma protein binding sites				Competition for plasma protein binding sites
Key Mechanism Factor 1
		Factor Name		Plasma protein binding
		Factor Description		Plasma protein binding refers to the degree of binding of a drug to proteins in the blood, and the lower the degree of binding, the more efficiently the drug can cross cell membranes or diffuse. Plasma protein binding alters the distribution and therapeutic characteristics of the drugs.
Mechanism Description		Increased plasma concentration of Clorazepic acid and Nitazoxanide due to competitive binding of plasma proteins

Recommended Action
Management		Caution is advised when other highly protein-bound drugs are used with nitazoxanide, particularly those with a narrow therapeutic index. Patients should be monitored more closely following the addition or withdrawal of nitazoxanide. When performing therapeutic drug monitoring, total plasma concentrations should be interpreted cautiously due to the possibility of increased free (unbound) drug.

References
1	Guo LQ, Yamazoe Y "Inhibition of cytochrome P450 by furanocoumarins in grapefruit juice and herbal medicines." Acta Pharmacol Sin 25 (2004): 129-36. [PMID: 14769198]
2	Product Information. Alinia (nitazoxanide). Romark Laboratories L.C., Tampa, FL.