Nitazoxanide (Alinia) Tablet Side Effects in Pakistan

Side effects of Nitazoxanide (Alinia / Nizonide) are generally mild and usually tolerable during the short 3-day course. The most confusing side effect: yellow/orange urine and eyes — this is a HARMLESS metabolite, not jaundice. This page provides complete side effect guidance.

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

Side Effects

Quick Answer

Nitazoxanide (Alinia / Nizonide) common side effects include abdominal pain, nausea, headache, and dizziness. A harmless but alarming side effect is yellow/orange discolouration of urine and eyes (sclera) — caused by the tizoxanide glucuronide metabolite — this is NOT jaundice and is NOT dangerous. Reassure patients about this before starting. Serious side effects are rare. Hepatotoxicity (true jaundice) is distinct from the metabolite discolouration and requires stopping the drug.

Side Effects at a Glance

Common

Abdominal pain / cramping
Nausea (matli)
Diarrhoea
Headache (sir dard)
Dizziness (chakkar)
Yellow/orange discolouration of urine — tizoxanide glucuronide metabolite — HARMLESS — reassure the patient
Scleral (eyes) yellowing — same metabolite — HARMLESS — this is not jaundice

Serious — See a Doctor

True hepatotoxicity (rare) — liver transaminase elevation; distinct from harmless metabolite discolouration; monitor patients with hepatic impairment
Severe hypersensitivity / allergic reaction (rare — rash, anaphylaxis)
Persistent/worsening diarrhoea despite treatment — antibiotic-associated colitis or treatment failure

When to See a Doctor Immediately

TRUE JAUNDICE — yellow skin + yellow eyes (sclera) + DARK (cola-coloured) urine + PALE/CLAY-COLOURED stools = hepatotoxicity — this is DISTINCT from tizoxanide metabolite discolouration — STOP the drug, see a doctor IMMEDIATELY
Diarrhoea that worsens or persists despite treatment — treatment failure or antibiotic-associated colitis
Severe allergic reaction — rash, urticaria, swelling, difficulty breathing
Signs of dehydration — severe thirst, no urine output, racing heart
Severe abdominal pain

Nitazoxanide (Alinia) Tablet Side Effects (Nuksanat)

Nitazoxanide (Alinia / Nizonide) is generally well-tolerated — especially during the short 3-day course. The most important side effect to know about: yellow/orange urine and eyes — this is a HARMLESS metabolite, not jaundice. Serious side effects are rare.

Common Side Effects (Aam Nuksanat)

Abdominal pain / cramping — mild to moderate; reduced when taken with food
Nausea — taking with food is helpful
Diarrhoea
Headache (sir dard) — mild
Dizziness (chakkar) — mild

Yellow Discolouration — HARMLESS (Peeli Rang — Bezarar)

Feature	Tizoxanide Metabolite (HARMLESS)	True Jaundice (STOP DRUG)
Urine	Yellow/orange — harmless	Dark brown/cola
Eyes	Sclera slightly yellow	Yellow sclera
Skin	Normal	Yellow skin
Stool	Normal colour	Pale/clay coloured
Cause	Tizoxanide glucuronide metabolite	Liver disease/hepatotoxicity
Action	Reassure — continue drug	STOP drug, see doctor

Warn patients from the start — yellow urine is expected, is HARMLESS, and the medicine does not need to be stopped.

Serious Side Effects (Sanjeedah Nuksanat — Rare)

True Hepatotoxicity — rare; different from metabolite yellowing; true jaundice signs (yellow skin + dark urine + pale stools); STOP drug
Severe allergic reaction — anaphylaxis, severe rash, breathing difficulty
Persistent/worsening diarrhoea — antibiotic-associated colitis or treatment failure

When to See a Doctor

True jaundice (yellow skin + cola urine + pale stools) — hepatotoxicity — STOP the drug, see a doctor IMMEDIATELY
Diarrhoea that worsens after 3 days — treatment failure
Severe allergic reaction
Signs of dehydration — extreme thirst, no urine output

Reassurance Guide for Yellow Discolouration

Urine may turn yellow/orange — HARMLESS
Eyes may appear slightly yellow — HARMLESS
Returns to normal after the 3-day course is completed
Always inform your doctor if you are unsure

Reporting Side Effects

If you notice any unexpected side effect, report it on the DRAP pharmacovigilance portal: https://www.dra.gov.pk/pharmacovigilance

The information in this guide is for educational purposes only. If you notice any side effect, contact your doctor or pharmacist.

Frequently Asked Questions

Nitazoxanide se peshab peeli kyun ho jaati hai?

Nitazoxanide is converted in the body to the tizoxanide glucuronide metabolite — this enters the urine and gives it a yellow or orange colour. The white part of the eyes (sclera) may also appear slightly yellow. This is HARMLESS — it is not jaundice — do not be alarmed; do not stop the medicine.

Nitazoxanide se peeli aankhein — kya yeh jaundice hai?

The yellowing of the sclera is caused by the tizoxanide metabolite of nitazoxanide — it is HARMLESS. Real jaundice is different: yellow skin + yellow eyes + DARK (brown/cola) urine + PALE/CLAY stool — this combination indicates hepatotoxicity — stop the medicine and see a doctor.

Nitazoxanide se kya diarrhoea aur badh sakta hai?

Yes — in some cases, nitazoxanide may briefly worsen diarrhoea at first. This is usually short-lived. Complete the 3-day course. If diarrhoea persists or worsens after 3 days, see a doctor — it may be treatment failure or another cause.

Nitazoxanide ke serious side effects kya hain?

Serious side effects are rare: hepatotoxicity, severe allergic reaction (anaphylaxis), persistent worsening diarrhoea. Common side effects (abdominal pain, nausea, headache, yellow urine/eyes) are generally mild and harmless.

Nitazoxanide ke side effects se kaise bachein?

Take WITH FOOD. Know about yellow urine/eyes in advance — do not panic. Drink plenty of water or ORS. It is a short 3-day course — complete it. Tell your doctor about all your medicines.

Brand alternatives, same-class options, and other medicines used for the same conditions as Nitazoxanide Tablet.

Used for the same conditions

Other medicines commonly used for diarrhea and overlapping conditions.

Diarrhea hub →

Sources

DRAP Registered Products Database — Drug Regulatory Authority of Pakistan
WHO Model List of Essential Medicines, 23rd ed. (2023) — World Health Organization
British National Formulary (BNF) — BMJ Group & Pharmaceutical Press

Medical disclaimer

This page is for educational use only and does not replace professional medical advice. Always confirm diagnosis, dose, and interactions with a qualified doctor or pharmacist before starting or changing any medicine.