Dawaa Reference

infectious

Cryptosporidiosis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ALINIA (nitazoxanide) US prescribing information, section 2.1 Recommended Dosage, Table 1 (DailyMed SetID e90f98d9-3c9b-4e75-ba18-5517283eadf0) · WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2 · Egyptian National Drug Formulary - GIT medicines 2025 (loperamide monograph)

Verified against3 documents
  • ALINIA (nitazoxanide) US prescribing information, section 2.1 Recommended Dosage, Table 1 (DailyMed SetID e90f98d9-3c9b-4e75-ba18-5517283eadf0)
  • WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2
  • Cryptosporidiosis - disease-level clinical article (cryptosporidiosis-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • Immunocompetent patients in high-income settings typically have mild, nonbloody diarrhea [diarrhoea]
  • Diarrhea may come with vomiting, dehydration, cramping, low-grade fever, and poor appetite [dehydration · diarrhoea · fever · muscle cramps · poor appetite · vomiting]
  • HIV patients with CD4 under 50 cells/microL are at higher risk of biliary or pancreatic disease from Cryptosporidium
  • Transplant patients present with diarrhea, abdominal pain, weight loss, and vomiting [abdominal pain · diarrhoea · vomiting · weight loss]
  • Affected children have watery diarrhea, vomiting, dehydration, and possible signs of malnutrition [dehydration · diarrhoea · vomiting]

Tests (5)

  • Oocysts measure 4 to 6 micrometers on acid-fast stain, smaller than Cyclospora or Cystoisospora
  • Immunofluorescence microscopy is the gold-standard microscopy method, more sensitive than acid-fast stain
  • Multiplex PCR panels reach 95 to 100 percent sensitivity and 99.6 to 100 percent specificity
  • Up to three stool samples over several days improve detection since oocyst shedding is intermittent
  • Ultrasound is the best initial test when biliary involvement is suspected

If not this — what else fits (4)

  • Cyclospora cayetanensis is a protozoan differential
  • Giardia lamblia is on the differential list
  • Tumors such as colorectal cancer or carcinoid are noninfectious differentials
  • Small intestinal bacterial overgrowth is on the differential list

SourceStatPearls "Cryptosporidiosis" - disease-level clinical article

Presentation findings are traced to the source above.

Rx: Main treatment | Symptom control - mild to moderate diarrhoea only

MAIN TREATMENT - choose one, plus any add-on marked below

1

NITAZOXANIDE

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

500 mg twice daily with food x 3 days

Paediatric dose

(1-3 years: 100 mg (5 mL) twice daily; 4-11 years: 200 mg (10 mL) twice daily with food for 3 days)

Dose by age
1 to 3 years:100 mg (5 mL) twice daily with food, for 3 days
4 to 11 years:200 mg (10 mL) twice daily with food, for 3 days
Dose source

ALINIA (nitazoxanide) US prescribing information, section 2.1 Recommended Dosage, Table 1 (DailyMed SetID e90f98d9-3c9b-4e75-ba18-5517283eadf0)

Why

Antiparasitic agent that is first-line therapy for Cryptosporidium in immunocompetent patients; it disrupts an enzyme-dependent energy pathway the parasite depends on to survive.

Cautions
  • Nitazoxanide is the first-line antiparasitic for Cryptosporidium in immunocompetent hosts.
  • Take with food to increase absorption.
  • May cause green discoloration of urine and sclera.
Egyptian brands
Egyptian brandManufacturerIndicative price
UNINITAPROZAX 500MG 12 F.C. TAB.UNIPHARMA CO. > UNIPHARMA16.00 EGP (1.33/unit)
CRYPTOPER 500MG 30 F.C. TAB.EGPI > TAG PHARMA56.00 EGP (1.87/unit)
XEROVIRINC 500MG 18 F.C. TAB.MINA PHARM42.00 EGP (2.33/unit)
PARAZOXANIDE 500 MG 18 CAP.MISR > PHARMACARE63.00 EGP (3.50/unit)
TRUSTNAL 500 MG 10 F.C. TABS.ADWIA40.00 EGP (4.00/unit)
NIT CLEAN 500MG 12 F.C. TABS.WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA72.00 EGP (6.00/unit)
CRYPTONAZ 500MG 12 F.C.TAB.COPAD PHARMA82.00 EGP (6.83/unit)
NIT CLEAN 500MG 5*6 F.C. TABS.WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA180.00 EGP (30.00/unit)
UNINITAPROZAX 100MG/5ML SUSP. 60ML? strength differs? different route - not oral solidUNIPHARMA CO. > UNIPHARMA6.00 EGP
ZOLIFUTAL 100MG/5ML SUSP. 60 ML? strength differs? different route - not oral solidFUTURE PHARMACEUTICAL INDUSTRIES (FPI)13.50 EGP
2

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose source

Cryptosporidiosis - disease-level clinical article (cryptosporidiosis-clinical.txt)

Why

Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.

Cautions
  • RED FLAG - The criteria for evaluation are severe symptoms, immunosuppression, or illness lasting longer than 2 weeks.
3

ORS

add-on - not a substitute

Formoral.liquid

Adult dose and duration

Make the sachet up to the volume printed on the pack - a WHO/UNICEF standard sachet makes 1 litre, and using less water than the label says makes the solution dangerously concentrated. Egypt also sells ready-mixed 240-360 mL packs, which need no dilution. Drink after each loose stool. - until diarrhoea resolves

Paediatric dose

Some dehydration (WHO Plan B): give the child's weight in kg x 75 mL of ORS solution in the first 4 hours, then reassess. Add replacement for ongoing losses. (50-100 mL/kg is WHO's estimate of the fluid DEFICIT at this level of dehydration, not the volume to give.)

Dose source

WHO. The treatment of diarrhoea: a manual for physicians and other senior health workers, 4th rev. Geneva: WHO; 2005 (IRIS 10665/43209), section 4.3.1 and Table 2

Why

Oral rehydration solution (ORS) is essential supportive therapy for fluid loss.

Cautions
  • Never make the solution up in less water than the pack states. A five-fold concentrated ORS given to a dehydrated patient causes hypernatraemia, and an infant is the one least able to survive it.
  • Oral rehydration is primary life-saving measure against dehydration.
  • In immunocompromised (HIV/AIDS), cryptosporidiosis can be chronic and severe; refer urgently.
  • Ensure clean drinking water supply to prevent reinfection.
  • Sachets are far cheaper than the ready-made syrups - GLUCOHYDRAN and REHYDRAN N are under 5 EGP for ten.
Egyptian brands
Egyptian brandManufacturerIndicative price
GLUCOHYDRAN 10 SACHET.ARAB DRUG COMPANY (ADCO)1.75 EGP
REHYDRAN N 10 SACHETCID4.50 EGP
REHYDRO ZINC 10 SACHETSCID7.00 EGP
ORS 20 SACHETSPHAROPHARMA40.00 EGP
ELECTRO MASH SYRUP 200 MLMASH PREMIERE60.00 EGP
FLEXOLYTE ORAL REHYDRATION SOL. 240 MLKEMPETRO FOR CHEMICAL INDUSTRIES65.00 EGP
HERO ORS 200 MLHERO > HERO MEA TRADING120.00 EGP
SANSO ORS SYRUP 140 MLAUG PHARMA400.00 EGP

SYMPTOM CONTROL - MILD TO MODERATE DIARRHOEA ONLY - give alongside

4

LOPERAMIDE

Symptom control - mild to moderate diarrhoea only

add-on - not a substitute

Strength2 mg

Formoral.solid

Adult dose and duration

4 mg once, then 2 mg after each loose stool; not more than 12 to 16 mg in a day - Stop as soon as the stools firm up; the patient should see a doctor if there is no improvement within 48 hours

Paediatric dose

Contraindicated under 2 years. The formulary's indication is 12 years and over, yet its own paediatric table gives 6 to 8 years (20 to 30 kg) 2 mg twice a day and 8 to 12 years (over 30 kg) 2 mg three times a day, then 1 mg per 10 kg after each further loose stool - the monograph contradicts itself, so under 12 it is a doctor's decision.

Dose source

Egyptian National Drug Formulary - GIT medicines 2025 (loperamide monograph) - verbatim: "Initial dose: 4 mg, followed by 2 mg after each loose stool."

Why

Cryptosporidial diarrhoea is treated mainly with fluids and nitazoxanide; loperamide is added purely to reduce stool frequency in mild to moderate illness while the rest of the treatment works.

Cautions
  • Do not give it when there is blood in the stool with fever - that is dysentery, and slowing the bowel there is dangerous.
  • It does not clear the parasite and helps little in severe or prolonged disease, which in practice means the immunosuppressed patient.
  • Fluid and electrolyte replacement stays the main treatment; loperamide must not be used as a reason to withhold oral rehydration.
  • Stop it and reassess if there is abdominal pain without diarrhoea, or any abdominal distension.
Egyptian brands
Egyptian brandManufacturerIndicative price
MOTIJUST 2 MG 30 CAPSINTERNATIONAL DRUG INDUSTRIES > NOVELL PHARMA27.00 EGP (0.90/unit)
STOPRRHEA 2 MG 10 ORODISPERSIBLE TABS.WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA10.00 EGP
IMODIUM INSTANT 2MG 6 ORODISPERSIBLE TABS.MCNEIL PRODUCTS LTD. > JOHNSON & JOHNSON SCIENTIFIC OFFICE80.00 EGP
STOPRRHEA 2 MG 30 ORODISPERSIBLE TABS.WESTERN PHARMACEUTICALS INDUSTRIES > WESTERN PHARMA96.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.