# Cryptosporidiosis - Category: infectious - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - 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) ## Treatment metadata - Nitazoxanide — 500 mg — oral.solid - Referral & safety-netting (no drug therapy) - ORS — oral.liquid - Loperamide — 2 mg — oral.solid ## Complete treatment card ```text CRYPTOSPORIDIOSIS 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) Review status: REVIEWED against 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) (2026-08) 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 Source StatPearls "Cryptosporidiosis" - disease-level clinical article Status 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] Adult 500 mg twice daily with food x 3 days Peds 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 (1-3 years: 100 mg (5 mL) twice daily; 4-11 years: 200 mg (10 mL) twice daily with food for 3 days) 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. Caution 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. Egypt UNINITAPROZAX 500MG 12 F.C. TAB. UNIPHARMA CO.... 16.00 EGP (1.33/unit) CRYPTOPER 500MG 30 F.C. TAB. EGPI > TAG PH... 56.00 EGP (1.87/unit) XEROVIRINC 500MG 18 F.C. TAB. MINA PHARM 42.00 EGP (2.33/unit) PARAZOXANIDE 500 MG 18 CAP. MISR > PHARMA... 63.00 EGP (3.50/unit) TRUSTNAL 500 MG 10 F.C. TABS. ADWIA 40.00 EGP (4.00/unit) NIT CLEAN 500MG 12 F.C. TABS. WESTERN PHARM... 72.00 EGP (6.00/unit) CRYPTONAZ 500MG 12 F.C.TAB. COPAD PHARMA 82.00 EGP (6.83/unit) NIT CLEAN 500MG 5*6 F.C. TABS. WESTERN PHARM... 180.00 EGP (30.00/unit) UNINITAPROZAX 100MG/5ML SUSP. 60ML UNIPHARMA CO. > UNIPHARMA 6.00 EGP -> ? strength differs, ? different route - not oral solid ZOLIFUTAL 100MG/5ML SUSP. 60 ML FUTURE PHARMA... 13.50 EGP -> ? strength differs, ? different route - not oral solid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult 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. Caution RED FLAG - The criteria for evaluation are severe symptoms, immunosuppression, or illness lasting longer than 2 weeks. 3. ORS [add-on - not a substitute] Adult 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 Peds 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.) 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. Caution 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. Egypt GLUCOHYDRAN 10 SACHET. ARAB DRUG COM... 1.75 EGP REHYDRAN N 10 SACHET CID 4.50 EGP REHYDRO ZINC 10 SACHETS CID 7.00 EGP ORS 20 SACHETS PHAROPHARMA 40.00 EGP ELECTRO MASH SYRUP 200 ML MASH PREMIERE 60.00 EGP FLEXOLYTE ORAL REHYDRATION SOL. 240 ML KEMPETRO FOR CHEMICAL INDUSTRIES 65.00 EGP HERO ORS 200 ML HERO > HERO M... 120.00 EGP SANSO ORS SYRUP 140 ML AUG PHARMA 400.00 EGP SYMPTOM CONTROL - MILD TO MODERATE DIARRHOEA ONLY - give alongside 4. LOPERAMIDE [add-on - not a substitute] Adult 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 Peds 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. 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. Caution 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. Egypt MOTIJUST 2 MG 30 CAPS INTERNATIONAL... 27.00 EGP (0.90/unit) STOPRRHEA 2 MG 10 ORODISPERSIBLE TABS. WESTERN PHARMACEUTICALS INDUSTRIE... 10.00 EGP IMODIUM INSTANT 2MG 6 ORODISPERSIBLE TABS. MCNEIL PRODUCTS LTD. > JOHNSO... 80.00 EGP STOPRRHEA 2 MG 30 ORODISPERSIBLE TABS. WESTERN PHARMACEUTICALS INDUSTRIE... 96.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)