Secnidazole (Solosec) for BV

A scientific review was conducted on secnidazole (also known as Solosec), an antibiotic used to treat bacterial vaginosis. Conclusion? It has the same success rate as metronidazole.

Understanding the research

Secnidazole has been in six clinical trials with 1528 participants included.

Key findings of the review

  • Treatment with 2g secnidazole may significantly reduce the risk of BV in those with three or fewer BV flare-ups in the past year.
  • But not in those with four or more BV flare-ups in the past year.
  • Two grams of secnidazole was significantly more effective than 1g.
  • The cure rate of 2g secnidazole was equal to metronidazole (500mg twice daily for five days), secnidazole with metronidazole, a 2g single dose of metronidazole and 2g secnidazole with vaginal ornidazole.
  • Two grams of secnidazole was better than placebo.

What is secnidazole?

Secnidazole is an antibiotic structurally similar to other antibiotics commonly used to treat BV, such as metronidazole. Secnidazole is effective against many anaerobic gram-positive and gram-negative micro-organisms, including those that cause BV and various parasites.

Secnidazole is absorbed quickly after oral administration with a longer half-life than other drugs in its class (17-29 hours), used in a single dose of one or two milligrams. The single dose makes it attractive for both patients and practitioners.

Resistance is reported to be rare. This drug is offered in a pill/tablet or in granules to be sprinkled on food.

Microbes secnidazole is effective against

  • Bacteroides fragilis
  • Trichomonas vaginalis
  • Entamoeba histolytica
  • Giardia lamblia

Side-effects of secnidazole

In clinical trials, secnidazole appears to be well-tolerated overall, with most adverse events being related to the digestive tract.

  • Nausea
  • Vomiting
  • Loss of appetite
  • Digestive tract pain
  • Metallic taste
  • Swollen tongue
  • Headaches
  • Dizziness
  • Abnormalities in leucocyte counts
  • Increase in blood urea nitrogen
  • Yeast infection

References

Abd El Aziz, M.A., Sharifipour, F., Abedi, P. et al. Secnidazole for treatment of bacterial vaginosis: a systematic reviewBMC Women’s Health 19, 121 (2019) doi:10.1186/s12905-019-0822-2

Gillis, J.C., Wiseman, L.R. SecnidazoleDrugs 51, 621–638 (1996) doi:10.2165/00003495-199651040-00007



Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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