New Drug Reviews

Secnidazole (Solosec) for Bacterial Vaginosis


Am Fam Physician. 2019 Aug 15;100(4):242-243.

Journal Audio: An audio version of this article is available.

Secnidazole (Solosec) is a nitroimidazole antibiotic labeled for the single-dose treatment of bacterial vaginosis in women older than 18 years. Secnidazole has a half-life of 17 hours compared with metronidazole (Flagyl), the other common drug in this class, which has a half-life of only eight hours.1

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DrugDosageDose formCost*

Secnidazole (Solosec)

2 g taken once

One 2-g packet of granules to be sprinkled on soft food


*—Estimated retail price based on information obtained at (accessed July 3, 2019).

DrugDosageDose formCost*

Secnidazole (Solosec)

2 g taken once

One 2-g packet of granules to be sprinkled on soft food


*—Estimated retail price based on information obtained at (accessed July 3, 2019).


Studies have shown secnidazole to be safe with few adverse effects. The most significant adverse effect is vulvovaginal candidiasis, which occurred in 9.6% of women vs. 2.9% taking placebo.1 Secnidazole has not been studied in pregnant women, though no adverse outcomes have been reported in animal studies using doses four times the usual clinical dose.1 Similarly, there is no information on the effect of secnidazole on breastfeeding women, although the manufacturer recommends that patients refrain from breastfeeding during treatment and for 96 hours after administration because of the potential for serious adverse reactions.


Secnidazole is generally well tolerated. As with other nitroimidazole antibiotics, secnidazole may be associated with headache, nausea, dysgeusia (altered taste), abdominal pain, and diarrhea in less than 6% of patients, a rate higher than with placebo.1


Based on two studies of 352 women with clinically diagnosed bacterial vaginosis, about 50% of women treated with secnidazole will respond clinically (i.e., normal vaginal discharge, negative 10% potassium hydroxide whiff

Address correspondence to Jeffrey C. Leggit, MD, CAQSM, at Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.


show all references

1. Daily Med. Drug label information. Solosec–secnidazole granule. Accessed February 25, 2019.

2. Schwebke JR, Morgan FG Jr, Koltun W, et al. A phase-3, double-blind, placebo-controlled study of the effectiveness and safety of single oral doses of secnidazole 2 g for the treatment of women with bacterial vaginosis [published correction appears in Am J Obstet Gynecol. 2018;219(1):110]. Am J Obstet Gynecol. 2017;217(6):678.e1–678.e9.

3. Center for Drug Evaluation and Research. Application number: 209363Orig1s000. Summary review. Accessed March 6, 2019.

4. Bohbot JM, Vicaut E, Fagnen D, et al. Treatment of bacterial vaginosis: a multicenter, double-blind, double-dummy, randomised phase III study comparing secnidazole and metronidazole. Infect Dis Obstet Gynecol. 2010;2010:705692.

STEPS new drug reviews cover Safety, Tolerability, Effectiveness, Price, and Simplicity. Each independent review is provided by authors who have no financial association with the drug manufacturer.

This series is coordinated by Allen F. Shaughnessy, PharmD, MMedEd, Assistant Medical Editor.

A collection of STEPS published in AFP is available at



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