clindamycin topical (Rx)

Brand and Other Names:Cleocin T, Clindagel, more...Clindacin P, ClindaReach, ClindaDerm, ClindaMax, Clindets, Evoclin
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

gel/lotion/solution/foam/swab

  • 1%

vaginal suppository

  • 100mg

vaginal cream

  • 2%

Acne Vulgaris

Gel/lotion/solution (Cleocin, ClindaMax): Apply a thin film to affected area q12hr

Foam/gel (Evoclin, Clindagel): Apply a thin film to affected area qDay

Swab: Use a swab to apply a thin film of clindamycin to affected area q12hr; each swab should be used only once, and then discarded

Bacterial Vaginosis

Suppository: Insert 1 suppository into vagina qHS for 3 days

Vaginal cream: 1 full applicator inserted intravaginally qHS for 3 days in nonpregnant patients and for 7 days in pregnant patients

Gardnerella Vaginalis (Off-label)

Suppository: Insert 1 suppository into vagina qHS for 3 days

Vaginal cream: 1 full applicator inserted intravaginally qHS for 3 days in nonpregnant patients and for 7 days in pregnant patients

Dosage Forms & Strengths

gel/lotion/solution/foam/swab

  • 1%

Acne Vulgaris

<12 years old

  • Safety and efficacy not established

>12 years

  • Gel/lotion/solution (Cleocin T, ClindaMax): Apply a thin film to affected area q12hr
  • Foam/gel (Evoclin, Clindagel): Apply a thin film to affected area qDay
  • Swab: Use a swab to apply a thin film of clindamycin to affected area q12hr; each swab should be used only once, and then discarded
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Adverse Effects

>10%

Dryness (18-23%)

Oiliness (1-18%)

Erythema (7-16%)

Peeling (7-11%)

Burning/itching (6-11%)

1-10%

Headache (3%)

Postmarketing Reports

Local skin effects

  • Application site pain/erythema/rash
  • Gram-negative folliculitis
  • Hypersensitivity
  • Seborrhea
  • Urticaria

Systemic effects

  • Abdominal discomfort
  • Abdominal pain
  • Colitis (including pseudomembranous colitis)
  • Diarrhea
  • Dizziness
  • Hemorrhagic diarrhea
  • Hypersensitivity
  • Nausea

Postmarketing Reports

Eye pain

Contact dermatitis

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Warnings

Black Box Warnings

Pseudomembranous colitis reported with nearly all antibacterial agents, including clindamycin, and may range in severity from mild to life-threatening; orally and parenterally administered clindamycin associated with severe colitis which may end fatally; diarrhea, bloody diarrhea, and colitis (including pseudomembranous colitis) reported with use of orally and parenterally administered clindamycin, as well as with topical (dermal and vaginal) formulations of clindamycin; important to consider this diagnosis in patients who present with diarrhea subsequent to administration of clindamycin, even when administered by vaginal route, because approximately 5% of clindamycin dose is systemically absorbed from vagina

Contraindications

Hypersensitivity to clindamycin or lincomycin or to any of its components

History of regional enteritis, ulcerative colitis, or antibiotic-associated colitis (including pseudomembranous colitis)

Not indicated for inflammatory acne

Cautions

Systemic absorption of clindamycin has been demonstrated following topical use; discontinue immediately if significant diarrhea occurs

May cause irritation, especially when used with concomitant topical acne therapy, including with peeling, desquamating, or abrasive agents

Should be used with caution in atopic individuals

For external use only; avoid contact with eyes and mucous membranes

If applied to chest by nursing mothers, care should be taken to avoid accidental ingestion by infant

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Pregnancy & Lactation

Pregnancy

In clinical trials with pregnant women, systemic administration of clindamycin during second and third trimesters has not been associated with increased frequency of congenital abnormalities; there are no adequate studies in pregnant women during first trimester of pregnancy; clindamycin should be used during first trimester of pregnancy only if clearly needed

Lactation

Not known whether clindamycin is excreted in human milk following therapy; however, orally and parenterally administered clindamycin has been reported to appear in breast milk; clindamycin has potential to cause adverse effects on breastfed infant's gastrointestinal flora; if oral or intravenous clindamycin is required by a nursing mother, it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred; monitor infant for possible adverse effects on gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in the stool indicating possible antibiotic-associated colitis

Developmental and health benefits of breastfeeding should be considered along with mother's clinical need for clindamycin and any potential adverse effects on breastfed child from clindamycin or from underlying maternal condition

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Clindamycin is an antibacterial agent that binds to the 50S ribosomal subunits of susceptible bacteria and prevents elongation of peptide chains by interfering with peptidyl transfer, thereby suppressing protein synthesis; reduces surface fatty acids on skin; exact mechanism of action in treating acne unknown, but clindamycin inhibits Propionibacterium acnes in vivo

Pharmacokinetics

Absorption: 5% (vaginal cream); 30% (vaginal suppository); minimal (topical solution of foam)

Half-life: 1.5-2.8 hr (following repeated dosing); 11 hr (vaginal suppository)

Peak serum time: 10-14 hr (vaginal cream); 5 hr (vaginal suppository)

Metabolism: Hepatic

Excretion: Urine (0.2% with topical foam and solution)

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Images

BRAND FORM. UNIT PRICE PILL IMAGE
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
clindamycin injection
-
150 mg/mL vial
Cleocin vaginal
-
100 mg suppos
Cleocin vaginal
-
2 % cream
Clindacin P topical
-
1 % swab
clindamycin phosphate topical
-
1 % gel
clindamycin phosphate topical
-
1 % gel
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % gel
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % foam
clindamycin phosphate topical
-
1 % foam
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % swab
clindamycin phosphate topical
-
1 % lotion
clindamycin phosphate topical
-
1 % gel
clindamycin phosphate topical
-
1 % gel
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % lotion
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % solution
clindamycin phosphate topical
-
1 % swab
Cleocin injection
-
150 mg/mL vial
Cleocin injection
-
150 mg/mL vial
Cleocin injection
-
150 mg/mL vial
Cleocin injection
-
150 mg/mL vial
Cleocin injection
-
150 mg/mL vial
Clindacin ETZ topical
-
1 % swab
Clindacin ETZ topical
-
1 % kit
Clindacin ETZ topical
-
1 % swab
Clindagel topical
-
1 % gel
Clindesse vaginal
-
2 % cream
Cleocin T topical
-
1 % solution
Cleocin T topical
-
1 % swab
Cleocin T topical
-
1 % gel
Cleocin T topical
-
1 % lotion
Cleocin T topical
-
1 % gel
clindamycin vaginal
-
2 % cream
clindamycin vaginal
-
2 % cream
Evoclin topical
-
1 % foam
Evoclin topical
-
1 % foam

Copyright © 2010 First DataBank, Inc.

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Patient Handout

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Patient Education
clindamycin injection

CLINDAMYCIN - INJECTION

(klin-duh-MY-sin)

COMMON BRAND NAME(S): Cleocin

WARNING: This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur weeks to months after treatment has stopped. Tell your doctor right away if you develop: persistent diarrhea, abdominal or stomach pain/cramping, blood/mucus in your stool. If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.

USES: This medication is used to treat a wide variety of bacterial infections. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.This medication should not be used to treat meningitis.

HOW TO USE: This medication is given by injection into a vein or muscle as directed by your doctor, usually 2 to 4 times a day. The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight.If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.Antibiotics work best when the amount of medicine in your body is kept at a constant level. Use this drug at evenly spaced intervals.Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a return of the infection.Tell your doctor if your condition persists or worsens.

SIDE EFFECTS: See also Warning section.Nausea, vomiting, an unpleasant/metallic taste in mouth (if this drug is injected into a vein), or pain at the injection site (if this drug is injected into a muscle) may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: pain/swelling at injection site (if this drug is injected into a vein), dark urine, yellowing eyes/skin, persistent nausea/vomiting, easy bruising/bleeding, pain in several joints, fast/slow/irregular heartbeat, fainting.Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever that doesn't go away, new or worsening lymph node swelling, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using clindamycin, tell your doctor or pharmacist if you are allergic to it; or to lincomycin; or if you have any other allergies. This product may contain inactive ingredients (such as benzyl alcohol), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this drug, tell your doctor your medical history, especially of: kidney disease, liver disease, stomach/bowel disease (e.g., colitis).Clindamycin may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially diarrhea.Tell your doctor if you are pregnant before using this medication.This drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Laboratory and/or medical tests (e.g., kidney or liver function test) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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Formulary

FormularyPatient Discounts

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Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
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6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
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Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
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Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.