clindamycin topical/tretinoin topical (Rx)

Brand and Other Names:Veltin, Ziana
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

clindamycin/tretinoin

gel

  • 1.2%/0.025%

Acne Vulgaris

Apply pea-sized amount to entire face qHS

Dosage Forms & Strengths

clindamycin/tretinoin

gel

  • 1.2%/0.025%

Acne Vulgaris

<12 years old: Safety and efficacy not established

≥12 years: Apply pea-sized amount to entire face qHS

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Interactions

Interaction Checker

and clindamycin topical/tretinoin topical

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Contraindicated (0)

              Serious - Use Alternative (34)

              • aminolevulinic acid oral

                aminolevulinic acid oral, tretinoin topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

              • aminolevulinic acid topical

                tretinoin topical, aminolevulinic acid topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              • bendroflumethiazide

                bendroflumethiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • chlorothiazide

                chlorothiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • chlorpromazine

                chlorpromazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • chlorthalidone

                chlorthalidone, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • ciprofloxacin

                ciprofloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Both drugs have increased risk of phototoxicity, use caution with concomitant use.

              • cyclopenthiazide

                cyclopenthiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • demeclocycline

                demeclocycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • doxycycline

                doxycycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • fleroxacin

                fleroxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • fluphenazine

                fluphenazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • gemifloxacin

                gemifloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • hydrochlorothiazide

                hydrochlorothiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • indapamide

                indapamide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • levofloxacin

                levofloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • methotrexate

                methotrexate, tretinoin topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive hepatotoxicity.

              • methyclothiazide

                methyclothiazide, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • methyl aminolevulinate

                tretinoin topical, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              • metolazone

                metolazone, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • minocycline

                minocycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • moxifloxacin

                moxifloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • ofloxacin

                ofloxacin, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • oxytetracycline

                oxytetracycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • perphenazine

                perphenazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • prochlorperazine

                prochlorperazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • promazine

                promazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • promethazine

                promethazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • sulfadiazine

                sulfadiazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • sulfamethoxazole

                sulfamethoxazole, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • sulfisoxazole

                sulfisoxazole, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • tetracycline

                tetracycline, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • thioridazine

                thioridazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              • trifluoperazine

                trifluoperazine, tretinoin topical. Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased phototoxicity.

              Monitor Closely (3)

              • mifepristone

                mifepristone will increase the level or effect of tretinoin topical by Other (see comment). Use Caution/Monitor. Inhibits CYP2C8/2C9; use smallest recommended doses for substrates and monitor

              • porfimer

                tretinoin topical will increase the level or effect of porfimer by pharmacodynamic synergism. Use Caution/Monitor. May enhance the photosensitizing effects of porfimer

              • stiripentol

                stiripentol will increase the level or effect of tretinoin topical by Other (see comment). Modify Therapy/Monitor Closely. Stiripentol is a CYP2C8 inhibitor. Consider dosage reduction for CYP2C8 substrates if adverse effects are experienced when coadministered.

              Minor (2)

              • ketoconazole

                ketoconazole increases levels of tretinoin topical by decreasing metabolism. Minor/Significance Unknown.

              • levoketoconazole

                levoketoconazole increases levels of tretinoin topical by decreasing metabolism. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Erythema (21-35%)

              Scaling (13-19%)

              Itching (15-17%)

              1-10%

              Dryness (6%)

              Irritation (5%)

              Exfoliation (5%)

              Erythema (4%)

              Pruritus (2%)

              Stinging (2%)

              Burning (2%)

              Sunburn (1%)

              Dermatitis (1%)

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              Warnings

              Contraindications

              Hypersensitivity to clindamycin or lincomycin or any of its components

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

              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 peeling, desquamating, or abrasive agents

              Should be used with caution in atopic individuals

              For external use only; avoid contact with eyes and mucous membranes; not for oral, ophthalmic or intravaginal use

              Avoid sunlight/UV exposure; wear sunscreen daily

              Do not use with erythromycin-containing products

              Coadministration with topical agents with drying effect can increase skin irriation; caution advised

              Clindamycin can cause severe colitis; discontinue if significant diarrhea occurs

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: excretion in milk unknown; use with caution

              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: 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

              Tretinoin: Exact mechanism unknown; appears to cohesiveness of follicular epithelial cells with decrease microcomedo formation; also increases turnover of follicular cells to cause extrusion of comedones

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              Formulary

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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.
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              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              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
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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.