clindamycin topical/tretinoin topical (Rx)

>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%)

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

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.

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