Clindamycin
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Clindamycin Overview
Clindamycin (topical) is a prescription medication used to treat acne. Clindamycin (vaginal) is a prescription medication used to treat bacterial infections of the vagina, a female reproductive organ. Clindamycin (oral and injection) is a prescription medication used to treat bacterial infections of the skin, airways, blood, joints, bones, female reproductive organs, and internal organs.
Clindamycin (topical, vaginal, oral, and injection) belongs to a group of drugs called lincosamide antibiotics, which slow or stop the growth of bacteria.
Clindamycin (topical) comes in topical foam, solution, lotion, gel, and medicated swab forms. These dosage forms are applied to the skin with acne once or twice a day. Clindamycin (vaginal) comes in vaginal suppository and cream forms. These dosage forms are typically used once a day at bedtime. Clindamycin (oral) comes in capsule and solution forms, and is taken by mouth up to 4 times a day with or without food. Clindamycin (injection) is given into the vein (IV) or into the muscle (IM) by a healthcare professional when needed.
Common side effects of clindamycin (topical) include dry, peeling, and irritated skin. Common side effects of clindamycin (vaginal) include vaginal irritation, swelling, and discharge. Common side effects of clindamycin (oral and injection) include nausea, vomiting, constipation, and rash.
Uses of Clindamycin
- Clindamycin (topical) is a prescription medication used to treat acne.
- Clindamycin (vaginal) is a prescription medication used to treat bacterial infections of the vagina, a female reproductive organ.
- Clindamycin (oral and injection) is a prescription medication used to treat bacterial infections of the skin, airways, blood, joints, bones, female reproductive organs, and internal organs.
These medications may be prescribed for other uses. Ask your doctor or pharmacist for more information.
Side Effects of Clindamycin
Serious side effects have been reported with clindamycin. See “Drug Precautions” section.
Common side effects of clindamycin (topical) include:
- dry, peeling, or red skin
- irritated, itchy, or burning skin
- oily skin and new blemishes
- headache
Common side effects of clindamycin (vaginal) include:
- vaginal irritation, itching, burning, or swelling
- vaginal discharge
- burning or painful urination
- nausea
- headache
- white patches in the mouth
Common side effects of clindamycin (oral and injection) include:
- stomach pain
- nausea
- vomiting
- skin rash
This is not a complete list of these medications’ side effects. Ask your doctor or pharmacist for more information.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Clindamycin Interactions
Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:
Clindamycin (topical, vaginal, oral, and injection)
- erythromycin
- neuromuscular blocking agents, such as doxacurium (Nuromax) and vecuronium (Norcuron)
This is not a complete list of these medications’ drug interactions. Ask your doctor or pharmacist for more information.
Clindamycin Precautions
Serious side effects have been reported with clindamycin (topical, vaginal, oral, and injection) including:
- Clostridium difficile (C. difficile) associated diarrhea: Clindamycin and other antibiotics can kill the “good” bacteria in the colon leading to a growth of C. difficile bacteria. This is a “bad” bacterium that can cause diarrhea and other digestive problems.
- Extra caution for this side effect is advised in the elderly population.
- Superinfection: Clindamycin should not be used for extended periods. Prolonged use can lead to the growth of dangerous organisms that are resistant to clindamycin. Take clindamycin for the duration prescribed by your doctor.
- Clindamycin (topical only):
- All precautions listed above, plus...
- Can irritate the skin. Do not apply to eyes, mouth, lips, broken skin, or mucous membranes. If the medication gets on these areas, rinse thoroughly with cool water.
- Clindamycin (vaginal only):
- All precautions listed above, plus...
- Can weaken the materials in contraceptive devices, such as condoms and vaginal diaphragms, causing them to break.
- Do not have vaginal intercourse or use vaginal products (tampons and douches).
Do not take clindamycin (topical, vaginal, oral, and injection) if you:
- are allergic to clindamycin, lincomycin (Lincocin), or other lincosamide antibiotics
- have a history of digestive problems, such as enteritis (inflammation of the small intestine) or colitis (inflammation of the large intestine, or colon)
Clindamycin Food Interactions
Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case clindamycin, there are no specific foods that you must exclude from your diet when receiving clindamycin.
Inform MD
Before taking clindamycin, tell your doctor about all of your medical conditions. Especially tell your doctor if you:
- are allergic to clindamycin, lincomycin (Lincocin), or other lincosamide antibiotics
- have had an allergic skin reaction in the past to other medications
- have a history of digestive problems, such as enteritis (inflammation of the small intestine) or colitis (inflammation of the large intestine, or colon)
- are pregnant or breastfeeding
Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.
Clindamycin and Pregnancy
Tell your doctor if you are pregnant or plan to become pregnant.
The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.
Clindamycin (topical, vaginal, oral, and injection) falls into category B. Studies in animals have failed to demonstrate a risk to the unborn baby and there are no well-controlled studies in pregnant women.
Clindamycin and Lactation
Tell your doctor if you are breastfeeding or plan to breastfeed.
Clindamycin (topical, vaginal, oral, and injection) has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from this medication, a choice should be made whether to stop nursing or to stop use of clindamycin. Determining the importance of the drug to the mother should be considered.
Clindamycin Usage
- Take clindamycin (topical, vaginal, oral, or injection) exactly as prescribed for the full duration.
- Continue to take this medication even if you feel well. Do not stop taking clindamycin (topical, vaginal, oral, or injection) without talking to your doctor.
- Clindamycin (topical):
- Comes in topical foam, solution, lotion, gel, and medicated swab forms.
- The foam, gels, lotions, solutions, and medicated swabs are used on the skin with acne once or twice a day, depending on the brand prescribed.
- Shake the lotion before each use.
- Throw the swabs away after each use.
- Do not apply to the eyes, mouth, lips, broken skin, or mucous membranes. If the medication gets on these areas, rinse with cool water.
- Clindamycin (vaginal):
- Comes in vaginal suppository and cream forms.
- The vaginal suppositories are inserted once a day at bedtime for 3 days in a row.
- One brand of vaginal cream (Clindesse) is applied as a single dose at any time of day.
- The other vaginal creams are applied once a day at bedtime for 3 or 7 days in a row, depending on the brand prescribed.
- Do not have vaginal intercourse or use vaginal products (tampons and douches) while using vaginal clindamycin.
- Vaginal clindamycin can weaken the materials in contraceptive devices, such as condoms and vaginal diaphragms.
- Clindamycin (oral):
- Comes in capsule and solution forms, and is taken by mouth up to four times a day, with or without food.
- To avoid the possibility of heartburn, clindamycin capsules should be taken with a full glass of water.
- Clindamycin (injection):
- Clindamycin (injection) is given into the vein (IV) or into the muscle (IM) by a healthcare professional when needed.
If you miss a dose of clindamycin (topical, vaginal, or oral), take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of clindamycin at the same time.
Clindamycin Dosage
Take clindamycin exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.
For topical clindamycin:
- The foam, gels, lotions, solutions, and medicated swabs are used on the skin with acne once or twice a day, depending on the brand prescribed.
- Your doctor will determine the dosage schedule appropriate for you depending on your condition.
For vaginal clindamycin:
- One 100 mg suppository is inserted vaginally once a day at bedtime for 3 days.
- One brand of vaginal cream (Clindesse) is applied as a single dose at any time of day.
- The other vaginal creams are applied once a day at bedtime for 3 or 7 days in a row in non-pregnant women and for 7 days in pregnant women.
- Your doctor will determine the dosage schedule appropriate for you depending on your condition.
For oral clindamycin:
- Adults, capsule form:
- Serious infections: 150 to 300 mg every 6 hours
- More severe infections: 300 to 450 mg every 6 hours
- Children, capsule form:
- Serious infections: 8 to 16 mg/kg/day given as 3 or 4 equal doses
- More severe infections: 16 to 20 mg/kg/day given as 3 or 4 equal doses
- Children, oral solution form:
- Serious infections: 8–12 mg/kg/day given as 3 or 4 equal doses
- Severe infections: 13–16 mg/kg/day given as 3 or 4 equal doses
- More severe infections: 17–25 mg/kg/day given as 3 or 4 equal doses
- In children weighing 10 kg or less, ½ teaspoon (37.5 mg) three times a day should be considered the minimum recommended dose.
For injection clindamycin:
- Adults, injection form:
- 600 to 2700 mg/day in 2, 3 or 4 equal doses
- More severe infections: up to 4800 mg/day
- Single IM (injection into muscle) of greater than 600 mg are not recommended
- Neonates (less than 1 month old), injection form:
- 15 to 20 mg/kg/day in three to four equal doses
- Children (1 month to 16 years old), injection form:
- 20 to 40 mg/kg/day in 3 or 4 equal doses, or…
- 350 mg/m2/day for serious infections and 450 mg/m2/day for more severe infections
Clindamycin Overdose
If you take too much clindamycin, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.
Forms of Clindamycin
Clindamycin (topical) is available in:
- 50 and 100 gram aerosol foams with a concentration of 1% clindamycin
- 30 and 60 mL topical solutions with a concentration 1% clindamycin
- 30 gram and 60 gram topical gels with a concentration 1% clindamycin
- 45 mL and 75 mL topical gels with a concentration of 1% clindamycin
- 60 mL topical lotions with a concentration 1% clindamycin
- swabs with a concentration 1% clindamycin
Clindamycin (vaginal) is available in:
- 100 mg vaginal suppositories with 3 suppositories per package
- 40 grams of vaginal creams with a concentration of 2% clindamycin
Clindamycin (oral) is available in:
- Comes as 75 mg, 150 mg, and 300 mg capsules
- Comes as 75 mg/5 mL oral solution
Clindamycin (injection) is available in:
- Comes in vials with the following strengths:
- 300 mg/2 mL
- 600 mg/4 mL
- 900 mg/6 mL
- 9000 mg/60 mL
- 300 mg/50 mL
- 600 mg/50 mL
- 900 mg/50 mL
Active ingredient: clindamycin
Inactive ingredients: varies by manufacturers and dosage forms
Other Requirements
- Store clindamycin at room temperature.
- Clindamycin (oral solution) is stable for only 2 weeks at room temperature. Discard after 2 weeks has passed.
- Keep the foam (clindamycin topical) away from open flames or extreme heat.
- Keep this and all medicines out of the reach of children.
Clindamycin FDA Warning
Clindamycin (oral and injection):
Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile. Because clindamycin therapy has been associated with severe colitis which may end fatally, it should be reserved for serious infections where less toxic antimicrobial agents are inappropriate, as described in the INDICATIONS AND USAGE section. It should not be used in patients with nonbacterial infections such as most upper respiratory tract infections. C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile, and surgical evaluation should be instituted as clinically indicated.