More information about Clindamycin
Pronunciation(klin da MYE sin)
U.S. Brand NamesCleocin®; Cleocin HCl®; Cleocin Pediatric®; Cleocin Phosphate®; Cleocin T®; Clindagel®; ClindaMax™; Clindesse™; Clindets®; Evoclin™
SynonymsClindamycin Hydrochloride; Clindamycin Palmitate; Clindamycin Phosphate
Generic AvailableYes: Excludes foam, vaginal suppositories, vaginal cream
Canadian Brand NamesAlti-Clindamycin; Apo-Clindamycin®; Clindoxyl®; Dalacin® C; Dalacin® T; Dalacin® Vaginal; Novo-Clindamycin
UseTreatment against aerobic and anaerobic streptococci (except enterococci), most staphylococci, Bacteroides sp and Actinomyces; bacterial vaginosis (vaginal cream, vaginal suppository); pelvic inflammatory disease (I.V.); topically in treatment of severe acne; vaginally for Gardnerella vaginalis
Use - DentalAlternate antibiotic, when amoxicillin cannot be used, for the standard regimen for prevention of bacterial endocarditis in patients undergoing dental procedures; alternate antibiotic in the treatment of common orofacial infections caused by aerobic gram-positive cocci and susceptible anaerobes; alternate antibiotic for prophylaxis for dental patients with total joint replacement
Use - Unlabeled/InvestigationalMay be useful in PCP; alternate treatment for toxoplasmosis
Pregnancy Risk FactorB
LactationEnters breast milk/compatible
ContraindicationsHypersensitivity to clindamycin or any component of the formulation; previous pseudomembranous colitis; regional enteritis, ulcerative colitis
Warnings/PrecautionsDosage adjustment may be necessary in patients with severe hepatic dysfunction; can cause severe and possibly fatal colitis; discontinue drug if significant diarrhea, abdominal cramps, or passage of blood and mucus occurs. Vaginal products may weaken latex or rubber condoms, or contraceptive diaphragms. Barrier contraceptives are not recommended concurrently or for 3-5 days (depending on the product) following treatment. Some dosage forms contain benzyl alcohol or tartrazine. Use caution in atopic patients.
>10%: Gastrointestinal: Diarrhea, abdominal pain
1% to 10%:
Dermatologic: Urticaria, rash, Stevens-Johnson syndrome
Gastrointestinal: Pseudomembranous colitis, nausea, vomiting
Local: Thrombophlebitis, sterile abscess at I.M. injection site
Miscellaneous: Fungal overgrowth, hypersensitivity
<1% (Limited to important or life-threatening): Renal dysfunction (rare), neutropenia, granulocytopenia, thrombocytopenia, polyarthritis
>10%: Dermatologic: Dryness, burning, itching, scaliness, erythema, or peeling of skin (lotion, solution); oiliness (gel, lotion)
1% to 10%: Central nervous system: Headache
<1% (Limited to important or life-threatening): Pseudomembranous colitis, nausea, vomiting, diarrhea (severe), abdominal pain, folliculitis, hypersensitivity reactions
>10%: Genitourinary: Fungal vaginosis, vaginitis or vulvovaginal pruritus (from Candida albicans)
1% to 10%:
Central nervous system: Back pain, headache
Gastrointestinal: Constipation, diarrhea
Genitourinary: Urinary tract infection
Miscellaneous: Fungal infection
<1% (Limited to important or life-threatening): Atrophic vaginitis, bladder infection, bladder spasm, cervical dysplasia, diarrhea, dizziness, epistaxis, erythema, fever, hypersensitivity, hyperthyroidism, local edema, menstrual disorder, nausea, pain, palpable lymph node, pruritus, pyelonephritis, pyrexia, rash, sciatica, stomach cramps, upper respiratory urticaria, uterine cervical disorder, uterine spasm, vaginal burning, vertigo, vomiting, vulvar erythema, vulvar laceration, wheezing
Overdosage/ToxicologySymptoms of overdose include diarrhea, nausea, and vomiting. Treatment is supportive.
Drug InteractionsIncreased duration of neuromuscular blockade from tubocurarine, pancuronium
Food: Peak concentrations may be delayed with food.
Herb/Nutraceutical: St John's wort may decrease clindamycin levels.
Capsule: Store at room temperature of 20°C to 25°C (68°F to 77°F)
Cream: Store at room temperature
Foam: Store at room temperature of 20°C to 25°C (68°F to 77°F); avoid fire, flame, or smoking during or following application
Gel: Store at room temperature
Clindagel®: Do not store in direct sunlight
I.V.: Infusion solution in NS or D5W solution is stable for 16 days at room temperature
Lotion: Store at room temperature of 20°C to 25°C (68°F to 77°F)
Oral solution: Do not refrigerate reconstituted oral solution (it will thicken); following reconstitution, oral solution is stable for 2 weeks at room temperature of 20°C to 25°C (68°F to 77°F)
Ovule: Store at room temperature of 15°C to 30°C (68°F to 77°F)
Pledget: Store at room temperature
Topical solution: Store at room temperature of 20°C to 25°C (68°F to 77°F)
CompatibilityStable in D5LR, D51/2NS, D5NS, D5W, D10W, LR, NS; variable stability (consult detailed reference) in peritoneal dialysis solutions
Y-site administration: Compatible: Amifostine, amiodarone, amphotericin B cholesteryl sulfate complex, amsacrine, aztreonam, cefpirome sulfate, cisatracurium, cyclophosphamide, diltiazem, docetaxel, doxorubicin liposome, enalaprilat, esmolol, etoposide, fludarabine, foscarnet, gatifloxacin, gemcitabine, granisetron, heparin, hydromorphone, labetalol, levofloxacin, linezolid, magnesium sulfate, melphalan, meperidine, midazolam, morphine, multivitamins, ondansetron, perphenazine, piperacillin/tazobactam, propofol, remifentanil, sargramostim, tacrolimus, teniposide, theophylline, thiotepa, vinorelbine, vitamin B complex with C, zidovudine. Incompatible: Allopurinol, filgrastim, fluconazole, idarubicin
Compatibility in syringe: Compatible: Amikacin, aztreonam, gentamicin, heparin. Incompatible: Tobramycin
Compatibility when admixed: Compatible: Amikacin, ampicillin, aztreonam, cefamandole, cefazolin, cefepime, cefoperazone, cefotaxime, cefoxitin, ceftazidime, ceftizoxime, cefuroxime, cephalothin, cimetidine, fluconazole, gentamicin, heparin, hydrocortisone sodium succinate, kanamycin, methylprednisolone sodium succinate, metoclopramide, metronidazole, metronidazole with sodium bicarbonate, ofloxacin, penicillin G, piperacillin, potassium chloride, sodium bicarbonate, tobramycin, verapamil, vitamin B complex with C. Incompatible: Aminophylline, barbiturates, calcium gluconate, ceftriaxone, ciprofloxacin, gentamicin with cefazolin, magnesium sulfate, phenytoin. Variable (consult detailed reference): Ranitidine
Mechanism of ActionReversibly binds to 50S ribosomal subunits preventing peptide bond formation thus inhibiting bacterial protein synthesis; bacteriostatic or bactericidal depending on drug concentration, infection site, and organism
Absorption: Topical: ~10%; Oral: Rapid (90%)
Distribution: High concentrations in bone and urine; no significant levels in CSF, even with inflamed meninges; crosses placenta; enters breast milk
Bioavailability: Topical: <1%
Half-life elimination: Neonates: Premature: 8.7 hours; Full-term: 3.6 hours; Adults: 1.6-5.3 hours (average: 2-3 hours)
Time to peak, serum: Oral: Within 60 minutes; I.M.: 1-3 hours
Excretion: Urine (10%) and feces (~4%) as active drug and metabolites
Infants and Children:
Oral: 8-20 mg/kg/day as hydrochloride; 8-25 mg/kg/day as palmitate in 3-4 divided doses; minimum dose of palmitate: 37.5 mg 3 times/day
<1 month: 15-20 mg/kg/day
>1 month: 20-40 mg/kg/day in 3-4 divided doses
Children: Prevention of bacterial endocarditis (unlabeled use): Oral: 20 mg/kg 1 hour before procedure with no follow-up dose needed; for patients allergic to penicillin and unable to take oral medications: 20 mg/kg I.V. within 30 minutes before procedure
Gel, pledget, lotion, solution: Apply a thin film twice daily
Foam (Evoclin™): Apply once daily
Oral: 150-450 mg/dose every 6-8 hours; maximum dose: 1.8 g/day
Prevention of bacterial endocarditis in patients unable to take amoxicillin (unlabeled use): Oral: 600 mg 1 hour before procedure with no follow-up dose needed; for patients allergic to penicillin and unable to take oral medications: 600 mg I.V. within 30 minutes before procedure
I.M., I.V.: 1.2-1.8 g/day in 2-4 divided doses; maximum dose: 4.8 g/day
Pelvic inflammatory disease: I.V.: 900 mg every 8 hours with gentamicin 2 mg/kg, then 1.5 mg/kg every 8 hours; continue after discharge with doxycycline 100 mg twice daily to complete 14 days of total therapy
Pneumocystis carinii pneumonia (unlabeled use):
Oral: 300-450 mg 4 times/day with primaquine
I.M., I.V.: 1200-2400 mg/day with pyrimethamine
I.V.: 600 mg 4 times/day with primaquine
Bacterial vaginosis: Intravaginal:
Suppositories: Insert one ovule (100 mg clindamycin) daily into vagina at bedtime for 3 days
Cleocin®: One full applicator inserted intravaginally once daily before bedtime for 3 or 7 consecutive days in nonpregnant patients or for 7 consecutive days in pregnant patients
Clindesse™: One full applicator inserted intravaginally as a single dose at anytime during the day in nonpregnant patients
Dosing adjustment in hepatic impairment: Adjustment recommended in patients with severe hepatic disease
I.M.: Deep I.M. sites, rotate sites; do not exceed 600 mg in a single injection
Cream: Insertion should be as far as possible into the vagina without causing discomfort
Ovule: The foil should be removed; if the applicator is used for insertion, it should be washed for additional use
I.V.: Never administer as bolus; administer by I.V. intermittent infusion over at least 10-60 minutes, at a rate not to exceed 30 mg/minute (not exceed 1200 mg/hour); final concentration for administration should not exceed 18 mg/mL
Oral: Administer with a full glass of water to minimize esophageal ulceration; give around-the-clock to promote less variation in peak and trough serum levels
Topical foam: Dispense directly into cap or onto a cool surface; do not dispense directly into hands
Monitoring ParametersObserve for changes in bowel frequency, monitor for colitis and resolution of symptoms; during prolonged therapy monitor CBC, liver and renal function tests periodically
Dietary ConsiderationsMay be taken with food.
I.M., I.V.: Report any burning, pain, swelling, or redness at infusion or injection site.
Oral: Take as directed. Take each dose with a full glass of water. Complete full prescription, even if feeling better. If a dose is missed, take as soon as possible, but do not double doses. Report immediately any diarrhea, bloody stools, abdominal pain or cramping (do not use antidiarrheals without consulting prescriber). You may experience headache (consult prescriber for appropriate analgesic); nausea or vomiting (small, frequent meals, frequent mouth care, chewing gum, or sucking lozenges may help). Report dizziness, skin redness or rash; fever, chills, unusual bruising, bleeding, or signs of infection (plaques on tongue, vaginal itching or discharge); other persistent adverse effects, or no improvement.
Topical, foam: Wash hands thoroughly or wear gloves. Do not dispense directly onto hands or face (foam will begin to melt on contact with warm skin). Dispense an amount the will cover the affected area directly into the cap or onto a cool surface. If can seems warm or foam seems runny, run can under cold water. Pick up small amounts of foam with fingertips and gently massage into affected areas until foam disappears. Wash hands thoroughly. Wait 30 minutes before shaving or applying make-up.
Topical, gel, lotion, or solution: Wash hands thoroughly before applying or wear gloves. Apply thin film of gel, lotion, or solution to affected area. May apply porous dressing. Wash hands thoroughly. Wait 30 minutes before shaving or applying make-up. Report persistent burning, swelling, itching, excessive dryness, or worsening of condition.
Vaginal: Wash hands before using. At bedtime, gently insert full applicator into vagina and expel cream. Wash applicator with soap and water following use. Remain lying down for 30 minutes following administration. Avoid intercourse during therapy. Report adverse reactions (dizziness, nausea, vomiting, stomach cramps, or headache) or lack of improvement or worsening of condition.
Anesthesia and Critical Care Concerns/Other ConsiderationsClindamycin may increase the duration of neuromuscular blockade after anesthesia. In adults, clindamycin injection can usually be dosed effectively on an every-8-hour basis.
Cardiovascular ConsiderationsClindamycin may increase the duration of neuromuscular blockade after anesthesia. Clindamycin may also be considered in the prevention of bacterial endocarditis.
Dental Health: Effects on Dental TreatmentNo significant effects or complications reported
Dental Health: Vasoconstrictor/Local Anesthetic PrecautionsNo information available to require special precautions
Mental Health: Effects on Mental StatusNone reported
Mental Health: Effects on Psychiatric TreatmentMay cause neutropenia; use caution with clozapine and carbamazepine
Dosage FormsNote: Strength is expressed as base
Capsule, as hydrochloride: 150 mg, 300 mg
Cleocin HCl®: 75 mg [contains tartrazine], 150 mg [contains tartrazine], 300 mg
Cream, vaginal, as phosphate:
Cleocin®: 2% (40 g) [contains benzyl alcohol and mineral oil; packaged with 7 disposable applicators]
Clindesse™: 2% (5 g) [contains mineral oil; prefilled single disposable applicator]
Foam, topical, as phosphate (Evoclin™): 1% (50 g, 100 g) [contains ethanol 58%]
Gel, topical, as phosphate: 1% [10 mg/g] (30 g, 60 g)
Cleocin T®: 1% [10 mg/g] (30 g, 60 g)
Clindagel®: 1% [10 mg/g] (40 mL, 75 mL)
ClindaMax™: 1% (30 g, 60 g)
Granules for oral solution, as palmitate (Cleocin Pediatric®): 75 mg/5 mL (100 mL) [cherry flavor]
Infusion, as phosphate [premixed in D5W] (Cleocin Phosphate®): 300 mg (50 mL); 600 mg (50 mL); 900 mg (50 mL)
Injection, solution, as phosphate (Cleocin Phosphate®): 150 mg/mL (2 mL, 4 mL, 6 mL, 60 mL) [contains benzyl alcohol and disodium edetate 0.5 mg]
Lotion, as phosphate (Cleocin T®, ClindaMax™): 1% [10 mg/mL] (60 mL)
Pledgets, topical: 1% (60s) [contains alcohol]
Clindets®: 1% (69s) [contains isopropyl alcohol 52%]
Cleocin T®: 1% (60s) [contains isopropyl alcohol 50%]
Solution, topical, as phosphate (Cleocin T®): 1% [10 mg/mL] (30 mL, 60 mL) [contains isopropyl alcohol 50%]
Suppository (ovule), vaginal, as phosphate (Cleocin®): 100 mg (3s) [contains oleaginous base; single reusable applicator]
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International Brand NamesAclinda® (DE); Acnestop® (AR); Albiotin® (ID); Alti-Clindamycin (CA); Anerocid® (ID); Apo-Clindamycin® (CA); Basocin® (DE); Bexon® (CO); Chinacin-T® (TH); Cindala® (ID); Clamine-T® (TR); Cleocin® (AT, AU, TR); Cleocin® [extern./inj.] (AT, IT, TR); Cleocin T® (TR); Clidacin-T® (JO, RO); Clidam® (AT); Clidets® (CO); Climadan® (ID, SG); Clinac® (NZ); Clinbercin® (ID); Clinda 1A Pharma® (DE); Clindabeta® (DE); Clindac® (AT, ZA); Clindacin® (AR, JO, PL, RO); Clindacne® (PL); Clinda-hameln® (DE); Clindahexal® (DE, ZA); Clindahexal injekt® (DE); Clinda Lich® (DE); Clindamicina Biocrom® (AR); Clindamicina Biol® (AR); Clindamicina Combino Pharm® (ES); Clindamicina Fabra® (AR); Clindamicina Fosfato IBP® (IT); Clindamicina IBI® (IT); Clindamicina Klonal® (AR); Clindamicina Larjan® (AR); Clindamicina Normon® (ES); Clindamicina Northia® (AR); Clindamicina Richet® (AR); Clindamicina Rovi® (ES); Clindamicina Same® (IT); Clindamicin® (RU); Clindamycin 1A Pharma® (AT); Clindamycin Abbott® (TH); Clindamycin AbZ® (DE); Clindamycin AL® (DE); Clindamycin Azupharma® (DE); Clindamycin® (BG, ID, IL, NO, RU); Clindamycin curasan® (DE); Clindamycin dura® (DE); Clindamycine FNA® (NL); Clindamycin findusFit® (DE); Clindamycin-Fresenius® (ZA); Clindamycin Heumann® (DE); Clindamycin Klast® (DE); Clindamycin Lindo® (DE); Clindamycin-MIP (PL); Clindamycin ratiopharm® (AT); Clindamycin-ratiopharm® (DE); Clindamycin ratiopharm® (SE); Clindamycin Sandoz® (DE); clindamycin von ct® (DE); Clindamyl® (BG, JO, KW, LB, MA, MY, SY); Clinda-saar® (DE); Clinda-saar® [inj.] (DE); Clindastad® (DE); Clindatop® (DE); Clinda-Wolff® (DE); Clindazyn® [inj.] (MX); Clindexcin® (ID); Clindopax® (AR); Clindo® (PL); Clindoxyl® (CA); Clin® [inj.] (TR); Clinium® (ID); Clinjos® (ID); Clinmas® (ID); Clin-Sanorania® (DE); Clintopic® (AR); Clin® [caps] (TR); Clinwas® (ES); Cloridrato de Clindamicina® (BR); C-Mycin® (SG); Cutaclin® [gel] (MX); Dacin-F® (TH); Dalacin® (AR, AT, BE, CZ, DK, ES, FI, GB, HR, HU, IE, IN, LU, NO, PL, RU, SE, ZA); Dalacin C® (AR, AT, AU, BE, BG, BR); Dalacin® C (CA); Dalacin C® (CH, CL, CO, CR, CZ, GB, GT, HK, HN, HR, HU, ID, IE, IL, IT, LU, MX, NL, NZ, PA, PL, PT, RO, RU, SG, SI, SV, ZA); Dalacin C Fosfato® [inj.] (CL, IT, PT); Dalacin C® [inj.] (BE, BG, BR, CH, CO, CR, CZ, GB, GT, HN, IL, LU, MX, NL, PA, SV, TH); Dalacin C Paranova® (DK); Dalacin C Phosphate® (AU, GB, NZ, RU, SG); Dalacin C Phosphat® [inj.] (AT, HK); Dalacine® (FR); Dalacin S T® (AR); Dalacin T® (AU, BE, BG, BR); Dalacin® T (CA); Dalacin T® (CH, CL, CO, GB, HK, HR, HU, ID, IE, IT, MX, NL, NZ, PT, RU, SG, SI, TH, ZA); Dalacin® Vaginal (CA); Dalacin Vaginal Cream® (CZ, ES, IL); Dalacin Vaginal® (ES); Dalacin Vaginal Ovule® (IL); Dalacin V® (BG, BR, CH, CL, CO, CR, GT, HN, MX, PA, PT, RO, SV); Dalacin V Cream 2%® (AU, NZ); Dalacin V Ovulos® (CO); Dalagis T® (IL); Dalcap® (IN); Damicine® (CO); Damiclin® (CO); Damiclin V® (CO); Dentomycin® (DE); Ethidan® (ID); Euroclin® (DO, EC, GT, HN, PA, SV); Fosfato de Clindamicina® (BR); Galecin® [inj.] (MX); Indanox® (ID); Infex® (CO); Jutaclin® (DE); Klimicin® (CZ, HR, HU, PL, RO, RU, SI, TH); Klindamicin® (YU); Klindan® [inj.] (RO, TR); Klindan® (TR); Klindaver® (TR); Klinna® (TH); Klinoksin® [inj.] (TR); Klinoksin® (TR); Klitopsin® [inj.] (TR); Klitopsin® (TR); Klyndaken® (MX); Lacin® (TH); Lanacine® (AT, RO); Lanacine® [inj.] (AT); Lando® (ID); Librodan® (ID); Lindacyn® (ID); Lindan® (ID); Lindhaver® (TR); Mediklin® (ID); Microxin® (DO); Microxin-T® (DO); Microxin-V® (DO); Niladacin® (ID); Novo-Clindamycin (CA); Nufaclind® (ID); Probiotin® (ID); Prolic® (ID); Queritan® (AR); Sobelin® [caps.] (DE); Sobelin Granulat® (DE); Sobelin Solubile® [inj.] (DE); Sobelin Vaginalcreme® (DE); Teclind® (BR); Tidact YSP® (SG); Topicil® (SG); Torgyn® (AR); Turimycin® (DE); Turimycin® [inj.] (DE); Xeldac® (ID); Zindaclin® (BE, DE, GB, IE); Zindacline® (FR); Zumatic® (ID)