Benzoyl Peroxide/ClindamycinBenzoyl peroxide / Clindamycin

About Benzoyl Peroxide/Clindamycin

Clindamycin is an antibiotic that blocks protein synthesis in the bacteria that drive acne; benzoyl peroxide is an oxidizing agent that kills the same bacteria and loosens the plugs in pores, and the labels note that acne bacteria resistant to clindamycin have been reported. The label for the Duac type (clindamycin 1.2 percent with benzoyl peroxide 5 percent) approves it for inflammatory acne vulgaris in people 12 and older, applied as a thin layer to the face once a day in the evening after washing gently, rinsing with warm water and patting dry. The BenzaClin type (clindamycin 1 percent with benzoyl peroxide 5 percent) is applied twice a day, morning and evening, to the affected areas; its safety and effectiveness have not been established under age 12. MedlinePlus advises a thin layer spread with the fingertips, washing the hands afterward, and using less if a white film is visible on the skin. Acanya is another brand of the combination with its own strength and directions.

There is no boxed warning. The gels must not be used by anyone allergic to clindamycin, lincomycin or benzoyl peroxide, or by anyone with a history of regional enteritis, ulcerative colitis or antibiotic-associated colitis, because clindamycin, even applied to the skin, has been linked to severe and sometimes fatal colitis; significant diarrhea, bloody stools or stomach cramps mean stopping the gel and calling the prescriber, and anti-diarrhea medicines can make the condition worse. The common side effects are local: dryness, peeling, redness, burning and itching, more so when other acne products that peel or abrade the skin are used at the same time. The labels advise minimizing sun and tanning bed exposure and using sunscreen, and the gel is kept away from the eyes, mouth and other mucous membranes.

What is distinctive is the handling. Benzoyl peroxide bleaches hair, towels, pillowcases and colored clothing. The BenzaClin type is mixed by the pharmacist from a clindamycin powder and the peroxide gel before it is handed over, is kept at room temperature, and must be thrown away three months after mixing; the Duac type is stored refrigerated at the pharmacy and then at room temperature by the patient, with a 60 day use-by date from the day it is dispensed, so the dates on the label matter. The labels advise against using clindamycin with erythromycin products because the two antibiotics work against each other in the laboratory. There are no well-controlled studies in pregnancy, and it is not known whether the gel passes into breast milk, though oral and injected clindamycin do. These gels are not controlled substances.

Taking Benzoyl Peroxide/Clindamycin

How to take it

Wash the skin gently, rinse with warm water and pat dry, then spread a thin layer with your fingertips over the affected area, once a day in the evening for the Duac type or morning and evening for the BenzaClin type. Keep it away from the eyes, nose and mouth, wash your hands afterward, and use sunscreen; if you see a white film on the skin you have used too much.

If you miss a dose

Apply it as soon as you remember, unless it is almost time for the next application; then skip the missed one. Do not apply a double amount.

Storage

At room temperature in the original container, away from heat and moisture (not in the bathroom), out of reach of children. Do not freeze. Throw away the BenzaClin type three months after the pharmacist mixed it and the Duac type 60 days after it was dispensed, or as the pharmacy label says.

Interactions to know about

Do not use it together with erythromycin skin products. Other acne treatments and harsh or abrasive skin products add to irritation, so ask before combining them. Tell the prescriber about any history of bowel disease or severe diarrhea after an antibiotic.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Benzoyl Peroxide/Clindamycin differs from pharmacy to pharmacy

The two strengths are different products, and a prescription for one cannot be filled with the other, so the quote depends first on which is written: the Duac type has several generic makers and a single 45 g tube size, while the BenzaClin type comes in three sizes, is mixed by the pharmacist, and has a dated shelf life once mixed, so some pharmacies stock one and order the other. A prescription for the brand without substitution is priced as a brand.

Tube and pump sizes matter more than usual: a 45 g or 50 g pack lasts weeks of once or twice daily use on the face, so the quote is per pack rather than per month, and a pump that is thrown away after 60 days or three months may not be used up.

Ways to pay less for Benzoyl Peroxide/Clindamycin without insurance

• Ask the prescriber to write the combination generically and allow substitution; both common strengths have rated generics.
• Ask which strength and pack size is written, and whether a smaller pack would suit you, since any gel left after the use-by date is wasted.
• Compare more than one pharmacy, and ask whether yours stocks the strength or needs to order and mix it.
• If the combination is priced as a brand, ask the prescriber whether separate generic clindamycin and benzoyl peroxide products would suit you; the maker of the brand may also have a savings program, so ask whether it applies when you pay cash.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Benzoyl Peroxide/Clindamycin

1. 1.Is my gel the once a day or the twice a day type, and when does it expire after I pick it up?
2. 2.How do I keep it off my towels, pillowcases and clothes, since it bleaches fabric?
3. 3.Which of my other acne or skin products should I stop or space out while I use it?
4. 4.What stomach symptoms mean I should stop the gel and call my doctor?

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