ClindamycinClindamycin Hydrochloride

About Clindamycin

Clindamycin stops susceptible bacteria from making proteins; like other antibiotics, it does not treat viral infections such as the common cold. By mouth, it is labeled for serious infections caused by susceptible anaerobic bacteria (including lung abscess, skin and soft tissue infections, septicemia, peritonitis and infections of the female pelvis and genital tract), and for serious respiratory infections caused by streptococci, pneumococci or staphylococci and serious skin and soft tissue infections caused by streptococci or staphylococci. The label says its use should be reserved for people allergic to penicillin or for whom a penicillin is inappropriate, and that less toxic alternatives should be considered first. Adults take 150 to 300 mg every 6 hours, or 300 to 450 mg for more severe infections. Children take 8 to 20 mg/kg a day as capsules or 8 to 25 mg/kg a day as the oral solution, in three or four doses. Beta-hemolytic streptococcal infections are treated for at least 10 days.

Its boxed warning says Clostridioides difficile-associated diarrhea (CDAD) has been reported with nearly all antibacterial drugs, including clindamycin, and may range from mild diarrhea to fatal colitis. Because clindamycin has been associated with severe colitis that may end fatally, it should be reserved for serious infections where less toxic antibiotics are inappropriate, and not used for nonbacterial infections such as most upper respiratory tract infections. CDAD has occurred more than two months after treatment, so watery or bloody stools need a call to the prescriber even after the course. Anyone allergic to clindamycin or lincomycin must not take it. Other warnings cover anaphylaxis, severe skin reactions (toxic epidermal necrolysis, DRESS and Stevens-Johnson syndrome) and acute kidney injury; it is used with caution after colitis or other bowel disease, and not for meningitis. Side effects include nausea, vomiting, diarrhea, abdominal pain and an unpleasant or metallic taste.

Cleocin HCl 75 and 150 mg capsules contain tartrazine (FD&C Yellow No. 5), which can cause allergic-type reactions, including asthma. Long courses call for periodic liver and kidney tests and blood counts. The label says to use it in the first trimester of pregnancy only if clearly needed, and that needing it is not a reason to stop breastfeeding, though another drug may be preferred and the baby is watched for diarrhea or thrush. Clindamycin phosphate 1 percent gel and lotion (Cleocin T and generic) are separate acne products whose safety and effectiveness under age 12 have not been established; some is absorbed through the skin, diarrhea and colitis have been reported, and they must not be used by people with a history of regional enteritis, ulcerative colitis or antibiotic-associated colitis. Vaginal clindamycin for bacterial vaginosis is another separate product.

Taking Clindamycin

How to take it

Capsules or oral solution three or four times a day; take each capsule with a full glass of water (6 to 8 ounces) and at least 30 minutes before lying down. Apply Cleocin T gel or lotion as a thin film twice a day, shaking the lotion first. Finish the prescription even if you feel better.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take a double dose.

Storage

Capsules, gel and lotion at room temperature, away from excess heat and moisture, out of reach of children; do not let topicals freeze. Do not refrigerate the mixed oral solution, which can thicken; it keeps 2 weeks at room temperature; then throw away what is left.

Interactions to know about

It may strengthen neuromuscular blocking drugs used during surgery. Drugs that inhibit the liver enzyme CYP3A4 can raise its levels, and strong inducers such as rifampin can lower them. Tell the prescriber about colitis or other bowel disease, asthma or allergies, and kidney or liver problems.

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 Clindamycin differs from pharmacy to pharmacy

Generic capsules come from several makers per strength, so quotes for the same course differ by each pharmacy’s fee and markup and by whether clindamycin is on its flat-price generic list. A prescription that names a Cleocin brand and blocks substitution is filled with the brand.

Generic gels are rated equivalent to either Cleocin T gel or Clindagel, not both, so a pharmacist substitutes only a generic rated to the gel written.

Ways to pay less for Clindamycin without insurance

• Ask for a generic, and check that the prescription does not block substitution.
• For a child’s oral solution, ask how many bottles the full course needs, so the quote covers all of it.
• For acne gel or lotion, ask for a generic rated to the product prescribed.
• 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 Clindamycin

1. 1.Which diarrhea symptoms mean I should call, even after I finish the course?
2. 2.How should I take the capsules to avoid throat irritation?
3. 3.Do my other medicines, kidneys or liver change how I take it?
4. 4.Can a generic be dispensed for my prescription?

Related medications