Drugs List

Therapeutic Indications

Uses

Acne vulgaris

Dosage

Alcoholic solution and aqueous lotion
Apply a thin film twice daily to the affected area.

Gel
Apply a thin film once daily to the affected area.

Contraindications

None known

Precautions and Warnings

Atopy
Breastfeeding
History of gastrointestinal disorder
Pregnancy

Some formulations contain hydroxybenzoate
Some formulations contain propylene glycol
Avoid contact with eyes, lips or mouth
Avoid contact with mucous membranes
Breastfeeding: Wash product off breasts prior to breastfeeding infant
Do not apply to broken or denuded skin
If accidental contact with eyes or mucous membranes - rinse with cool water
Advise patient to inform physician if severe diarrhoea occurs
Prolonged use may result in superinfection with non-susceptible organisms
Discontinue therapy if marked diarrhoea occurs
Advise patient that the use of topical moisturisers may be necessary
Advise patients that maximal therapeutic benefit will take several weeks
Some preparations are flammable: keep away from flame or fire

Pregnancy and Lactation

Pregnancy

Use clindamycin with caution during pregnancy.

The manufacturer suggests clindamycin should be administered with caution during pregnancy with the potential benefit weighed against possible risks. Briggs (2011) suggests clindamycin is compatible with use during pregnancy.

In a clinical trial in pregnant women during the second trimester, clindamycin cream was effective in treating bacterial vaginosis, and no drug-related medical events were reported in the neonates. Available data suggests that systemic administration of clindamycin has not been associated with an increased frequency of congenital abnormalities or feto/neonatal toxicity.

Lactation

Use clindamycin with caution during breastfeeding.

The manufacturer suggests for use in breastfeeding benefit and possible risks have to be weighed up against each other. The Drugs and Lactation Database (LactMed) suggests infant side effects are unlikely after topical administration however topical administration to the nipple may increase the risk of diarrhoea in the infant.

It is not known if topical clindamycin is excreted into human milk. Clindamycin is excreted into breast milk after oral and parenteral clindamycin use. It is unlikely that a nursing infant can absorb a significant amount of clindamycin from its gastro-intestinal tract. Topical application to the nipple may increase the risk of diarrhoea in the infant. If applied to the breast area, the area should be washed and dried prior to breastfeeding and the preparation applied afterwards.

Side Effects

Abdominal pain
Burning and stinging of the eyes
Contact dermatitis
Diarrhoea
Dry skin
Erythema
Exacerbation of acne
Gastro-intestinal disturbances
Gram-negative folliculitis
Irritant dermatitis
Oily skin
Painful facial skin
Pruritus
Pseudomembranous colitis
Rash
Skin irritation
Urticaria

Presentation

Topical formulations containing clindamycin (as clindamycin phosphate)

Drugs List

Therapeutic Indications

Uses

Acne vulgaris

Dosage

Alcoholic solution and aqueous lotion
Apply a thin film twice daily to the affected area.

Gel
Apply a thin film once daily to the affected area.

Contraindications

None known

Precautions and Warnings

Atopy
Breastfeeding
History of gastrointestinal disorder
Pregnancy

Some formulations contain hydroxybenzoate
Some formulations contain propylene glycol
Avoid contact with eyes, lips or mouth
Avoid contact with mucous membranes
Breastfeeding: Wash product off breasts prior to breastfeeding infant
Do not apply to broken or denuded skin
If accidental contact with eyes or mucous membranes - rinse with cool water
Advise patient to inform physician if severe diarrhoea occurs
Prolonged use may result in superinfection with non-susceptible organisms
Discontinue therapy if marked diarrhoea occurs
Advise patient that the use of topical moisturisers may be necessary
Advise patients that maximal therapeutic benefit will take several weeks
Some preparations are flammable: keep away from flame or fire

Pregnancy and Lactation

Pregnancy

Use clindamycin with caution during pregnancy.

The manufacturer suggests clindamycin should be administered with caution during pregnancy with the potential benefit weighed against possible risks. Briggs (2011) suggests clindamycin is compatible with use during pregnancy.

In a clinical trial in pregnant women during the second trimester, clindamycin cream was effective in treating bacterial vaginosis, and no drug-related medical events were reported in the neonates. Available data suggests that systemic administration of clindamycin has not been associated with an increased frequency of congenital abnormalities or feto/neonatal toxicity.

Lactation

Use clindamycin with caution during breastfeeding.

The manufacturer suggests for use in breastfeeding benefit and possible risks have to be weighed up against each other. The Drugs and Lactation Database (LactMed) suggests infant side effects are unlikely after topical administration however topical administration to the nipple may increase the risk of diarrhoea in the infant.

It is not known if topical clindamycin is excreted into human milk. Clindamycin is excreted into breast milk after oral and parenteral clindamycin use. It is unlikely that a nursing infant can absorb a significant amount of clindamycin from its gastro-intestinal tract. Topical application to the nipple may increase the risk of diarrhoea in the infant. If applied to the breast area, the area should be washed and dried prior to breastfeeding and the preparation applied afterwards.

Side Effects

Abdominal pain
Burning and stinging of the eyes
Contact dermatitis
Diarrhoea
Dry skin
Erythema
Exacerbation of acne
Gastro-intestinal disturbances
Gram-negative folliculitis
Irritant dermatitis
Oily skin
Painful facial skin
Pruritus
Pseudomembranous colitis
Rash
Skin irritation
Urticaria

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: July 2013

Reference Sources

British National Formulary, 65th Edition (March - September 2013) Pharmaceutical Press, London.

BNF for Children (2012-2013) Pharmaceutical Press, London.

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

Medications and Mothers' Milk, 14th Edition (2010) Hale, T. Hale Publishing, Amarillo, Texas.

Summary of Product Characteristics: Dalacin T Topical Solution. Pharmacia Limited. Revised July 2018.
Summary of Product Characteristics: Dalacin T Topical Lotion or Clindamycin Phosphate Topical Lotion. Pharmacia Limited. Revised May 2012.

US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Clindamycin. Last revised: January 31, 2011
Last accessed: July 12, 2013