Clindamycin

Registered South African indications: 

• Bacterial vaginosis

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to lincomycin
• History of inflammatory bowel disease 
• History of antibiotic-associated colitis
• Patients with existing diarrhoea

Cautions

• Pregnancy
• Breastfeeding
• Concomitant use of barrier contraceptive methods
• Children

Forms avail. in SA and covered in this monograph: cre

Symptomatic bacterial vaginosis

• Topical (cre): 100mg (1 full applicator), intravaginally at night; Treatment duration: 3-7 days

Not established for use in children

Pregnancy

• Caution
• There are no adequate and well-controlled studies in pregnant women during the first trimester. A moderate amount of data from clinical trials in pregnant women (between 300-1000 pregnancy outcomes) during the second and third trimesters indicates systemic administration of clindamycin has not been associated with an increased frequency of congenital abnormalities or fetal/neonatal toxicity. Animal reproductive toxicity studies revealed no evidence of impaired fertility or harm to the foetus due to clindamycin, except at doses that caused maternal toxicity. Animal reproduction studies are not always predictive of human response 
• Clindamycin should be used during pregnancy only if clearly needed

Breastfeeding

• Caution; not recommended
• It is not known whether clindamycin is excreted in human milk following topical application. However, orally and parenterally administered clindamycin has been reported to appear in breast milk. Because of the potential for adverse reactions in breastfeeding infants, clindamycin should not be used by breastfeeding mothers

Fertility

• Fertility studies in rats treated orally with clindamycin revealed no effects on fertility or mating ability

Renal Impairment

• No dose adjustment recommended

Hepatic Impairment

• No dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Probably not porphyrinogenic (PNP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Dizziness 
• Headache
• Vertigo

Gastrointestinal Disorders

• Heartburn
• Nausea and vomiting
• Diarrhoea
• Constipation
• Abdominal pain

Genitourinary Disorders

• Cervicitis
• Vaginitis 
• Vulvo-vaginal irritation

Skin and Subcutaneous Tissue Disorders

• Rash
• Exanthema

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity reactions
• Urticaria

• Neuromuscular blocking agents
• Other intravaginal agents
• Vitamin K antagonists
• Erythromycin
• Lincomycin 

None routine. Specific cases may require

• Coagulations tests

Clindamycin does not penetrate the blood/brain barrier in therapeutically effective quantities

Excipients

• Clindamycin may contain small amounts of ethanol (alcohol), less than 100 mg per dose

Clindamycin phosphate is a synthetic antibiotic produced from lincomycin. Clindamycin phosphate is hydrolysed in vivo to clindamycin, which inhibits bacterial protein synthesis. It binds to the 50S subunit of the bacterial ribosome and thereby prevents peptide bond formation.

Vaginal cream (per g) 20mg

• Dalacin VC (Pfizer) originator

Also available in the following forms: Solution, lotion, capsule and injection.