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Topical clindamycin (Cleocin T) for Acne: Side Effects & Dosage

What is topical clindamycin?

Clindamycin is an antibiotic used
for treating several infections. It is effective against several types of
bacteria such as Staphylococcus aureus, Streptococcus pneumoniae, Staphylococcus
epidermidis
, and Propionibacterium acnes.

Why is topical clindamycin prescribed to patients?

  • Clindamycin topical (for application to the
    skin) is available as gels, foam, lotion, solution, and swab for treating
    acne.

What brand names are available for topical clindamycin?

Cleocin T, Clindagel, ClindaDerm, Clindets, and Evoclin are the brand names available for topical
clindamycin phosphate in the US.

What are the side effects of topical clindamycin?

  • The most common side effects of topical
    clindamycin are:

    • Burning
    • Itching

    • Dryness
    • Skin redness
    • Oily skin
  • Some clindamycin topical solutions contain an alcohol base which will cause
    burning and irritation in the eye.
  • Possible serious side effects of clindamycin include:
  • Stomach pain and
    folliculitis (inflammation of the tissue surrounding the
    base of hairs) may occur during treatment with topical clindamycin.
  • Orally administered and injected clindamycin may cause severe
    colitis.
    Orally or injected clindamycin have been associated with severe colitis which may result in death. Diarrhea, colitis, and pseudomembranous colitis may begin up to several weeks after stopping oral and parenteral therapy with clindamycin.
  • Topical formulations of clindamycin may be absorbed from the skin surface, and
    diarrhea,
    bloody diarrhea, and colitis (including pseudomembranous colitis) have
    been reported with the use of topical clindamycin.

What is the dosage for topical clindamycin?

  • A thin film of the lotion, and solution should be
    applied to affected areas every 12 hours.
  • A thin film of the foam should be
    applied to the affected areas once daily.
  • The gel may be applied once or twice
    daily depending on the brand.
  • The swab is used to apply a thin layer of
    clindamycin film to the affected area twice daily. Each swab should be used once
    and then discarded.

Which drugs or supplements interact with topical clindamycin?

Clindamycin given orally may act as a neuromuscular blocker. This means it can increase the action of neuromuscular blocking drugs (for example, pancuronium and vecuronium) that block the contraction of muscles. Less clindamycin is absorbed into the blood stream when given topically so the likelihood of this drug interaction is less likely.

Is topical clindamycin safe to use during pregnancy or while breastfeeding?

  • The frequency of congenital abnormalities was
    not increased when
    pregnant women used clindamycin during the second and third trimesters. Clindamycin has not been properly evaluated during the first
    trimester of
    pregnancy. It should only be used during the
    first trimester of
    pregnancy if it is clearly needed.
  • Oral clindamycin is excreted in breast milk
    and either should not be used by
    nursing mothers or nursing should be stopped.
    It is not known whether clindamycin given topically is excreted in breast milk.

What else should I know about topical clindamycin?

What preparations of topical clindamycin are available?
  • Gel, foam, lotion, solution, swab: 1%
How should I keep topical clindamycin stored?
  • Clindamycin topical preparations should be stored
    at room temperature, 20 C to 25 C (68 F to 77 F).
How does topical clindamycin work?
  • Clindamycin reduces growth of bacteria by
    interfering with their ability to make proteins.
When was topical clindamycin approved by the FDA?
  • The FDA approved clindamycin
    for topical (on the skin) use in July, 1980.
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