Clindamycin (Oral)

Clindamycin is an antibiotic drug useful for the treatment of a large number of bacterial infections. It does not work for virus infections, such as flu or the common cold.

Overview

Clindamycin works by slowing down and completely stopping the growth of infectious bacteria. Clindamycin is often prescribed for patients who are allergic to penicillin and is only available with a doctor's prescription.

The most common side effect of taking clindamycin is diarrhea. It could range in severity from mild to severe and fatal colitis. Because of the potential for severe colitis, clindamycin is only used for serious infections where less toxic antimicrobial agents cannot be used. Diarrhea can sometimes occur even up to two months after completing a full prescription of clindamycin. It does not cause drowsiness.

Past experience has shown that some patients over the age of 65 should not take clindamycin if they have a lower tolerance for diarrhea. If clindamycin is used with this subgroup of patients, they must be closely monitored to deter any changes in bowel frequency.

The FDA has given a high-priority warning about clindamycin for the risk of developing a dangerous and infectious form of diarrhea. Clindamycin alters the balance of microorganisms in the intestines. This imbalance allows the growth of a bacteria called Clostridium difficile. This type of bacteria produces toxins and inflammation that can damage your intestines.

Studies have shown that clindamycin is safe for use by pregnant women during their second and third trimesters. Clinical trials have not shown any increase in the frequency of congenital abnormalities. However, there have not been enough studies conducted to determine if clindamycin is safe to use during the first trimester, and this drug should only be used if absolutely necessary. Traces of clindamycin have been found in babies who are breastfeeding. Mothers who are breastfeeding should discuss with their doctor the possible side effects on a nursing infant of taking clindamycin during that time.

If your doctor prescribes clindamycin, you must take the entire course prescription. You should not stop taking the drug or skip any doses when your conditions starts to improve.

Clindamycin is also sometimes used by veterinarians to treat infections in dogs and cats. The infections treated are abscesses, tooth infections and skin rashes. Prescriptions for animals usually come as liquid and are given by mouth.

Conditions treated

  • Empyema
  • Pneumonitis
  • Lung abscess
  • Serious soft tissue and skin infections
  • Endometritis
  • Female genital tract and pelvic infections
  • Acne
  • Bacterial vaginosis
  • Middle ear infections
  • Joint or bone infections
  • Strep throat
  • Bacterial pneumonia
  • Endocarditis
  • Acne
  • Malaria when combined with quinine
  • Pus in the lungs
  • Abscess of the lung caused by anaerobic bacteria
  • Skin infection due to Streptococcus Pyogenes bacteria
  • Abscess within the abdomen
  • Falciparum malaria resistant to the drug chloroquine
  • Infection of a heart valve
  • Sinus irritation and congestion
  • Diabetic with foot infection
  • Bacterial stomach or intestine infection caused by anthrax
  • Infection cause by the parasite toxoplasma gondii
  • AIDS from toxoplasmosis

Type of medicine

  • Antibiotic

Side Effects

Clindamycin has two common side effects that can result in serious discomfort: diarrhea and abdominal pain. These side effects are expected, but if they continue for a long period of time or become very intense, you should contact your physician.

It is not unusual for antibiotic drugs to cause diarrhea, but this could be an indication of a new infection. If you are experiencing diarrhea that is bloody or watery, stop taking the clindamycin, and contact your doctor. Do not begin to take any anti-diarrhea medicines unless your doctor instructs you to do so.

Clindamycin can also produce these other side effects:

  • Vomiting
  • Itching
  • Nausea
  • Skin rash
  • Metallic or unpleasant taste in your mouth
  • Low blood pressure
  • Severe diarrhea
  • Bloody diarrhea
  • Fever
  • Weight loss
  • Loss of appetite
  • Dehydration
  • Muscle aches
  • Unusual bruising
  • Yellowing of the skin or eyes
  • Bleeding gums
  • Blood in urine
  • Blurred vision
  • Dizziness
  • Increased thirst
  • Unpleasant breath odor

Dosage

The dosage for clindamycin-oral depends on several factors:

  • Your age
  • the type of bacteria being treated
  • Severity of your condition
  • Other medical conditions present
  • Reaction for the first dose

Your doctor will prescribe a dosage and frequency. You must take the entire dosage as prescribed. Do not stop taking the drug or skip any doses just because you start feeling better. Stopping the medication could allow the infection to rejuvenate itself; the infection would then last longer. It is also possible to develop resistance to the drug if you interrupt the usage as prescribed. If this happens, you would not be able to use clindamycin again to treat another bacterial infection.

This medication is taken by mouth with or without food, typically four times a day. It should be taken with a full glass of water, and you should not lie down for a minimum of 10 minutes after taking this drug.

Taking an excess dosage of clindamycin can cause severe side effects like the following:

  • A drop in blood pressure
  • Temporary paralysis
  • Convulsions caused by tightening of the muscles
  • Diarrhea

If you believe that you have taken more than the amount required by your prescription, immediately contact your doctor or your nearest poison control center. In the case of severe symptoms, call 911 or go to the nearest emergency room.

If you miss a dose, take the required amount as soon as you realize that you are late. However, if it has been a few hours since the missed dose, wait until the next prescribed time and get back on schedule. Do not double up on the dosage. This could increase the concentration of the drug and cause problems with the liver.

Interactions

Clindamycin can have interactions with other medications, over-the-counter products and even herbs and vitamins.

While certain drugs should never be taken together, it is possible to combine some medicines even if there is a possibility of an interaction. In such situations, your doctor might want to modify the dosage and increase the frequency of monitoring as a precaution. Regular blood tests may be required to make sure there are no unexpected side effects.

Using clindamycin with a cholera vaccine or erthromycin is usually not recommended. These combinations of drugs have shown to cause increased risks of certain side effects. However, there could be certain situations where both drugs are required, and your doctor will make the proper adjustments to the prescriptions in an attempt to minimize any adverse side effects.

Erythromycin can blunt the effectiveness of clindamycin and make your infection worse.

The following medicines may also increase the intensity of some side effects when combined with clindamycin:

  • Tubocurarine
  • Metocurine
  • Cyclosporine
  • Atracurium

Certain drugs known as CYP3A4 inducers, such as rifampicin, should not be taken with clindamycin. These drugs prevent the body from absorbing clindamycin and inhibit the prescription from fighting the bacterial infections.

Warnings

One of the most serious side effects of clindamycin is a severe skin reaction. These symptoms are peeling skin, rash, and swelling of the face or tongue. In the worst cases, blisters could form on your skin and around your eyes, mouth, and nose. If not treated immediately, any of these skin reactions could be fatal. You should immediately stop taking the drug and contact your doctor.

If you are experiencing a gastrointestinal disease, clindamycin may not be safe for you to use. It could cause severe diarrhea and inflammation of your colon, making your condition worse. You should consult with your doctor to determine if clindamycin is safe to use in this situation.

Clindamycin may not be safe for people with liver problems or a history of liver disease. If your liver is not fully functioning, it may not be able to clear the drug from your body. This would cause the concentration of clindamycin to rise in your body and cause more serious side effects to develop. You should have your doctor test the effectiveness of your liver before starting to take clindamycin, and, afterward, have more liver tests while taking the prescription.

Women who are pregnant or are planning to become pregnant should consider the consequences of taking clindamycin. Studies have not found any negative effects for pregnant women in their second and third trimesters. However, that is not the case in the first trimester. Studies with pregnant animals in the first trimester have not shown any risks to the fetus, but there have not been enough studies conducted on pregnant women in the first trimester to determine if the drug is safe to use during that time. You must consult with your doctor if you are pregnant to determine which antibiotic would be the safest to use and when to use it.

Tests have shown that clindamycin will pass into breast milk and could cause side effects for a child who is being breastfed. If you are breastfeeding your child, you must discuss whether clindamycin is safe to use or if you should change to another medication.

People who are older than the age of 65 may not be able to tolerate diarrhea that frequently occurs from taking clindamycin. You and your doctor should closely monitor your bowel movements. Studies have not found any problems specific to the geriatric population. However, some elderly patients have shown a tendency to develop colitis while taking clindamycin, but the problem is not widespread.

Your doctor must be completely aware of all of your medical conditions. Tell him if you have liver disease, colitis, Crohn's disease, kidney disease, and if you have a history of eczema, asthma, skin reactions to any medications and if you are allergic to yellow food dye.

If are planning to have surgery, tell your surgeon well in advance that you are taking clindamycin. It may be necessary to stop taking the medication for a short time. Your surgeon and doctor should coordinate their recommendations to make sure that your bacterial infection is being treated and also that your surgery will go as planned.

Clindamycin should not be given to a child without the advice of a physician. Studies so far have not found any problems that would prevent the use of clindamycin with children. Nevertheless, a physician must be consulted before using this drug on a child.

If you are having any immunizations or vaccinations, you should advise your doctor before taking clindamycin. This drug may prevent some live bacterial vaccines, such as typhoid vaccine, from working.

Patients with meningitis should not use clindamycin.

Storage

Clindamycin should be stored at moderate temperatures from 68 to 77 degrees F. Do not store in damp or moist areas, such as bathrooms. Do not store in direct light. Keep from freezing, and keep away from children. If the medicine is no longer needed or becomes out of date, it should be thrown away. Consult with your doctor to determine the proper method for disposal.

There are certain precautions to take when traveling with this medication:

  • Always keep your medication with you
  • When flying, keep your medication in a carry-on bag. Do not put in a checked bag
  • X-ray machines at the airport will not affect the medication
  • Always take the medication in its prescription container
  • Do not put this drug in the glove compartment of a car or leave out in a car

Summary

Clindamycin is a very effective drug for combatting bacterial infections. It was first produced in 1967 and is on the World Health Organization's List of Essential Medicines. Clindamycin is useful for the treatment of inflammatory pelvic diseases, middle ear infections, joint or bone infections, endocarditis, pneumonia and strep throat. It could also be used to treat acne and can be taken with quinine to fight malaria. Clindamycin is one of the few drugs available to treat Methicillin-resistant Staphylococcus aureus.

Clindamycin should always be taken under the supervision of a medical doctor because it can have several serious and intense side effects. The most common side effects are diarrhea, abdominal pain, skin rashes and swelling of the face or tongue. While these adverse conditions are expected, they must be monitored and controlled so that they do not become life-threatening. If your diarrhea shows traces of blood or becomes watery, you should cease taking the clindamycin and contact your physician immediately.

The patient must make his doctor aware of all medications that he is taking in addition to any vitamins and herbs that are used as dietary supplements. There are a number of drugs known to have interactions with clindamycin, but each application and patient is different and should be carefully monitored to watch for any unexpected results.