Clindamycin (Vaginal)

Clindamycin is the generic brand of a vaginal cream or suppository taken intravaginally for the treatment of certain bacterial infections in women and teenage girls.

Overview

Clindamycin is an antibiotic agent that is commonly used to treat vaginal infections, such as Bacterial Vaginosis (BV). This condition occurs when 'œharmful'bacteria overgrows and upsets the balance of 'œgood' bacteria in the vagina.

Vaginal Clindamycin works by killing and preventing further growth of the infectious bacteria. It cannot be used for treating yeast infections or sexually transmitted diseases such as trichomoniasis or gonorrhea.

Patients with Inflammatory Bowel Disease (IBD) or a history of it should not use Clindamycin. Patients who suffer from severe diarrhea should also not use this drug.

The medication is sold in the US as a prescription drug. Its brand names are Cleocin Vaginal, ClindaMax, and Clindesse.

Condition treated:

  • Vaginal infections

Type of medicine:

  • Lincomycin antibiotic

Before using Clindamycin

Patients should discuss with their doctor the risks and benefits of using this medication, before deciding to take it. Your doctor will determine use and dosage based on the infection being treated.

Tell your doctor and pharmacist about any prescription and over-the-counter medicines (OTC's) you use or plan to use. This includes nutritional supplements, vitamins, and herbal products.

Allergies: Patients allergic to Clindamycin should not use it. You should tell your doctor if you are allergic to the medicine or any of its inactive ingredients. Disclose any allergy to foods, preservatives, dyes or animals.

If you've used the medicine before and experienced any unusual symptoms, tell your doctor.

Pediatrics: This medicine is intended for use in adult patients and teenagers. No specific information is available on its use in children.

Geriatrics: There is no specific information available on the use of the medicine for treating elderly patients. Therefore, the safety and efficacy of use in this group of patients is not determined.

Pregnancy: Studies in pregnant women have not shown any adverse effect that poses a risk of harm to an unborn baby.

Breastfeeding: There is no clinical evidence that a breastfeeding infant can be adversely affected by Clindamycin being used by the breastfeeding mother.

Side Effects:

Most, if not all, medicines have side effects. Some may be mild; others may be serious and require medical attention. All of the possible side effects may not occur in one patient, but if any of the following occurs, call your doctor right away:

More likely to occur

  • a discharge from the vagina that is thick and white (sometimes with a mild odor)
  • vaginal itching or itching in the area of the genitals
  • pain during sexual intercourse.

Less likely to occur

  • nausea or vomiting
  • cramps or pain in the stomach
  • diarrhea
  • feeling dizzy
  • headache

Rarely occurs

  • A rash, itching, burning, redness or swelling of the skin that occurred after you started using this medicine.

Serious side effects

If you experience any of the following symptoms, call your doctor right away or get emergency care. They are signs of a serious adverse reaction.

  • watery or bloody stools
  • diarrhea (severe)
  • fever
  • blisters, itching, rash or hives
  • difficulty breathing or swallowing

Other side effects may occur that are not mentioned in this medicine guide. Call your doctor right away if you notice any unusual symptoms, or if your symptoms do not go away or get worse. You may also report side effects to the FDA by calling 1-800-FDA-1088.

Dosage:

Follow all directions given by your doctor, pharmacist or healthcare professional before taking vaginal Clindamycin. Also read the prescription label and patient information leaflet for additional directions and instructions.

The amount of your dose, the strength of it, the time you take it, the time between each dose, and the duration of your treatment is based on the condition being treated. It may also depend on if you are pregnant.

The following is a guide of average dosage. Since dosage may vary patient to patient, only use the dose prescribed for you. Your exact dose will be on the prescription label. Do not change your dose unless your doctor advises you to.

Treatment with the vaginal cream

Adults and teenagers who are not pregnant: Insert 100 mg of the cream into the vagina using an applicator that was filled immediately before insertion. This should be done once a day, usually at bedtime, for three to seven days in a row.

Adults and teenagers who are pregnant: Insert 100 mg of the cream into the vagina using an applicator that was filled immediately before insertion. This should be done once a day, usually at bedtime, for seven days in a row.

Administering the prefilled applicator

Adults and teenagers:

This is a one-day treatment. Take it by inserting one prefilled applicator of 100 mg of the cream into the vagina, all at once. You may do this at any time of the day.

Children:

Clindamycin cream or suppository is not indicated for use in children. Use and dose must be determined by a doctor.

Using the applicator with the vaginal cream

The following information may be useful in helping you take your vaginal cream medicine in a way that is safe and effective. You may need to fill the applicator provided with your medicine, if it is not pre-filled. There is usually a sterilized one for each dose you will take.

Filling the applicator

  • Wash and sanitize your hands immediately before filling the applicator.
  • Unscrew the cap from the tube of medicine.
  • Take one of the applicator that was provided with the medicine. Screw it onto the tube, turning clockwise.
  • Slowly squeeze the medicine into the applicator until its filled.
  • Unscrew the applicator from the tube by turning it anticlockwise.
  • Replace the cap on the tube.

Inserting the vaginal cream

  • Lay on your back, in a relaxed position, with your knees bent.
  • With clean hands, hold the applicator between your fingers. Gently insert it into the vagina. Begin pushing it inwards as gently as possible, and as far as feel comfortable. Stop before you feel any discomfort.
  • Press the plunger attached to the applicator. Do so slowly until all of the cream is ejected into the vagina.
  • Slowly and gently withdraw the applicator. The applicator should now be empty.
  • Store the medicine away safely.

Getting the best out of your treatment

  • To avoid re-infecting yourself with the bacteria that caused the infection being treated, do not use an applicator that you used before. Always discard an applicator immediately after use, as directed by your doctor or pharmacist.
  • Use all of the medicine on time, without skipping any dose. Continue to use it even if your symptoms begin to clear up before the treatment comes to an end.

Failure to do this may cause the infection to return or become worse. The infection may also become resistant to this antibiotic, making it no longer effective.

  • Wear a sanitary napkin or pantyliner to prevent the medicine from getting onto your clothing. This may be necessary since the vaginal cream may leak out of the vagina. Do not use a tampon.
  • If your menstrual cycle starts during therapy, do not stop the treatment. Continue to use it as instructed.

Missed dose

You may accidentally miss a dose if you are taking the three to seven days treatment. If this happens, take the medicine as soon as possible. If it is too close to your next scheduled dose, skip the missed dose and take the next dose on time. Continue the regular dosing schedule. Do not take extra doses to make up for a missed dose.

Overdose

If you or anyone swallows or accidentally overdose on this medicine, call your local poison control center at 1-800-222-1222.

Interactions:

You should tell your doctor if you are taking or plan to take any other medicines. Certain combination of medicines is prohibited because using two or more of them may increase the risk for serious side effects.

In some cases, your doctor may decide to treat you with this medicine even though you are taking other medications.

The following medicines are not usually recommended for use during treatment with Clindamycin, as they may cause significant interaction with the drug. But using them together may be best for your health.

Your doctor may take necessary precautions to ensure proper dosage of each medicine you take.

  • Erythromycin
  • Cholera Vaccine, Live

The following list of medicines may increase the risk of serious side effects if used during your Clindamycin therapy. However, it may be best that you use them for health reasons. Your doctor may change your dose or how often you use any of them during treatment with this antibiotic.

  • Tubocurarine
  • Metocurine
  • Atracurium

Other interactions

Food, alcohol, and tobacco: Using alcohol, tobacco or foods while taking certain medicines may cause an adverse interaction. Your doctor, pharmacist or healthcare professional may warn you of any such interaction and advise you of the necessary precautions to take.

Other medical problems:The function of the medication may be affected by the presence of any other existing medical condition. Tell your doctor about any medical problems you have (or history of), including the following:

  • Stomach or intestinal disease (or history of)

Patients who have a history of stomach or intestinal disease have an increased risk of side effects, including diarrhea. A history of the following conditions may also affect this medicine:

  • Enteritis
  • Colitis (including colitis caused by antibiotics)

Warnings:

  • This medicine is for use in the vagina only. Do not use by mouth.
  • Always wash and sanitize your hands before applying the medicine into your vagina. This is to avoid the spread of germs from your hands to your genital.
  • If the medicine gets into your eyes, rinse them immediately with water. If your eyes become irritated or hurt, check with your doctor.
  • Do not use tampons during your treatment, and do not douche.
  • Do not share your medicine with anyone even if they have similar symptoms.
  • Call you doctor if your symptoms do not get better within a few days or get worse.
  • Do not drive or use machinery until you know how this medicine affects you. Some patients may become dizzy when they use the medicine.
  • Avoid sexual intercourse during treatment. This may cause some of the medicine to be removed and prevent it from working well.
  • Latex contraceptives, such as condoms, should not be used for at least 72 hours after you complete your treatment. The vaginal cream may weaken it and put you at risk for pregnancy or infections.
  • Do not use expired medicine.
  • Make a follow-up visit so your doctor can check to see if the infection has cleared up.

Helpful tips

To avoid or prevent the recurrence of vaginal infections, it may help to practice good, personal hygiene. Wearing clean, freshly washed panties made of cotton instead of those made of synthetic materials, such as nylon, may also help.

Storage

Always keep the medicine in the tube with the cap screwed on. Store at room temperature. Keep away from direct light, moisture, and heat. Do not freeze.

Store out of the reach of children.

Throw away expired medicine or medicine no longer needed.

Summary

Clindamycin is widely used in the treatment of vaginal infections in women and teenage girls. Bacterial Vaginosis is one of the vaginal infections commonly treated with this medicine.

It is safe to use and can effectively clear up the infection being treated if the patient follows all the directions for use and completes the treatment without skipping doses.

Its use is prohibited in patients with allergies to it or with certain medical conditions. Because one of the side effects is diarrhea, Clindamycin should not be used by patients with severe diarrhea.

There are few known side effects, some of which rarely occurs. There are also a few medical problems or drugs that cause interaction with the vaginal medicine. For these reasons, Clindamycin is one of the preferred medication for treating certain vaginal infections.