Clindamycin

Topical Antibiotic

Clindamycin is available as a prescription topical treatment. Clindamycin can be prescribed alone or in combination with other topical or oral acne treatments. 

  • Available forms:

    • Topical treatment: 

      • Gel:
        Available as prescription
        Generic available (US)
      • Foam: 
        Available as prescription
        Generic available (US)
      • Lotion: 
        Available as prescription
        Generic available (US)
      • Solution (liquid):
        Available as prescription
        Generic available (US)
      • Pad (pledget or swab):
        Available as prescription
        Generic available (US)
    • Brand names (US):

      • Cleocin T®
      • Clindacin ETZ®
      • Clindacin P®
      • Clindacin Pac®
      • Clinda-Derm®
      • Clindagel®
      • ClindaMax®
      • ClindaReach®
      • Clindets® 
      • Evoclin®
      • Z-Clinz®

Combination products of clindamycin are also available, such as clindamycin + tretinoin. 

  • Available in these doses:

    • Gel: 1%
    • Foam: 1%
    • Lotion: 1%
    • Solution: 1%
    • Pad: 1%
  • Who is it for? 

    • Gender:
      • Males and females
    • Severity of acne:
      • Moderate-to-severe
    • Age:
      • Children of 12 years and older, adolescents, and adults 

How to use it:

Clindamycin is a topical treatment and is available as gel, foam, lotion, solution and pads. 

Your physician will specify how much of the medication you need to apply and how often. 

Clindamycin is usually applied twice a day, once in the morning and once in the evening, except for the foam and 1 brand of gel (Clindagel®) which are applied once a day. Use it at the same time(s) every day. 

Clindamycin should only be applied to intact skin. If clindamycin gets into a cut or scrape, rinse it off with water. Do not get clindamycin in your eyes, nose, or mouth. If it does get into your eyes, wash your eyes with a generous amount of water and seek medical attention if there is any irritation. 

Before applying clindamycin, wash acne-prone areas with water and cleanser. Do not scrub the skin. Rinse and pat the skin dry gently with a soft towel. 

Do not wash the acne-affected skin too often because this could dry your skin and make your acne worse. Wash your skin with water and a cleanser no more than 2 or 3 times a day. 

It may take some time before the effects of clindamycin are seen on acne. Clindamycin needs to be taken for 2 to 3 months in order to see its full effect. If there is no improvement after 6 weeks or your acne becomes worse, consult your physician. 

Clindamycin helps controls your acne but it does not cure it. Continue using clindamycin even if your acne clears up after a few days. You may have to use clindamycin for months or longer, as prescribed by your physician. If you stop using clindamycin too soon, acne may return. It is therefore also important to not miss a dose. 

Use enough clindamycin to lightly cover the acne-affected areas. Clindamycin should be applied to the whole acne-affected area and not only to the pimples. This is to avoid a break out of new pimples. 

  • Gel:
    • Gel needs to be applied twice a day to acne-prone areas (except for Clindagel® which is applied once a day).
  • Foam:
    • Do not apply the foam within 30 minutes after washing or shaving the skin. The alcohol in the foam may cause irritation of the washed or shaved skin. 
    • The foam may be flammable so stay away from heat, open flames and do not smoke when you are applying the foam and for a short time afterwards. 
  • Lotion:
    • Shake the lotion before use.
    • Lotion needs to be applied twice a day to acne-prone areas.
  • Solution: 
    • Do not apply the solution within 30 minutes after washing or shaving the skin. The alcohol in the solution may cause irritation of the washed or shaved skin.
    • Solution needs to be applied twice a day to acne-prone areas.
    • The alcohol in the solution may be flammable so stay away from heat, open flames and do not smoke when you are applying the solution. 
  • Pad:
    • The pads are for one-time use only and should be disposed of after use. Only remove the pad from its pouch until you are ready to use it. 
    • Pads are used twice a day to apply the medication to acne-prone areas.

Be aware of: 

  • Before using clindamycin, let your physician or pharmacist know if you are allergic to clindamycin, lincomycin (Lincocin) or to any of the other ingredients in the gel, foam, lotion, suspension or pads or to any other medication. 
  • Before using clindamycin, inform your physician about the prescription and non-prescription medications you are using/taking. Make sure to mention erythromycin or other skin products. Your physician may want to monitor closely for side-effects or to adjust doses of your medications. Furthermore, when your physician also prescribes other topical treatments along with clindamycin, it is preferable to apply medications at different times to avoid skin irritation. Some medications do not work properly when used at or near the same time.
  • Before using clindamycin, inform your physician if you ever have ever suffered from inflammatory bowel disease (a condition in which all or a part of the intestine is swollen or irritated), stomach or intestinal disease or severe diarrhea. Your physician may advise you not to take clindamycin.
  • Before using clindamycin, inform your physician if you ever have ever suffered from asthma, eczema allergies.
  • If you are using clindamycin and are pregnant or are planning to become pregnant, talk to your physician about using clindamycin during pregnancy.
  • If you are using clindamycin and are breastfeeding, talk to your physician about using clindamycin during this period.
  • Before having surgery (which also includes dental surgery), tell your physician or dentist that you use clindamycin.
  • Before using clindamycin, be aware that abrasive or medicated soaps and skin products containing alcohol increase the side-effects of clindamycin. Inform your physician about the skin care products you intend to use. 
  • You can continue your regular diet unless your physician tells you otherwise.
  • Inform your physician if the use of clindamycin solution dries your skin. This may already happen with normal use.
  •  You may continue using cosmetics / make-up while using clindamycin but it is best to use “water-based” cosmetics only. Cosmetics may make your acne worse so use cosmetics not too often or too heavily. Consult your physician is you have any questions. 
  • Do not use clindamycin for a skin condition that it was not prescribed for, without consulting your physician first. 
  • Do not share your medication with anyone else. 
  • Keep your regular appointments with your physician to track your response to clindamycin.

Drug interactions: 

Do not use alcohol-containing or abrasive skin care products, while using clindamycin. Inform your physician or pharmacist about all the prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take before starting clindamycin. Also inform your physician or pharmacist of the skin products you use including soaps, cleansers, moisturizers, and cosmetics. 

Some drugs interact with clindamycin and should not be used together with clindamycin. However, your physician may prescribe other drugs together with clindamycin which may cause a slight interaction, and in this case precautions are necessary.

Drugs that are not recommended to be used with clindamycin, but may be required to be taken together, are (dose and dosing regime may need to be adjusted):

  • Cholera vaccine (live)
  • Erythromycin

Full list of drug interactions (From PubMed and Medline Plus):

  • Atracurium
  • Metocurine
  • Tubocurarine

Do not swallow

If clindamycin is swallowed, contact an emergency facility or call the American Association of Poison Control Centers at 1 (800) 222-1222 (available 24/7).

If immediate assistance is necessary because the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, call 911.

Information can also be found online at https://www.poisonhelp.org/help

What if I miss a dose?

As soon as you recall that you have missed a dose, apply the missed dose. However, skip the missed dose if it is almost time for your next dose and continue with your prescribed dosing schedule. Do not increase the quantity or frequency of application to make up for the missed dose. 

Storage:

Store your medication in the container that the pharmacist provided and keep it out of reach and out of sight of children. Many containers can be opened by children. Keep the container tightly closed. Always lock safety caps and immediately place the medication in a safe location that is up and away from the sight of young children, to prevent poisoning (www.upandaway.org).

Store the medication at room temperature. Keep the medication away from excessive heat and moisture – do not store in the bathroom. Do not freeze clindamycin.

Foam: The can of clindamycin foam should not be stored at temperatures above 49 degrees Celcius (120 degrees Fahrenheit). Do not poke holes in the can. Clindamycin foam is flammable so keep it well away from flames and extreme heat. Do not throw the can into a fire, even when the can is empty. 

Disposal:

Do not keep outdated medication and medication that you no longer use. Unneeded medications should be disposed of in a way that pets, children, and other people cannot consume them. Do not flush the medication down the toilet. Contact your pharmacist to learn about the availability of a medicine take-back program in your neighborhood, or get in touch with your local garbage/recycling department to ensure safe disposal. If you do not have access to a take-back program, you can find more information on safe disposal of medication on the FDA website: (https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm)

References
  1. Medlineplus.gov. (2018). Clindamycin Topical: MedlinePlus Drug Information. [online] Available at: https://medlineplus.gov/druginfo/meds/a609005.html [Accessed 16 Apr. 2018].
  2. Ncbi.nlm.nih.gov. (2018). Clindamycin (topical route). [online] Available at:https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0044546/ . [Accessed 16 Apr. 2018].
  3. Toxnet.nlm.nih.gov. (2018). Clindamcyin. [online] Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/search2/f?./temp/~KXyUEZ:1. [Accessed 16 Apr. 2018].
  4. Uptodate.com. (2018). Clindamycin (topical). [online] Available at: https://www.uptodate.com/contents/clindamycin-topical-patient-drug-information?search=clindamycin%20topical&source=search_result&selectedTitle=5~34&usage_type=default&display_rank=5. [Accessed 16 Apr. 2018].
  5. Epocrates.com. (2018). Clindamycin. [online] Available at: https://online.epocrates.com/drugs/51010/clindamycin-topical/Monograph. [Accessed 16 Apr. 2018].