Clostridium difficile associated diarrhea CDAD has been reported with use of nearly all antibacterial agents, including clindamycin palmitate hydrochloride for oral solution Pediatric , and may range in severity from mild diarrhea to fatal colitis. In case of such an anaphylactic or severe hypersensitivity reaction, discontinue treatment permanently and institute appropriate therapy. Usage in Meningitis: Since clindamycin does not diffuse adequately into the cerebrospinal fluid, the drug should not be used in the treatment of meningitis.
Review of experience to date suggests that a subgroup of older patients with associated severe illness may tolerate diarrhea less well. When clindamycin is indicated in these patients, they should be carefully monitored for change in bowel frequency. Clindamycin palmitate hydrochloride for oral solution Pediatric should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.
Clindamycin palmitate hydrochloride for oral solution Pediatric should be prescribed with caution in atopic individuals. Indicated surgical procedures should be performed in conjunction with antibiotic therapy. The use of clindamycin palmitate hydrochloride for oral solution Pediatric occasionally results in overgrowth of nonsusceptible organisms-particularly yeasts.
Should superinfections occur, appropriate measures should be taken as indicated by the clinical situation. Clindamycin dosage modification may not be necessary in patients with renal disease. In patients with moderate to severe liver disease, prolongation of clindamycin half-life has been found.
However, it was postulated from studies that when given every eight hours, accumulation should rarely occur. Therefore, dosage modification in patients with liver disease may not be necessary. However, periodic liver enzyme determinations should be made when treating patients with severe liver disease.
Prescribing clindamycin palmitate hydrochloride for oral solution Pediatric in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Patients should be counseled that antibacterial drugs including clindamycin palmitate hydrochloride for oral solution Pediatric should only be used to treat bacterial infections.
They do not treat viral infections e. When clindamycin palmitate hydrochloride for oral solution Pediatric is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed.
Skipping doses or not completing the full course of therapy may 1 decrease the effectiveness of the immediate treatment and 2 increase the likelihood that bacteria will develop resistance and will not be treatable by clindamycin palmitate hydrochloride for oral solution Pediatric or other antibacterial drugs in the future.
Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools with or without stomach cramps and fever even as late as two or more months after having taken the last dose of the antibiotic.
If this occurs, patients should contact their physician as soon as possible. During prolonged therapy, periodic liver and kidney function tests and blood counts should be performed. Clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents.
Therefore, it should be used with caution in patients receiving such agents. Clindamycin is metabolized predominantly by CYP3A4, and to a lesser extent by CYP3A5, to the major metabolite clindamycin sulfoxide and minor metabolite N-desmethylclindamycin. Therefore inhibitors of CYP3A4 and CYP3A5 may increase plasma concentrations of clindamycin and inducers of these isoenzymes may reduce plasma concentrations of clindamycin.
In the presence of strong CYP3A4 inhibitors, monitor for adverse reactions. In the presence of strong CYP3A4 inducers such as rifampicin, monitor for loss of effectiveness. Long term studies in animals have not been performed with clindamycin to evaluate carcinogenic potential. Genotoxicity tests performed included a rat micronucleus test and an Ames Salmonella reversion test.
Both tests were negative. In clinical trials with pregnant women, the systemic administration of clindamycin during the second and third trimesters, has not been associated with an increased frequency of congenital abnormalities.
Clindamycin should be used during the first trimester of pregnancy only if clearly needed. There are no adequate and well-controlled studies in pregnant women during the first trimester of pregnancy. Because animal reproduction studies are not always predictive of the human response, this drug should be used during pregnancy only if clearly needed. Limited published data based on breast milk sampling reports that clindamycin appears in human breast milk in the range of less than 0. Clindamycin has the potential to cause adverse effects on the breast-fed infant's gastrointestinal flora.
If oral or intravenous clindamycin is required by a nursing mother, it is not a reason to discontinue breastfeeding, but an alternate drug may be preferred. Monitor the breast-fed infant for possible adverse effects on the gastrointestinal flora, such as diarrhea, candidiasis thrush, diaper rash or rarely, blood in the stool indicating possible antibiotic-associated colitis. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for clindamycin and any potential adverse effects on the breast-fed child from clindamycin or from the underlying maternal condition.
When clindamycin palmitate hydrochloride for oral solution Pediatric is administered to the pediatric population birth to 16 years , appropriate monitoring of organ system functions is desirable. Clinical studies of clindamycin did not include sufficient numbers of patients age 65 and over to determine whether they respond differently from younger patients. These patients should be carefully monitored for the development of diarrhea.
Pharmacokinetic studies with clindamycin have shown no clinically important differences between young subjects 18 to 39 years and elderly subjects 61 to 79 years with normal hepatic function and normal age-adjusted renal function after oral or intravenous administration.
Infections and infestations: Clostridium difficile colitis. An unpleasant or metallic taste has been reported after oral administration. Hypersensitivity Reactions: Generalized mild to moderate morbilliform-like maculopapular skin rashes are the most frequently reported adverse reactions. Do not use this medicine in larger or smaller amounts or for longer than recommended. Using more medicine or applying it more often than prescribed will not make it work any faster, and may increase side effects.
Benzoyl peroxide can cause a rare but serious allergic reaction or severe skin irritation. Before you start using this medicine, you may choose to apply a "test dose" to see if you have a reaction. Apply a very small amount of the medicine to 1 or 2 small acne areas every day for 3 days in a row. If there is no reaction, begin using the full prescribed amount on the 4th day. Benzoyl peroxide and clindamycin topical is usually applied twice daily, in the morning and evening.
Avoid getting this medicine in your eyes, mouth, or nose or in the creases of your nose , or on your lips. If it does get into any of these areas, wash with water. Do not apply this medicine to sunburned, windburned, dry, chapped, irritated, or broken skin.
It may take several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. If you receive more than one supply of Acanya or Duac gel, store the unopened container in a refrigerator until you are ready to start using it. Do not freeze. Once in use, store the gel at room temperature away from moisture and heat. Throw away any unused medicine after the expiration date on the label has passed. Duac has an expiration date of 60 days.
Acanya has an expiration date of 10 weeks. BenzaClin has an expiration date of 3 months. Apply the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose. Overdose symptoms include bloody or watery diarrhea, which may result if you absorb this medicine through your skin by applying too much.
Avoid using skin products that can cause irritation, such as harsh soaps, shampoos, or skin cleansers, hair coloring or permanent chemicals, hair removers or waxes, or skin products with alcohol, spices, astringents, or lime. Avoid using other medications on the areas you treat with benzoyl peroxide and clindamycin topical unless your doctor tells you to. Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop using benzoyl peroxide and clindamycin topical and call your doctor.
Do not use anti-diarrhea medicine unless your doctor tells you to. Avoid exposure to sunlight or tanning beds. This medication can make you sunburn more easily.
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