Dosage/Direction for Use
Topical/Cutaneous Acne vulgaris Adult: As gel (containing clindamycin phosphate 1% w/w, 1.2% w/w and benzoyl peroxide 3% w/w, 5% w/w): Apply thinly onto affected area once daily at night after cleansing. Max: 12 wk of continuous use. Child: ≥12 yr Same as adult dose. |
Contraindications
Hypersensitivity to clindamycin, lincomycin, or benzoyl peroxide. History of regional enteritis, ulcerative colitis, pseudomembranous or antibiotic-associated colitis.
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Special Precautions
Atopic patients. Patient Counselling Avoid unnecessary sun exposure. May cause discolouration of hair and dyed fabrics.
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Adverse Reactions
Significant: Anaphylaxis, allergic reaction.
Dermatologic: Erythema, peeling, burning sensation, dryness, desquamation, itching, irritation, stinging, discolouration, exfoliation, contact dermatitis, rash, urticaria.
Potentially Fatal: Clostridium difficile-associated colitis manifested by severe persistent diarrhoea, severe abdominal cramps, stool w/ blood and mucous. |
Overdosage
Symptom: Severe irritation. Management: Symptomatic treatment.
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Drug Interactions
Clindamycin is antagonised by erythromycin. Clindamycin may enhance the action of other neuromuscular blocking agents. Benzoyl peroxide may cause temporary discolouration of skin and facial hair w/ topical sulfone preparations. May cause cumulative irritation or dermatitis w/ other topical acne preparations (e.g. tretinoin, isotretinoin, tazarotene).
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Action
Clindamycin is a semisynthetic lincosamide which is mainly bacteriostatic but may also be bactericidal depending on drug concentration, infection site, and organism. It inhibits bacterial protein synthesis by binding to the 50S ribosomal subunits, thereby blocking the peptide bond formation of susceptible organisms. Benzoyl peroxide has mild keratolytic effect and an antimicrobial activity which is attributed to its oxidising effect. Both are active against Propionibacterium acnes, an organism associated w/ acne vulgaris.
Absorption: Clindamycin: Minimal absorption (approx 4-5%) through the skin. Benzoyl peroxide: Approx 5% is absorbed through the skin. Metabolism: Benzoyl peroxide: Metabolised in the skin to benzoic acid. Excretion: Benzoyl peroxide: Via urine. |
Storage
Topical/Cutaneous: Store below 25°C. Do not freeze.
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CIMS Class
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ATC Classification
J01FF01 - clindamycin ; Belongs to the class of lincosamides. Used in the systemic treatment of infections.
G01AA10 - clindamycin ; Belongs to the class of antibiotics. Used in the treatment of gynecological infections. D10AF01 - clindamycin ; Belongs to the class of topical antiinfective preparations used in the treatment of acne. D10AE01 - benzoyl peroxide ; Belongs to the class of topical peroxide preparations used in the treatment of acne. |