Clindamycin interactions

Conditions

Conditions in which Clindamycin needs care, as documented in this source.

• Colitis

  Major

  Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

  31 sources

  1. "Product Information. Omnipen (ampicillin)." Wyeth-Ayerst Laboratories (2002):
  2. "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome (2002):
  3. "Product Information. Zinacef (cefuroxime)." Glaxo Wellcome (2002):
  4. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn (2002):
  5. "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  6. "Product Information. Macrodantin (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  7. "Product Information. Amoxil (amoxicillin)." SmithKline Beecham (2001):
  8. "Product Information. Merrem (meropenem)." Astra-Zeneca Pharmaceuticals (2001):

  Show all 31 sourcesShow fewer sources

  9. "Product Information. Coly-Mycin M Parenteral (colistimethate)." Parke-Davis (2001):
  10. "Product Information. Lincocin (lincomycin)." Pharmacia and Upjohn (2001):
  11. "Product Information. Cubicin (daptomycin)." Cubist Pharmaceuticals Inc (2003):
  12. "Product Information. Xifaxan (rifaximin)." Salix Pharmaceuticals (2004):
  13. "Product Information. Doribax (doripenem)." Ortho McNeil Pharmaceutical (2007):
  14. "Product Information. Penicillin G Procaine (procaine penicillin)." Monarch Pharmaceuticals Inc (2009):
  15. "Product Information. Vibativ (telavancin)." Theravance Inc (2009):
  16. "Product Information. Teflaro (ceftaroline)." Forest Pharmaceuticals (2010):
  17. "Product Information. Penicillin G Sodium (penicillin G sodium)." Sandoz Inc (2022):
  18. "Product Information. Dalvance (dalbavancin)." Durata Therapeutics, Inc. (2014):
  19. "Product Information. Orbactiv (oritavancin)." The Medicines Company (2014):
  20. "Product Information. Bicillin C-R (benzathine penicillin-procaine penicillin)." A-S Medication Solutions (2017):
  21. "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc. (2017):
  22. "Product Information. Polymyxin B Sulfate (polymyxin B sulfate)." AuroMedics Pharma LLC (2022):
  23. "Product Information. Zemdri (plazomicin)." Achaogen (2018):
  24. "Product Information. Seysara (sarecycline)." Allergan Inc (2018):
  25. "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc. (2018):
  26. "Product Information. Aemcolo (rifamycin)." Aries Pharmaceuticals, Inc. (2018):
  27. "Product Information. Fetroja (cefiderocol)." Shionogi USA Inc (2019):
  28. "Product Information. Biaxin (clarithromycin)." AbbVie US LLC (2019):
  29. "Product Information. Zithromax (azithromycin)." Pfizer U.S. Pharmaceuticals Group (2021):
  30. "Product Information. E.E.S.-400 Filmtab (erythromycin)." Arbor Pharmaceuticals (2018):
  31. "Product Information. Priftin (rifapentine)." sanofi-aventis (2020):

• Premature Birth

  Major

  Parenteral medications formulated in multidose vials often contain benzyl alcohol as a preservative. Their use is considered by drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. When used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, benzyl alcohol has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. Thus, single-dose formulations should always be used in infants whenever possible. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. However, the administration of high dosages of these medications must take into account the total amount of benzyl alcohol administered. The level at which toxicity may occur is unknown.

  6 sources

  1. "Product Information. Fragmin (dalteparin)." Pharmacia and Upjohn (2001):
  2. "Product Information. Mesnex (mesna)." Bristol-Myers Squibb (2001):
  3. "Product Information. Mivacron (mivacurium)." Glaxo Wellcome (2001):
  4. "Product Information. Nuromax (doxacurium)." Glaxo Wellcome (2001):
  5. "Product Information. Tracrium (atracurium)." Glaxo Wellcome (2001):
  6. ""Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Available from: URL: http://www.aap.org/policy/re9706.html." Pediatrics 99 (1997): 268-78

• Kidney Diseases

  Moderate

  Clindamycin is eliminated by the kidney to a limited extent. Therapy with clindamycin should be administered cautiously in patients with severely impaired renal function. Dosage adjustments are probably not necessary. However, serum clindamycin concentrations should be monitored during high-dose therapy, and periodic renal function tests should be performed during prolonged therapy.

  3 sources

  1. Eastwood JB, Gower PE "A study of the pharmacokinetics of clindamycin in normal subjects and patients with chronic renal failure." Postgrad Med J 50 (1974): 710-2
  2. Peddie BA, Dann E, Bailey RR "The effect of impairment of renal function and dialysis on the serum and urine levels of clindamycin." Aust N Z J Med 5 (1975): 198-202
  3. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn (2002):

• Liver Diseases

  Moderate

  Clindamycin is primarily metabolized by the liver. The serum concentration of clindamycin may be increased and the half-life prolonged in patients with severely impaired hepatic function. In addition, jaundice and liver enzyme abnormalities may occur during use of the drug. Therapy with clindamycin should be administered cautiously in patients with liver disease. Dosage adjustments may not be necessary when administered every 8 hours. However, serum concentrations should be monitored during high-dose therapy, and periodic liver function tests should be performed during prolonged therapy.

  4 sources

  1. Avant GR, Schenker S, Alford RH "The effect of cirrhosis on the disposition and elimination of clindamycin." Dig Dis 20 (1975): 223-30
  2. Hinthorn DR, Baker LH, Romig DA, et al. "Use of clindamycin in patients with liver disease." Antimicrob Agents Chemother 9 (1976): 498-501
  3. Eng RH, Gorski S, Person A, et al. "Clindamycin elimination in patients with liver disease." J Antimicrob Chemother 8 (1981): 277-81
  4. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn (2002):