6 Oral Clindamycin Side Effects You Should Know About

Oral clindamycin (Cleocin) is an antibiotic that treats infections caused by certain bacteria. It’s often prescribed if you’re allergic to penicillin or have a skin infection. It’s helpful to know what side effects to look out for before you start taking an antibiotic. Here, we’ll review what clindamycin side effects you should know about.

Clindamycin side effects at a glance

Below is a list of common and rare clindamycin side effects reported in clinical studies. Keep in mind that this isn’t a complete list of all possible side effects. Talk to your healthcare team about any bothersome side effects that occur while you or your child is taking clindamycin.

Common clindamycin side effects include:

• Nausea

• Vomiting

• Diarrhea

• Stomach pain

• Throat irritation

• Metallic taste in mouth

• Skin rashes

• Itching

• Vaginal irritation or infection

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Rare but serious clindamycin side effects include:

• Esophageal ulcers

• Kidney damage

• Yellowing of the skin or eyes (jaundice)

• Liver problems

• Low blood cell counts

• Joint pain

• Severe skin reactions

This medication also has a boxed warning, the FDA’s strictest warning for medications. That’s because clindamycin may cause Clostridioidies difficile-associated diarrhea (C. diff colitis). In severe cases, this side effect can be life-threatening.

Let’s review six clindamycin side effects in more detail.

1. Nausea

Nausea is one of the most common oral clindamycin side effects. That’s because antibiotics like clindamycin can irritate your stomach lining. They also kill off the healthy bacteria that help protect your gut, which can increase the chance of nausea.

You should take clindamycin with a full glass of water to help lessen irritation caused by the medication. You can take clindamycin with or without food, but taking it with food may help reduce nausea. Eating smaller portions of bland foods throughout the day can also help settle your stomach. Spicy or greasy foods can worsen nausea, so you may want to avoid these.

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If nausea is severe, long-lasting, or making you vomit, speak with your prescriber. They can help determine what to do about it.

2. Diarrhea

Diarrhea is another common side effect of oral clindamycin. Stomach pain and cramps are also possible. As mentioned, clindamycin can irritate your stomach and kill off the healthy bacteria that protects your gut. These effects can contribute to diarrhea as well as nausea.

In most cases, diarrhea is mild and will go away once you’ve finished your course of clindamycin. Be sure to stay well hydrated and consider adding probiotic-rich foods or a probiotic supplement to your routine. These can help replace healthy gut bacteria. Talk to your healthcare team about taking an over-the-counter (OTC) antidiarrheal medication, such as loperamide (Imodium A-D) or bismuth subsalicylate (Pepto-Bismol) if needed. 

In rare cases, clindamycin can cause a severe form of diarrhea called C. diff colitis. This happens when a bacteria called Clostridioidies difficile overgrows in your gut. Severe C. diff colitis can be deadly if it isn’t treated properly. The risk is higher if you’re age 65 and older or have a history of colitis or intestinal issues.

Signs and symptoms of C.diff colitis include:

• Watery diarrhea

• Abdominal pain and cramping

• Fever

• Fatigue

Seek medical care if these symptoms develop while you’re taking clindamycin. Keep in mind that it’s possible for C.diff colitis to occur weeks or even months after you’ve finished your course of treatment.

3. Metallic taste and throat irritation

People often report a metallic taste after taking clindamycin. This strange but common side effect might be alarming, but it should go away once you finish taking clindamycin. In the meantime, stay hydrated and try sugar-free gum or mints to help mask the taste.

A metallic taste can also be a symptom of heartburn. As mentioned, you should always take clindamycin with a full glass of water. Not only can this help lessen the metallic taste of the medication, but it helps prevent upset stomach and heartburn. What’s more, if you take clindamycin without enough water, medication can linger in your throat. This can cause throat irritation or pain when swallowing. In rare cases, it may even erode through the skin of your esophagus, causing an ulcer.

If you notice throat irritation or pain when swallowing while taking clindamycin, let your prescriber know. They may want to check your esophagus for any signs of damage. 

4. Vaginal infections

Clindamycin and other antibiotics may cause vaginal irritation or infections (vaginitis), including yeast infections. This can happen because the antibiotic kills off the healthy bacteria that help protect your vagina from infection.

Signs and symptoms of a vaginal infection include:

• Burning, itching, or swelling of the vaginal area

• Pain when peeing

• Discomfort during sex

• A change in your vaginal discharge

A cool compress or OTC vaginal moisturizer may help improve minor irritation. But if symptoms are severe or you have signs of an infection, speak to a healthcare professional. They can help determine what type of infection you have and what treatment is best. You should continue taking clindamycin until your full treatment course is finished.

5. Skin reactions

Skin rashes are another possible clindamycin side effect. In most cases, skin rashes are minor, and may be a sign of an allergic reaction to clindamycin. But in rare cases, rashes may be serious or even life-threatening. Skin rashes can appear while you’re taking clindamycin or up  to 8 weeks after treatment is finished.

Serious clindamycin skin rashes include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS). These rashes typically start as painful red or purple patches on the skin. But they often also cause flu-like symptoms as well. Over time, skin may start to blister and peel.

If you develop a skin rash while taking clindamycin or in the weeks after treatment, contact your prescriber right away, even if it seems mild. If you’re having trouble breathing or have swelling of your mouth, face, or throat, seek emergency care right away. 

6. Liver problems

It’s not common, but liver problems have been reported from clindamycin treatment. In most cases, this is a temporary issue that resolves once you stop taking clindamycin. Let your prescriber know if you notice any signs of liver problems. This includes yellowing of your skin or eyes (jaundice) or fatigue.

Does clindamycin make you drowsy?

No. Clindamycin doesn’t seem to cause drowsiness on its own. But you typically take clindamycin if you have an infection, and it’s common to feel more tired than usual if you’re sick. Extra sleep helps your body recover, so it’s fine if you need an extra nap during the day.

Keep in mind that dehydration or liver problems can also make you feel tired. So keep an eye out for other symptoms to help you determine what’s making you sleepy. And if your drowsiness seems unusual, talk to your prescriber about it.

How soon do clindamycin side effects start?

It’s possible for some clindamycin side effects to start soon after your first dose. This includes nausea, diarrhea, or a metallic taste in your mouth. Skin rashes can also start right away, although they can also appear later on, during or even after treatment.

Clindamycin side effects such as vaginal infections, throat irritation, and liver problems may take longer to show up, if they happen at all. C. diff colitis typically occurs weeks or months after your course of clindamycin is finished.

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Written by:

Jill Barat, PharmD

Jill Barat, PharmD has nearly 10 years of experience as a pharmacist, including serving as the pharmacist in charge at an independent sterile and non-sterile compounding pharmacy. She also worked as the head of medical content for a telemedicine company.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Patricia Weiser, PharmD

Patricia has 16 years of pharmacist experience. She previously held positions as a community pharmacist, pharmacy manager, and hospital pharmacist.

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