clindamycin
Clindamycin is an antibiotic that's used to treat vaginal bacterial infections. It comes as a cream and gel that are inserted into your vagina. Some formulations only have to be used as a single dose, while others require 3 or 7 days of treatment.
What is Clindamycin?
What is Clindamycin used for?
Vaginal bacterial infections (bacterial vaginosis)
How Clindamycin works
Clindamycin is a lincosamide antibiotic. It treats infections by stopping bacteria from making proteins, which prevents the bacteria from growing and spreading.
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What are the side effects of Clindamycin?
Common Side Effects
- Pain or discomfort in or around the vulva and vagina
- Inflammation in or around the vulva and vagina
- Vaginal yeast infection
- Headache
- Back pain
Other Side Effects
- Constipation
- Stomach pain or cramps
- Irregular menstrual cycles
- Urinary tract infections (UTIs)
- Skin yeast infections
Serious Side Effects
- Severe allergic reactions: hives, rash, swelling of the lips or tongue, difficulty breathing
- Severe diarrhea: stomach cramps, blood in your stool, watery diarrhea that doesn't go away, fever
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Incidence not known
Abdominal or stomach cramps, pain, or tenderness
black, tarry stools
bleeding gums
blistering, peeling, or loosening of the skin
blood in the urine or stools
blurred vision
chills
clay-colored stools
cloudy urine
confusion
cough or hoarseness
dark urine
decrease in the amount of urine
diarrhea, watery and severe, which may also be bloody
difficulty with swallowing
dizziness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast heartbeat
fever with or without chills
general feeling of tiredness or weakness
headache
heart stops
hives or welts, itching, or skin rash
increased thirst
itching of the vagina or genital area
joint or muscle pain
loss of appetite
lower back or side pain
nausea or vomiting
no breathing
no pulse or blood pressure
pain during sexual intercourse
pain in the lower back or side
pain, tenderness, or swelling of the foot or leg
painful or difficult urination
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rash
rash with flat lesions or small raised lesions on the skin
red skin lesions, often with a purple center
red, irritated eyes
redness of the skin
shortness of breath
sores, ulcers, or white spots in the mouth or on the lips
swollen glands
thick, white vaginal discharge with no odor or with a mild odor
thirst
tightness in the chest
unconscious
unpleasant breath odor
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight loss
vomiting of blood
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Clindamycin
Pros
Might not cause as many stomach-related side effects as oral medications
Some versions are safe to use during pregnancy.
Some versions only have to be used once as a single dose.
Cleocin comes as a lower-cost generic medication.
Clindesse comes in a convenient, prefilled applicator.
Cons
Vaginal application can be uncomfortable for some people.
Can cause yeast infections
Can't use condoms, diaphragms, or tampons for several days after finishing treatment
Single-dose cream and gel are brand-only, so they can be expensive
Shouldn't be used if you have bowel problems such as ulcerative colitis
Pharmacist tips for Clindamycin
Clindamycin comes in different formulations that are used for different lengths of time, so make sure you're using the medication as instructed by your provider. Ask your provider or pharmacist if you're unsure how to use this medication.
Cleocin, its generic, and Xaciato come with disposable applicators, but they aren't filled ahead of time for you. This means you need to draw up the medication into the applicator from a tube before inserting it into your vagina.
Clindesse and Xaciato are designed to leak out of the vagina less, which is why they can be used any time throughout the day. Both of these medications are just used one time as a single dose.
Throw the applicator away after you use it. You shouldn't reuse the applicators that come with any formulation of clindamycin.
For Cleocin vaginal cream and its generic
Insert the medication while lying down on your back.
It's best to use Cleocin and its generic at bedtime to prevent the cream from leaking from your vagina. Some of the medication might leak out, so it's a good idea to wear a panty liner while using it.
Cleocin and its generic are the only formulations of vaginal clindamycin that are approved for use during pregnancy (during the second and third trimesters). You'll typically use the medication once daily for 7 days if you're pregnant (non-pregnant people can use it for 3 or 7 days, depending on your provider's instructions).
For Clindesse vaginal cream
Clindesse comes in an applicator that has the medication already measured out for you. You just have to activate the plunger before inserting the medication. You can find detailed directions on how best to use Clindesse in the Instructions for Use that come with the medication.
Frequently asked questions about Clindamycin
In general, you don't absorb as much medication into your bloodstream when you use clindamycin vaginally as you do when taken orally. So a possible advantage to using clindamycin vaginally is that side effects are typically local (e.g., pain or discomfort around the vulva or vagina, vaginal yeast infection). On the other hand, oral clindamycin might cause some side effects that are more related to the digestive tract (e.g., nausea, vomiting, diarrhea, metallic taste in mouth). Discuss with your provider which formulation of clindamycin is right for you.
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What are the risks and warnings for Clindamycin?
Clindamycin can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reactions
Risk factors: Known allergy to clindamycin or lincosamides
Allergic reactions to clindamycin are possible, including life-threatening problems like anaphylaxis or airway swelling. If you notice hives, a rash, swelling of the lips or tongue, or difficulty breathing after using clindamycin, get medical help right away. You shouldn't use clindamycin if you know you're allergic to clindamycin or any lincosamide antibiotics.
Severe diarrhea
Risk factors: History of Clostridioides difficile-associated diarrhea | Crohn's disease | Ulcerative colitis | Regional enteritis
Like all antibiotics, clindamycin can cause diarrhea because it can get rid of the good bacteria in your gut. In rare cases, this diarrhea is caused by a bacteria called Clostridioides difficile (commonly called C. diff) that's usually kept under control by your other gut bacteria. C. diff diarrhea is very contagious and can lead to life-threatening dehydration. Having bowel problems, like Crohn's disease and ulcerative colitis, raises your risk of C. diff diarrhea while using antibiotics. Tell your provider if you have inflammatory bowel problems or have ever had severe diarrhea after using antibiotics before.
Contact your provider if you experience watery diarrhea, stomach cramps, fever, or fatigue. If you have C. diff, be sure to wash your hands frequently with soap for 20 seconds and try to use a different bathroom from anyone living with you until you're better. Taking probiotic supplements while using clindamycin might help prevent this problem.
Damage to condoms and diaphragms
Clindamycin can cause condoms and vaginal diaphragms to weaken and break. This puts you at risk for an unwanted pregnancy as well as STDs. Ask your provider or pharmacist about what barrier methods you can use in the meantime. In general, it's best to avoid having vaginal sex until your infection is cleared up, as sex can irritate your vagina even more and make your symptoms worse.
Vaginal yeast infections
Using clindamycin can raise your risk for vaginal yeast infections. This is because the medication can also affect the good bacteria in your vagina that usually keep fungi from overgrowing. When fungi overgrow in your vagina, it can sometimes result in a yeast infection. There are many different over-the-counter and prescription treatments available for vaginal yeast infections. Let your provider know if you have redness, pain, or burning around your vagina, or if you have thick, white vaginal discharge. These could be signs of a vaginal yeast infection, and you might need treatment for it.
Clindamycin dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 40g of 2% | 1 tube | $41.11 | $41.11 |
Typical dosing for Clindamycin
Clindamycin comes as a cream (two different versions) and a gel. The dosing is different depending on which formulation you're using. The typical dosing is as follows:
Vaginal cream
Clindesse: Insert 1 prefilled applicator (100 mg of clindamycin) into the vagina once at any time of the day.
Cleocin and generic: Insert 1 applicatorful (100 mg of clindamycin) into the vagina once a day, preferably at bedtime, for 3 or 7 days.
Vaginal gel
Xaciato: Insert 1 applicatorful (100 mg of clindamycin) into the vagina once at any time of the day.
Interactions between Clindamycin and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Cholera Vaccine, Live
- Erythromycin
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Atracurium
- Metocurine
- Tubocurarine
How much does Clindamycin cost?
Clindamycin contraindications
Allergy to clindamycin or lincosamide antibiotics
History of certain stomach or gut problems (e.g., regional enteritis, ulcerative colitis, antibiotic-associated colitis)
What are alternatives to Clindamycin?
Vaginal bacterial infections (bacterial vaginosis)
Trichomoniasis ("trich")
Giardiasis (parasitic gut infection)
Amebiasis (parasitic gut infection)
Bacterial vaginosis (BV)
What is the latest news about Clindamycin?
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