Cleocin Phosphate Side Effects

Generic Name: clindamycin

Note: This page contains information about the side effects of clindamycin. Some of the dosage forms included on this document may not apply to the brand name Cleocin Phosphate.

Not all side effects for Cleocin Phosphate may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to clindamycin: oral capsule, oral powder for solution

Other dosage forms:

In addition to its needed effects, some unwanted effects may be caused by clindamycin (the active ingredient contained in Cleocin Phosphate). In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking clindamycin:

Rare
  • Cracks in the skin
  • loss of heat from the body
  • red, swollen skin scaly skin
Incidence not known
  • Abdominal or stomach cramps, pain, or tenderness
  • black, tarry stools
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • bloating
  • blood in the urine or stools
  • blurred vision
  • chest pain
  • chills
  • clay-colored stools
  • cloudy urine
  • confusion
  • cough or hoarseness
  • dark urine
  • decrease in the amount of urine
  • diarrhea
  • 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
  • dry mouth
  • fast heartbeat
  • fever with or without chills
  • general feeling of tiredness or weakness
  • headache
  • heartburn
  • 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
  • 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 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
  • sore throat
  • 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

For Healthcare Professionals

Applies to clindamycin: compounding powder, injectable solution, intravenous solution, oral capsule, oral powder for reconstitution

Gastrointestinal

The onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment and is associated with the presence of Clostridium difficile toxin in the stool. Pseudomembranous colitis may also be associated with toxic megacolon, which can be life-threatening.

An unpleasant or metallic taste has occasionally been reported after high doses of IV clindamycin (the active ingredient contained in Cleocin Phosphate) [Ref]

Common (1% to 10%): Pseudomembranous colitis, diarrhea, abdominal pain
Uncommon (0.1% to 1%): Dysgeusia, nausea, vomiting
Frequency not reported: Esophageal ulcers, esophagitis (oral preparations)[Ref]

Dermatologic

Common (1% to 10%): Maculopapular rash
Uncommon (0.1% to 1%): Urticaria
Rare (less than 0.1%): Erythema multiforme, pruritus
Frequency not reported: Toxic epidermal necrolysis, Stevens-Johnson syndrome, exfoliative dermatitis, bullous dermatitis, generalized mild to moderate morbilliform-like rash, acute generalized exanthematous pustulosis (AGEP), Sweet's Syndrome
Postmarketing reports: Serious cutaneous adverse reaction[Ref]

Rash was particularly common in AIDS patients.

A 47-year-old female patient with multiple comorbidities was diagnosed with Sweet's Syndrome. The patient's symptoms developed 2 days after initiating oral clindamycin therapy for a tooth infection. The patient's symptoms persisted despite tooth extraction and continuance of antibiotic treatment with intravenous, then oral, clindamycin. Following discontinuation of clindamycin, the patient's symptoms resolved over several days. Drug-induced Sweet's syndrome was determined based on the temporal relationship of the patient's symptoms, the beginning and end of clindamycin therapy, and the exclusion of other etiologies.

Three days after starting oral clindamycin for the persistence of symptoms following a root canal, a 34-year-old male patient reported "pimples" on his scalp which changed to pustules 24 hours later. The lesions progressed and the patient's antibiotic therapy was discontinued. Two days later, the rash improved considerably. The patient met the diagnostic criteria for drug-induced Sweet's syndrome and clindamycin was the most likely cause due to the timeline of antibiotic therapy and the patient's improvement following its discontinuation.[Ref]

Hypersensitivity

Frequency not reported: Anaphylactoid reactions, drug reaction with eosinophilia and systemic systems (DRESS)[Ref]

Cardiovascular

Cardiorespiratory arrest and hypotension have been reported after too rapid IV administration. Thrombophlebitis has been reported after intravenous infusion.[Ref]

Common (1% to 10%): Thrombophlebitis (after IV infusion)
Uncommon (0.1% to 1%): Cardiorespiratory arrest, hypotension[Ref]

Genitourinary

Frequency not reported: Vaginitis[Ref]

Hematologic

Neutropenia (ANC 945 cells/mm3) occurred in a 68-year-old male 6 days after receiving a single 600 mg oral dose of clindamycin (the active ingredient contained in Cleocin Phosphate) The neutrophil count normalized after 2 weeks.[Ref]

Uncommon (0.1% to 1%): Eosinophilia
Frequency not reported: Neutropenia, leucopenia, agranulocytosis, thrombocytopenia[Ref]

Hepatic

Common (1% to 10%): Liver function test abnormalities
Frequency not reported: Jaundice[Ref]

Local

Pain, induration, and sterile abscess have been reported after intramuscular administration.[Ref]

Frequency not reported: Injection site irritation, pain, abscess formation[Ref]

Musculoskeletal

Frequency not reported: Polyarthritis[Ref]

Renal

Frequency not reported: Renal dysfunction, as shown by azotemia, oliguria, and/or proteinuria[Ref]

References

1. de Groot MC, van Puijenbroek EP "Clindamycin and taste disorders." Br J Clin Pharmacol 64 (2007): 542-5

2. Meadowcroft AM, Diaz PR, Latham GS "Clostridium difficile toxin-induced colitis after use of clindmycin phosphate vaginal cream." Ann Pharmacother 32 (1998): 309-11

3. Davies J, Beck E "Recurrent colitis following antibiotic-associated pseudomembranous colitis." Postgrad Med J 57 (1981): 599-601

4. Milstone EB, McDonald AJ, Scholhamer CF Jr "Pseudomembranous colitis after topical application of clindamycin." Arch Dermatol 117 (1981): 154-5

5. Bartlett JG "Narrative review: the new epidemic of Clostridium difficile-associated enteric disease." Ann Intern Med 145 (2006): 758-64

6. Cerner Multum, Inc. "Australian Product Information." O 0

7. Leigh DA, Simmons K, Williams S "Gastrointestinal side effects following clindamycin and lincomycin treatment: a follow up study." J Antimicrob Chemother 6 (1980): 639-45

8. George WL, Sutter VL, Finegold SM "Antimicrobial agent-induced diarrhea--a bacterial disease." J Infect Dis 136 (1977): 822-8

9. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

10. Wilson DH "Clindamycin in the treatment of soft tissue infections: a review of 15,019 patients." Br J Surg 67 (1980): 93-6

11. Mason SJ, O'Meara TF "Drug-induced esophagitis." J Clin Gastroenterol 3 (1981): 115-20

12. Geddes AM, Bridgwater FA, Williams DN, Oon J, Grimshaw GJ "Clinical and bacteriological studies with clindamycin." Br Med J 2 (1970): 703-4

13. Parry MF, Rha CK "Pseudomembranous colitis caused by topical clindamycin phosphate." Arch Dermatol 122 (1986): 583-4

14. Van Ness MM, Cattau EL Jr "Fulminant colitis complicating antibiotic-associated pseudomembranous colitis: case report and review of the clinical manifestations and treatment." Am J Gastroenterol 82 (1987): 374-7

15. Cone JB, Wetzel W "Toxic megacolon secondary to pseudomembranous colitis." Dis Colon Rectum 25 (1982): 478-82

16. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn, Kalamazoo, MI.

17. Clark BM, Homeyer DC, Glass KR, D'Avignon LC "Clindamycin-Induced Sweet's Syndrome." Pharmacotherapy 27 (2007): 1343-6

18. Vidal C, Iglesias A, Saez A, Rodriguez M "Hypersensitivity to clindamycin." DICP 25 (1991): 317

19. Kapoor R, Flynn C, Heald PW, Kapoor JR "Acute generalized exanthematous pustulosis induced by clindamycin." Arch Dermatol 142 (2006): 1080-1

20. Miller Quidley A, Bookstaver PB, Gainey AB, Gainey MD "Fatal clindamycin-induced drug rash with eosinophilia and systemic symptoms (DRESS) syndrome." Pharmacotherapy (2012):

21. Tian D, Mohan RJ, Stallings G "Drug rash with eosinophilia and systemic symptoms syndrome associated with clindamycin." Am J Med 123 (2010): e7-8

22. Paquet P, Schaaflafontaine N, Pierard GE "Toxic epidermal necrolysis following clindamycin treatment." Br J Dermatol 132 (1995): 665-6

23. Lammintausta K, Tokola R, Kalimo K "Cutaneous adverse reactions to clindamycin: results of skin tests and oral exposure." Br J Dermatol 146 (2002): 643-8

24. Bubalo JS, Blasdel CS, Bearden DT "Neutropenia after single-dose clindamycin for dental prophylaxis." Pharmacotherapy 23 (2003): 101-3

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