Clindamycin Side Effects

Some side effects of clindamycin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to clindamycin: for solution oral, oral capsule, oral powder for reconstitution

Get emergency medical help if you have any of these signs of an allergic reaction while taking clindamycin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using clindamycin and call your doctor at once if you have any of these serious side effects:

• diarrhea that is watery or bloody;

• jaundice (yellowing of the skin or eyes);

• urinating less than usual or not at all;

• fever, chills, body aches, flu symptoms, sores in your mouth and throat;

• easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin; or

• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Less serious side effects of clindamycin may include:

• change in bowel habits (especially in older adults);

• mild nausea, vomiting, or stomach pain;

• joint pain;

• vaginal itching or discharge;

• mild rash or itching; or

• heartburn, irritation in your throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

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. It appears as a pale plaque on direct visualization of the mucosa by endoscopy and is sensitive to oral vancomycin or metronidazole. Pseudomembranous colitis may be associated with toxic megacolon, which can be life-threatening.

Frequency not reported: Nausea, vomiting, abdominal pain, esophagitis, diarrhea, Clostridium difficile associated diarrhea, pseudomembranous colitis, dry mouth, hairy tongue, upset stomach, gastrointestinal bleeding, mouth irritation

Hypersensitivity

Rare (less than 0.1%): Erythema multiforme, anaphylactoid reactions, leukocytoclastic angiitis, toxic epidermal necrolysis, Stevens-Johnson syndrome
Frequency not reported: Vesiculobullous rashes, urticaria, edema, generalized mild to moderate morbilliform-like (maculopapular) skin rashes, drug rash with eosinophilia and systemic symptoms (DRESS syndrome)

Some cases of erythema multiforme resembled Stevens-Johnson syndrome.

Rare cases of leukocytoclastic angiitis, toxic epidermal necrolysis, erythema multiforme, and Stevens-Johnson syndrome associated with clindamycin hypersensitivity have been reported.

Dermatologic

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.

Rare (less than 0.1%): Exfoliative dermatitis, erythema multiforme, Stevens-Johnson syndrome, drug-induced Sweet's syndrome (at least 2 cases)
Frequency not reported: Pruritus, maculopapular rash (generalized pruritic), vesiculobullous rash, urticaria, acute generalized exanthematous pustulosis

Cardiovascular

Rare (less than 0.1%): High degree heart block, hypotension, cardiopulmonary arrest

Rare cases of high degree heart block, hypotension, and cardiopulmonary arrest have been reported after clindamycin was administered intravenously over several minutes. In these cases, the affected patients subsequently tolerated slow infusions of clindamycin.

Hematologic

Frequency not reported: Transient neutropenia (leukopenia), transient eosinophilia, agranulocytosis, thrombocytopenia, granulocytopenia

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 neutrophil count normalized after 2 weeks.

Hepatic

Frequency not reported: Jaundice, abnormalities in liver function tests, cholestatic liver disease with ductopenia

Renal

Rare (less than 0.1%): Renal dysfunction (as shown by azotemia, oliguria, proteinuria)

Nervous system

Frequency not reported: Taste perversion/disorders (including bitter taste, taste loss, bad taste, taste alteration), parosmia

Genitourinary

Frequency not reported: Vaginitis

Musculoskeletal

Rare (less than 0.1%): Polyarthritis

Local

Pain, induration, and sterile abscess have been reported after intramuscular administration and thrombophlebitis after intravenous infusion.

Frequency not reported: Pain, induration, sterile abscess, thrombophlebitis

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