Clindamycin topical Side Effects

Not all side effects for clindamycin topical 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 topical: vaginal cream, vaginal suppository

In addition to its needed effects, some unwanted effects may be caused by clindamycin topical. In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking clindamycin topical, check with your doctor or nurse as soon as possible:

More common
  • Itching of the vagina or genital area
  • pain during sexual intercourse
  • thick, white vaginal discharge with no odor or with mild odor
Less common
  • Diarrhea
  • dizziness
  • headache
  • nausea or vomiting
  • stomach pain or cramps
Rare
  • Burning, itching, rash, redness, swelling or other signs of skin problems not present before use of this medicine

After you stop taking this drug, it is possible that you may still experience side effects that need medical attention. If you notice any of the following side effects check with your doctor immediately:

  • Itching of the vagina or genital area
  • pain during sexual intercourse
  • thick, white vaginal discharge with no odor or with mild odor

For Healthcare Professionals

Applies to clindamycin topical: topical foam, topical gel, topical kit, topical lotion, topical solution, topical swab, vaginal cream, vaginal suppository

Gastrointestinal

Gastrointestinal side effects have included diarrhea in patients treated with clindamycin topical (less than 0.1% incidence), although in most cases it resolved despite continued therapy. Bloody diarrhea and colitis (including pseudomembranous colitis) have been reported rarely with topical clindamycin. In general, these cases involved extemporaneously prepared solutions of clindamycin hydrochloride. Rarely, heartburn, nausea, vomiting, constipation, and abdominal pain have been reported during use of clindamycin vaginal cream. Diarrhea, abdominal pain, abdominal discomfort, nausea, colitis (including pseudomembranous colitis), and hemorrhagic diarrhea have been reported during postmarketing experience with clindamycin topical foam. Abdominal pain and gastrointestinal disturbances have been reported during postmarketing experience with clindamycin topical. Oral and parenteral clindamycin have been associated with severe colitis, including fatal cases.[Ref]

Clindamycin has not been shown to have significant effects on colon flora. In one study, Clostridium difficile was detected in the stool of 4 of 19 patients receiving topical clindamycin for eight weeks. No C difficile was detected in the stool of patients receiving placebo. However, the difference was not statistically significant. Diarrhea was not reported in any patient.[Ref]

Local

Local side effects have been frequently reported with clindamycin topical. These have included transient drying, followed by erythema, burning, peeling, and itching. Contact dermatitis has been reported infrequently. Oiliness or oily skin has also been reported. Application site pain, application site erythema, and application site rash have been reported during postmarketing experience with clindamycin topical foam.[Ref]

The foam, gel, and lotion formulations are less drying than the solution formulation, which contains alcohol.[Ref]

Genitourinary

Genitourinary side effects have included vulvar irritation during use of clindamycin vaginal cream. Yeast overgrowth resulting in the development of fungal vaginitis has been reported. Symptomatic vaginal candida infection has also been reported in approximately 10% of women treated with intravaginal clindamycin.[Ref]

Nervous system

A 14-year-old boy developed reproducible ringing in his right ear and hearing loss while using clindamycin topical and after discontinuing use. He underwent a complete physical exam and labs which failed to find a cause for his symptoms. The patient was restarted on benzoyl peroxide/clindamycin topical and the ringing in his ear increased. He was told to stop all medications and was started on methylprednisolone. The tinnitus decreased in 1 to 2 days with no improvement in the hearing deficit. After the third time he was restarted on benzoyl peroxide/clindamycin gel, the tinnitus returned at an increased level together with right-sided headaches within 1 to 2 days. The patient again stopped using the benzoyl peroxide and clindamycin gel and the tinnitus returned to a low level over 1 to 2 days. It is believed that the clindamycin component played a part in this patient's tinnitus and hearing loss.[Ref]

Nervous system side effects associated with the topical foam have included headache (3%). Headache, dizziness, and vertigo have been reported with clindamycin vaginal cream. At least one case of ringing in the ear and partial hearing loss believed to be caused by clindamycin topical has been reported. Dizziness has been reported during postmarketing experience with clindamycin topical foam.[Ref]

Dermatologic

Dermatologic side effects have included urticaria, rash, seborrhea, and pain of skin during postmarketing experience with clindamycin topical foam. Gram-negative folliculitis has been reported during postmarketing experience with clindamycin topical.[Ref]

Hypersensitivity

Hypersensitivity side effects have included hypersensitivity during postmarketing experience with clindamycin topical foam.

References

1. Voron DA "Systemic absorption of topical clindamycin." Arch Dermatol 114 (1978): 798

2. Trexler MF, Fraser TG, Jones MP "Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream." Am J Gastroenterol 92 (1997): 2112-3

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

4. Siegle RJ, Fekety R, Sarbone PD, Finch RN, Deery HG, Voorhees JJ "Effects of topical clindamycin on intestinal microflora in patients with acne." J Am Acad Dermatol 15 (1986): 180-5

5. Gallerani M, Ricci L, Calo G, Manfredini R "Abdominal pain and diarrhoea caused by topical clindamycin phosphate." Clin Drug Invest 14 (1997): 243-5

6. Fisher AA "Adverse reactions to topical clindamycin, erythromycin and tetracycline." Cutis 32 (1983): 415,419,424,428

7. Borglund E, Hagermark O, Nord CE "Impact of topical clindamycin and systemic tetracycline on the skin and colon microflora in patients with acne vulgaris." Scand J Infect Dis Suppl 43 (1984): 76-81

8. "Product Information. Evoclin (clindamycin topical)." Connetics Inc, Palo Alto, CA.

9. Becker LE, Bergstresser PR, Whiting DA, Clendenning WE, Dobson RL, Jordan WP, Abell E, LeZotte LA, Pochi PE, Shupack JL, Sigafoes RB, Stoughton RB "Topical clindamycin therapy for acne vulgaris. A cooperative clinical study." Arch Dermatol 117 (1981): 482-5

10. Vikenes K, LundTonnesen S, Schreiner A "Clostridium difficile-associated diarrhea after short term vaginal administration of clindamycin." Am J Gastroenterol 94 (1999): 1969-70

11. "Product Information. Cleocin vaginal cream (clindamycin)." Pharmacia and Upjohn, Kalamazoo, MI.

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

13. "Product Information. Clindesse (clindamycin topical)." Ther-Rx Corporation, Bridgeton, MO.

14. Stoughton RB, Cornell RC, Gange RW, Walter JF "Double-blind comparison of topical 1 percent clindamycin phosphate (Cleocin T) and oral tetracycline 500 mg/day in the treatment of acne vulgaris." Cutis 26 (1980): 424-5,429

15. Thiboutot D, Zaenglein A, Weiss J, Webster G, Calvarese B, Chen D "An aqueous gel fixed combination of clindamycin phosphate 1.2% and benzoyl peroxide 2.5% for the once-daily treatment of moderate to severe acne vulgaris: Assessment of efficacy and safety in 2813 patients." J Am Acad Dermatol 59 (2008): 792-800

16. Shahlita AR, Smith EB, Bauer E "Topical erythromycin v clindamycin therapy for acne. A multicenter, double-blind comparison." Arch Dermatol 120 (1984): 351-5

17. Goltz RW, Coryell GM, Schnieders JR, Neidert GL "A comparison of Cleocin T 1 percent solution and Cleocin T 1 percent lotion in the treatment of acne vulgaris." Cutis 36 (1985): 265-8

18. Parker F "A comparison of clindamycin 1% solution versus clindamycin 1% gel in the treatment of acne vulgaris." Int J Dermatol 26 (1987): 121-2

19. Algra RJ, Rosen T, Waisman M "Topical clindamycin in acne vulgaris. Safety and stability." Arch Dermatol 113 (1977): 1390-1

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