Clindamycin Side Effects

For the Consumer

Applies to clindamycin: oral capsule, oral powder for solution

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

Major Side Effects

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
• 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
• trouble breathing
• unconscious
• unpleasant breath odor
• unusual bleeding or bruising
• unusual tiredness or weakness
• unusual weight loss
• vomiting of blood
• yellow eyes or skin

Applies to clindamycin: solution

In addition to its needed effects, some unwanted effects may be caused by clindamycin. 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, check with your doctor or nurse immediately:

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
• 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
• 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

Minor Side Effects

Some of the side effects that can occur with clindamycin may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

Incidence not known:

• Bitter taste
• changes in skin color
• pain, lump, or irritation at the injection site

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.^[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 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]

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