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Cleocin HCl (clindamycin) Disease Interactions

There are 4 disease interactions with Cleocin HCl (clindamycin):

Major

Mdvs (Includes Cleocin HCl) ↔ Prematurity

Severe Potential Hazard, Moderate plausibility

Applies to: Prematurity/Underweight in Infancy

Parenteral medications formulated in multidose vials often contain benzyl alcohol as a preservative. Their use is considered by drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. When used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, benzyl alcohol has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. Thus, single-dose formulations should always be used in infants whenever possible. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. However, the administration of high dosages of these medications must take into account the total amount of benzyl alcohol administered. The level at which toxicity may occur is unknown.

References

  1. ""Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Available from: URL: http://www.aap.org/policy/re9706.html." Pediatrics 99 (1997): 268-78
  2. "Product Information. Tracrium (atracurium)." Glaxo Wellcome, Research Triangle Park, NC.
  3. "Product Information. Fragmin (dalteparin)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 6 references
Moderate

Antibiotics (Includes Cleocin HCl) ↔ Colitis

Moderate Potential Hazard, High plausibility

Applies to: Colitis/Enteritis (Noninfectious)

Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.

References

  1. Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
  2. Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
  3. Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
View all 47 references
Moderate

Clindamycin (Includes Cleocin HCl) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Clindamycin is primarily metabolized by the liver. The serum concentration of clindamycin may be increased and the half-life prolonged in patients with severely impaired hepatic function. In addition, jaundice and liver enzyme abnormalities may occur during use of the drug. Therapy with clindamycin should be administered cautiously in patients with liver disease. Dosage adjustments may not be necessary when administered every 8 hours. However, serum concentrations should be monitored during high-dose therapy, and periodic liver function tests should be performed during prolonged therapy.

References

  1. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn, Kalamazoo, MI.
  2. Hinthorn DR, Baker LH, Romig DA, et al "Use of clindamycin in patients with liver disease." Antimicrob Agents Chemother 9 (1976): 498-501
  3. Eng RH, Gorski S, Person A, et al "Clindamycin elimination in patients with liver disease." J Antimicrob Chemother 8 (1981): 277-81
View all 4 references
Moderate

Clindamycin (Includes Cleocin HCl) ↔ Renal Dysfunction

Moderate Potential Hazard, Low plausibility

Applies to: Renal Dysfunction

Clindamycin is eliminated by the kidney to a limited extent. Therapy with clindamycin should be administered cautiously in patients with severely impaired renal function. Dosage adjustments are probably not necessary. However, serum clindamycin concentrations should be monitored during high-dose therapy, and periodic renal function tests should be performed during prolonged therapy.

References

  1. Eastwood JB, Gower PE "A study of the pharmacokinetics of clindamycin in normal subjects and patients with chronic renal failure." Postgrad Med J 50 (1974): 710-2
  2. Peddie BA, Dann E, Bailey RR "The effect of impairment of renal function and dialysis on the serum and urine levels of clindamycin." Aust N Z J Med 5 (1975): 198-202
  3. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn, Kalamazoo, MI.

Cleocin HCl (clindamycin) drug Interactions

There are 45 drug interactions with Cleocin HCl (clindamycin)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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