Clindamycin/niacinamide topical Disease Interactions

Clindamycin may be systemically absorbed when applied to the skin or mucosal membranes. Pseudomembranous colitis has been reported with systemically as well as topically administered clindamycin and may range in severity from mild to life-threatening, with an onset of up to several weeks following cessation of therapy. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. Therapy with topical clindamycin 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. Certain products may be contraindicated by the manufacturer, and prescribers are advised to consult the package labeling. Clindamycin 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.

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