Interactions between Cleocin Phosphate and Polymyxin b

The clindamycin in Cleocin Phosphate has a moderate potential interaction with 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.

The clindamycin in Cleocin Phosphate has a major potential interaction with Noninfectious Colitis.

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

The polymyxin B sulfate in polymyxin b has a major potential interaction with Noninfectious Colitis.

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

The clindamycin in Cleocin Phosphate has a major potential interaction with 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.

The polymyxin B sulfate in polymyxin b has a major potential interaction with Renal Dysfunction.

Albuminuria, cellular casts/cylindruria, and azotemia are generally seen in patients with nephrotoxicity due to polymyxin B sulfate; nephrotoxic reactions have also included rising blood levels without any increase in dosage. Renal function should be carefully determined, and the dosage should be reduced in patients with renal damage and nitrogen retention. Polymyxin B sulfate should be discontinued if urine output decreases and BUN increases.

Neurotoxic reactions with polymyxin B sulfate may be shown by drowsiness, irritability, weakness, perioral paresthesia, numbness of the extremities, ataxia, and blurring of vision; such reactions are generally associated with high serum levels found in patients with impaired renal function and/or nephrotoxicity. The neurotoxicity of polymyxin B sulfate can lead to respiratory paralysis from neuromuscular blockade, particularly when administered soon after anesthesia and/or muscle relaxants. If signs of respiratory paralysis develop, respiration should be assisted as required and polymyxin B sulfate should be discontinued.

Baseline renal function should be determined before therapy, and renal function and blood polymyxin B sulfate levels should be monitored frequently during parenteral therapy. Coadministration with or sequential use of other neurotoxic and/or nephrotoxic agents should be avoided.

The clindamycin in Cleocin Phosphate has a moderate potential interaction with 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.