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Drug Interactions between clindamycin and rifampin

This report displays the potential drug interactions for the following 2 drugs:

  • clindamycin
  • rifampin

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Interactions between your drugs

Moderate

clindamycin rifAMPin

Applies to: clindamycin and rifampin

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with strong CYP450 3A4 inducers may decrease plasma concentrations and antimicrobial effects of clindamycin, which is metabolized predominantly by the isoenzyme. In a pharmacokinetic analysis among patients (n=34) with staphylococcal osteoarticular infection receiving treatment with clindamycin (600 mg 3 times a day) and either rifampin (a strong CYP450 3A4 inducer; 600 mg twice a day) or levofloxacin (500 mg twice a day), rifampin treatment led to a statistically significant reduction in clindamycin mean trough concentrations and Cmax values of 0.79 and 3.48 mcg/mL, respectively, compared to 4.7 and 10.2 mcg/mL, respectively for patients treated with levofloxacin (p < 0.001). However, while these findings confirm rifampin is an effective inducer of clindamycin, this combination has been used clinically with some success. The extent of the interaction or clinical use with other 3A4 inducers has not been established.

MANAGEMENT: Monitor closely for diminished therapeutic response to clindamycin during coadministration with strong CYP450 3A4 inducers. Dosage adjustments as well as clinical and laboratory monitoring should be considered whenever a strong CYP450 3A4 inducer is added to or withdrawn from therapy with clindamycin. An alternative agent with no or minimal CYP450 3A4-inducing activity may also be considered.

References

  1. Bernard A, Kermarrec G, Parize P, et.al "Dramatic reduction of clindamycin serum concentration in staphylococcal osteoarticular infection patients treated with the oral clindamycin-rifampicin combination." J Infect 71 (2015): 200-6
  2. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn, Kalamazoo, MI.

Drug and food interactions

No interactions were found. This does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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