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Clindamycin and Tretinoin

Medically reviewed by Drugs.com. Last updated on Jun 18, 2020.

Pronunciation

(klin da MYE sin & TRET i noyn)

Index Terms

  • Clindamycin Phosphate and Tretinoin
  • Clindamycin/Tretinoin
  • Tretinoin and Clindamycin
  • Veltin

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Gel, External:

Veltin: Clindamycin phosphate 1.2% and tretinoin 0.025% (30 g, 60 g) [contains edetate disodium, methylparaben, propylene glycol]

Ziana: Clindamycin phosphate 1.2% and tretinoin 0.025% (30 g, 60 g) [contains methylparaben, propylparaben]

Generic: Clindamycin phosphate 1.2% and tretinoin 0.025% (30 g, 60 g)

Brand Names: U.S.

  • Veltin
  • Ziana

Pharmacologic Category

  • Acne Products
  • Retinoic Acid Derivative
  • Topical Skin Product
  • Topical Skin Product, Acne

Pharmacology

Clindamycin reversibly binds to 50S ribosomal subunits preventing peptide chain elongation thus inhibiting bacterial protein synthesis. Clindamycin exhibits in vitro activity against Cutibacterium acnes, an organism associated with acne vulgaris. Topical tretinoin is believed to decrease follicular epithelial cells cohesiveness and increase follicular epithelial cell turnover resulting in decreased microcomedo formation and increased expulsion of comedones.

Absorption

Topical: Tretinoin: Minimal systemic absorption; Clindamycin: Low, but variable systemic absorption

Use: Labeled Indications

Acne: For the treatment of acne vulgaris in patients ≥12 years.

Contraindications

Regional enteritis, ulcerative colitis, history of antibiotic-associated colitis

Canadian labeling: Additional contraindications (not in US labeling): Hypersensitivity to clindamycin, tretinoin, or any component of the formulation; hypersensitivity to lincomycin

Dosing: Adult

Acne: Topical: Apply once daily in the evening or at bedtime.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Pediatric

Acne vulgaris: Topical: Children ≥12 years and Adolescents: Topical: Apply pea-size amount to entire face once daily in the evening or at bedtime; Note: Higher dosages (larger amount or more frequent use) have not been shown to improve efficacy and are associated with increased adverse effects (eg, skin irritation).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Administration

For external use only. Not for ophthalmic, oral, or intravaginal use. Prior to application, gently wash face with a mild soap and pat dry. Apply in the evening or at bedtime. Apply a pea-size amount to one fingertip and then dotted on chin, cheeks, nose, and forehead. Avoid contact with sunburned skin. Gently rub over entire face or entire affected area while avoiding eyes, mouth, angles of nose, and mucous membranes.

Storage

Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F); do not freeze. Protect from heat and light.

Drug Interactions

Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). Avoid combination

Aminolevulinic Acid (Topical): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). Monitor therapy

Erythromycin (Systemic): May diminish the therapeutic effect of Clindamycin (Topical). Avoid combination

Erythromycin (Topical): May diminish the therapeutic effect of Clindamycin (Topical). Avoid combination

Multivitamins/Fluoride (with ADE): May enhance the adverse/toxic effect of Retinoic Acid Derivatives. Avoid combination

Multivitamins/Minerals (with ADEK, Folate, Iron): May enhance the adverse/toxic effect of Retinoic Acid Derivatives. Avoid combination

Multivitamins/Minerals (with AE, No Iron): May enhance the adverse/toxic effect of Retinoic Acid Derivatives. Avoid combination

Neuromuscular-Blocking Agents: Clindamycin (Topical) may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Monitor therapy

Porfimer: Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. Monitor therapy

Verteporfin: Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. Monitor therapy

Adverse Reactions

Frequency not defined.

>10%: Dermatologic: Burning sensation of skin, desquamation, erythema, xeroderma

1% to 10%:

Dermatologic: Dermatitis, pruritus, skin irritation, stinging of the skin, sunburn

Gastrointestinal: Gastrointestinal symptoms (unspecified)

Respiratory: Nasopharyngitis

Warnings/Precautions

Concerns related to adverse effects:

• Photosensitivity: Tretinoin use is associated with increased susceptibility/sensitivity to ultraviolet (UV) light; avoid sunlamps or excessive sunlight exposure. Daily sunscreen use and other protective measures recommended. Use is not recommended in patients with sunburn.

• Skin irritation: Treatment can increase skin sensitivity to weather extremes of wind or cold. Also, concomitant topical medications (eg, medicated or abrasive soaps, cleansers, or cosmetics with a strong drying effect) should be used with caution due to increased skin irritation.

• Superinfection: Prolonged use may result in fungal or bacterial superinfection, including Clostridioides (formerly Clostridium) difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment. Discontinue drug if significant diarrhea, abdominal cramps, or passage of blood and mucus occurs.

Dosage form specific issues:

• Polysorbate 80: Some dosage forms may contain polysorbate 80 (also known as Tweens). Hypersensitivity reactions, usually a delayed reaction, have been reported following exposure to pharmaceutical products containing polysorbate 80 in certain individuals (Isaksson 2002; Lucente 2000; Shelley 1995). Thrombocytopenia, ascites, pulmonary deterioration, and renal and hepatic failure have been reported in premature neonates after receiving parenteral products containing polysorbate 80 (Alade 1986; CDC 1984). See manufacturer’s labeling.

Other warnings/precautions:

• Appropriate use: For external use only; not for ophthalmic, oral, or intravaginal use; avoid mucous membranes, eyes, mouth, and angles of nose.

Pregnancy Risk Factor

C

Pregnancy Considerations

Adverse events were observed in animal reproduction studies using this combination topically. See individual agents.

Patient Education

What is this drug used for?

• It is used to treat pimples (acne).

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Skin irritation

• Itching

• Burning

• Peeling

• Skin discoloration

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Severe injection site irritation

• Severe diarrhea

• Black, tarry, or bloody stools

• Abdominal pain

• Abdominal cramps

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

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