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Clindamycin

Pronunciation: clin-dah-my-cin
Generic name: clindamycin
Brand names: Cleocin HCl, Cleocin Pediatric, Cleocin Phosphate, Cleocin Phosphate ADD-Vantage, Clindesse, ClindaMax Vaginal
Dosage form: oral capsule, oral solution, topical gel, topical foam, injectable solution, intravenous ready-to-use solution
Drug class: Lincomycin derivatives

Medically reviewed by Carmen Pope, BPharm. Last updated on Aug 14, 2024.

What is clindamycin?

Clindamycin is an antibiotic that fights bacteria in the body.

Clindamycin is used to treat serious infections caused by bacteria.

Clindamycin is usually available as one of three salts: clindamycin phosphate, clindamycin hydrochloride, or clindamycin nicotinamide. These salt forms are all prodrugs of clindamycin but once inside the body or applied to the skin, they are rapidly converted to active clindamycin by hydrolysis. All three salt forms of clindamycin: clindamycin phosphate, clindamycin hydrochloride, and clindamycin nicotinamide have the same antimicrobial spectrum and effectiveness.

Clindamycin first gained FDA approval on February 22, 1970.

What is clindamycin phosphate?

Clindamycin phosphate is a salt of clindamycin that is usually used for injectable or topical formulations of clindamycin.

What is clindamycin hydrochloride?

Clindamycin hydrochloride is a salt of clindamycin that is usually used for oral formulations of clindamycin.

What is clindamycin used to treat?

Clindamycin may be used to treat a wide range of infections, although it should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria to reduce the development of drug-resistant bacteria and to maintain its effectiveness.

Infections clindamycin treats in adults and children include serious:

  • Infections caused by susceptible anaerobic bacteria
  • Infections due to susceptible isolates of streptococci, pneumococci, and staphylococci, if a less toxic alternative (such as erythromycin) is not suitable
  • Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by susceptible isolates of anaerobes, Streptococcus pneumoniae, other streptococci (except Enterococcus faecalis), and Staphylococcus aureus in adults and children
  • Skin and skin structure infections caused by susceptible isolates of Streptococcus pyogenes, Staphylococcus aureus, and anaerobes in adults and children
    • Topical clindamycin 1% may be used to help treat and control severe acne.
  • Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes in adults and children
  • Intra-abdominal infections including peritonitis and intra-abdominal abscesses caused by susceptible anaerobic organisms in adults and children
  • Septicemia caused by susceptible isolates of Staphylococcus aureus, streptococci (except E. faecalis), and susceptible anaerobes in adults and children
  • Bone and joint infections including acute hematogenous osteomyelitis caused by susceptible isolates of S. aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections due to susceptible organisms in adults and children.

Clindamycin does not adequately penetrate the cerebrospinal fluid and should NOT be used to treat meningitis.

Clindamycin side effects

The most common clindamycin side effects include:

Clindamycin may also cause a metallic taste in your mouth. Talk to your healthcare provider about ways you can manage this.

Serious side effects and warnings

Clindamycin carries a Boxed Warning for Clostridium difficile-associated diarrhea (CDAD).

Clindamycin can cause diarrhea, which may range in severity from mild to fatal colitis. Diarrhea associated with clindamycin use is sometimes caused by an overgrowth of dangerous Clostridium difficile bacteria in the large intestine. Seniors especially should be monitored for diarrhea. If you have diarrhea that is watery or bloody, stop using clindamycin and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to. Seek urgent medical attention.

Get emergency medical help if you have any signs of an allergic reaction to clindamycin: (hives, difficulty breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Serious skin and other reactions can occur with clindamycin. Seek medical treatment if you have symptoms of a drug reaction such as skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after starting clindamycin.

Call your healthcare provider at once if you have:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking this medicine

Do not take clindamycin if you are allergic to clindamycin, lincomycin, Cleocin, Clindesse, ClindaMax, or any of the inactive ingredients in the clindamycin preparation you are taking (refer to the clindamycin Package Insert).

To make sure clindamycin is safe for you, tell your doctor if you have ever had:

Also, tell your healthcare provider if you are pregnant or intend to become pregnant or are breastfeeding.

Pregnancy

Animal studies have not shown any harm during pregnancy, but it is not known whether clindamycin will harm an unborn baby in humans.

Breastfeeding

Clindamycin does pass into breast milk and may cause side effects in the nursing baby. If you are breastfeeding while taking this medicine, call your doctor if your baby has diaper rash, redness or white patches in the mouth or throat, stomach discomfort, or diarrhea that is watery or bloody. Let your doctor know if you are breastfeeding before taking clindamycin.

Young infants

Clindamycin injection may contain an ingredient that can cause serious side effects or death in very young or premature babies. Do not give this medicine to a child without medical advice.

How should I take clindamycin?

Take clindamycin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Oral clindamycin capsules are taken by mouth.

Clindamycin injection is injected into a muscle, or as an infusion into a vein. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.

Take the capsule with a full glass of water to keep it from irritating your throat.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

You may need frequent medical tests during treatment.

If you need surgery, let your surgeon know you use clindamycin as it may interact with certain drugs used for anesthesia.

Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Clindamycin will not treat a viral infection such as the flu or a common cold.

Store at room temperature away from moisture and heat. Protect the injectable medicine from high heat.

Do not store the oral liquid in the refrigerator. Throw away any unused oral liquid after 2 weeks.

Take clindamycin for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Clindamycin will not treat a viral infection such as the common cold or flu.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using clindamycin?

Do not use clindamycin at the same time as erythromycin, another antibiotic.

What other drugs will affect clindamycin?

Other drugs may interact with clindamycin, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicines you start or stop using.

Clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents, such as succinylcholine, rocuronium, or vecuronium. Use with caution.

Clindamycin is metabolized predominantly by CYP3A4 hepatic enzymes, and to a lesser extent by CYP3A5, to the major metabolite clindamycin sulfoxide and minor metabolite N‑desmethylclindamycin. Caution should be used when using with strong or moderate inhibitors of CYP3A4 and CYP3A5, such as clarithromycin, nefazodone, itraconazole, ketoconazole, atazanavir, darunavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, or tipranavir. Caution should also be used when used together with inducers of these enzymes such as phenobarbital, phenytoin, rifampicin, St. John's Wort, and glucocorticoids because concentrations of clindamycin may be reduced and it may not be as effective.

This is not a complete list of interactions. See the clindamycin package insert for a complete list.

Clindamycin ingredients

Ingredients of clindamycin vary depending on the manufacturer. See the clindamycin package insert that corresponds to the clindamycin product you are using.

Who makes clindamycin?

Clindamycin is made by various manufacturers such as Baxter Healthcare, Northstar RX, Taro Pharmaceuticals, and Greenstone LLC.

Popular FAQ

What are the best antibiotics for a tooth infection?

There are several antibiotics that kill the common mouth bacteria that cause tooth infections. The best (first-line) antibiotics for tooth infection include: Amoxicillin, Penicillin, Cephalexin, Clindamycin, Azithromycin. Amoxicillin is often the first choice because it is widely effective and has the fewest gastrointestinal side effects. Continue reading

What is the best antibiotic to treat strep throat?

Penicillin or amoxicillin are considered the best first-line treatments for Strep throat. According to the CDC (Centers for Disease Control and Prevention) “ There has never been a report of a clinical isolate of group A strep that is resistant to penicillin”. For people with a penicillin allergy, treat Strep throat with either a narrow-spectrum cephalosporin (such as cephalexin or cefadroxil), clindamycin, azithromycin, or clarithromycin. Note that resistance to azithromycin and clarithromycin has been reported. Continue reading

Is clindamycin a strong antibiotic?

Clindamycin is a strong broad-spectrum antibiotic, typically prescribed for serious infections, such as life-threatening methicillin-resistant Staphylococcus aureus (MRSA) skin infections. Continue reading

Can I take clindamycin if I am allergic to penicillin?

Yes, you can. It is recommended that the use of the antibiotic clindamycin be reserved for patients who are allergic to penicillin or for those patients a healthcare provider determines penicillin to be an inappropriate treatment. Continue reading

Is clindamycin a penicillin?

No, clindamycin is not a penicillin antibiotic. Instead, it belongs to a class of medications known as lincomycin antibiotics, or lincosamides. Clindamycin is a broad-spectrum antibiotic, with the ability to impact many types of bacteria in the body. Continue reading

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Further information

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