In the U.S.—

In Canada—

• Antibacterial, systemic
• Antiprotozoal

Clindamycin (klin-da-MYE-sin ) is used to treat bacterial infections. It will not work for colds, flu, or other virus infections.

Clindamycin is available only with your doctor's prescription, in the following dosage forms:

Oral
• Capsules (U.S. and Canada)
• Oral solution (U.S. and Canada)

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For clindamycin, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to clindamycin, lincomycin, or doxorubicin. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Clindamycin has not been reported to cause birth defects or other problems in humans.

Breast-feeding—Clindamycin passes into the breast milk. However, clindamycin has not been reported to cause problems in nursing babies.

Children—This medicine has been tested in children and, in effective doses, has not been reported to cause different side effects or problems than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of clindamycin in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking clindamycin, it is especially important that your health care professional know if you are taking any of the following:

• Chloramphenicol (e.g., Chloromycetin) or
• Diarrhea medicine containing kaolin or attapulgite or
• Erythromycins (medicine for infection)—Taking these medicines along with clindamycin may decrease the effects of clindamycin

• Kidney disease (severe) or
• Liver disease (severe)—Severe kidney or liver disease may increase blood levels of this medicine, increasing the chance of side effects

• Stomach or intestinal disease, history of (especially colitis, including colitis caused by antibiotics, or enteritis)—Patients with a history of stomach or intestinal disease may have an increased chance of side effects

For patients taking the capsule form of clindamycin:

• The capsule form of clindamycin should be taken with a full glass (8 ounces) of water or with meals to prevent irritation of the esophagus (tube between the throat and stomach).

For patients taking the oral liquid form of clindamycin:

• Use a specially marked measuring spoon or other device to measure each dose accurately. The average household teaspoon may not hold the right amount of liquid.
• Do not use after the expiration date on the label. The medicine may not work properly after this date. Check with your pharmacist if you have any questions about this.

To help clear up your infection completely, keep taking this medicine for the full time of treatment, even if you begin to feel better after a few days. If you have a ``strep'' infection, you should keep taking this medicine for at least 10 days. This is especially important in "strep" infections. Serious heart problems could develop later if your infection is not cleared up completely. Also, if you stop taking this medicine too soon, your symptoms may return.

This medicine works best when there is a constant amount in the blood. To help keep the amount constant, do not miss any doses. Also, it is best to take each dose at evenly spaced times day and night. For example, if you are to take 4 doses a day, doses should be spaced about 6 hours apart. If this interferes with your sleep or other daily activities, or if you need help in planning the best times to take your medicine, check with your health care professional.

Dosing—

The dose of clindamycin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of clindamycin. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or teaspoonfuls of solution that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking clindamycin.

• For bacterial infection:
  • For oral dosage forms (capsules and solution):
    • Adults and teenagers—150 to 300 milligrams (mg) every six hours.
    • Children—
      • Infants up to 1 month of age: Use and dose must be determined by your doctor.
      • Infants and children 1 month of age and older: Dose is based on body weight. The usual dose is 2 to 5 mg per kilogram (kg) (0.9 to 2.3 mg per pound) of body weight every six hours; or 2.7 to 6.7 mg per kg (1.2 to 3.0 mg per pound) of body weight every eight hours.
  • For injection dosage form:
    • Adults and teenagers—300 to 600 mg every six to eight hours injected into a muscle or vein; or 900 mg every eight hours injected into a muscle or vein.
    • Children—
      • Infants up to 1 month of age: Dose is based on body weight. The usual dose is 3.75 to 5 mg per kg (1.7 to 2.3 mg per pound) of body weight every six hours injected into a muscle or vein; or 5 to 6.7 mg per kg (2.3 to 3.0 mg per pound) of body weight every eight hours injected into a muscle or vein.
      • Infants and children 1 month of age and older: Dose is based on body weight. The usual dose is 3.75 to 10 mg per kg (1.7 to 4.5 mg per pound) of body weight every six hours injected into a muscle or vein; or 5 to 13.3 mg per kg (2.3 to 6.0 mg per pound) of body weight every eight hours injected into a muscle or vein.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. This will help to keep a constant amount of medicine in the blood. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the capsule form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not refrigerate the oral liquid form of clindamycin. If chilled, the liquid may thicken and be difficult to pour. Follow the directions on the label.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

It is important that your doctor check your progress at regular visits.

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

In some patients, clindamycin may cause diarrhea.

• Severe diarrhea may be a sign of a serious side effect. Do not take any diarrhea medicine without first checking with your doctor . Diarrhea medicines, such as loperamide (Imodium A-D) or diphenoxylate and atropine (Lomotil), may make your diarrhea worse or make it last longer.
• For mild diarrhea, diarrhea medicine containing attapulgite (e.g., Kaopectate tablets, Diasorb) may be taken. However, attapulgite may keep clindamycin from being absorbed into the body. Therefore, these diarrhea medicines should be taken at least 2 hours before or 3 to 4 hours after you take clindamycin by mouth.
• If you have any questions about this or if mild diarrhea continues or gets worse, check with your health care professional.

Before having surgery (including dental surgery) with a general anesthetic, tell the medical doctor or dentist in charge that you are taking clindamycin.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• More common
  • Abdominal or stomach cramps and pain (severe);  abdominal tenderness;  diarrhea (watery and severe), which may also be bloody;  fever 
  
  

  (the above side effects may also occur up to several weeks after you stop taking this medicine)

• Less common
  • Sore throat and fever;  skin rash, redness, and itching;  unusual bleeding or bruising 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• Diarrhea (mild);  nausea and vomiting ;  stomach pain 

• Less common
  • Itching of rectal, or genital (sex organ) areas 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.