CLINDAMYCIN (Topical)

Some commonly used brand names are:

In the U.S.?

• Cleocin T Gel
• Cleocin T Lotion
• Cleocin T Topical Solution
• Clinda-Derm
• Evoclin Topical Foam

In Canada?

• Dalacin T Topical Solution

Generic name product may be available in the U.S.

Category

• Antiacne agent, topical
• Antibacterial, topical

Description

Clindamycin (klin-da-MYE-sin) belongs to the family of medicines calledantibiotics. Topical clindamycin is used to help control acne. It may be usedalone or with one or more other medicines that are used on the skin or takenby mouth for acne. Topical clindamycin may also be used for other problemsas determined by your doctor.

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

Topical
• Foam (U.S.)
• Gel (U.S.)
• Solution (U.S. and Canada)
• Suspension (U.S.)

Before Using This Medicine

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

Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to this medicine or any of the other clindamycins (by mouthor by injection) or to lincomycin. Also tell your health care professionalif you are allergic to any other substances, such as preservatives or dyes.

Pregnancy?Clindamycin has not been studied in pregnant women.However, this medicine has not been shown to cause birth defects or otherproblems in animal studies.

Breast-feeding?Small amounts of topical clindamycin are absorbedthrough the skin. It is possible that small amounts of the medicine may passinto the breast milk. However, this medicine has not been reported to causeproblems in nursing babies.

Children?Studies on this medicine have been done only in adultpatients, and there is no specific information comparing use of this medicinein children up to 12 years of age with use in other age groups.

Older adults?Many medicines have not been studied specificallyin older people. Therefore, it may not be known whether they work exactlythe same way they do in younger adults. Although there is no specific informationcomparing use of this medicine in the elderly with use in other age groups,this medicine is not expected to cause different side effects or problemsin older people than it does in younger adults.

Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. Tell your health careprofessional if you are using any other prescription or nonprescription (over-the-counter[OTC]) medicine.

Other medical problems?The presence of other medicalproblems may affect the use of topical clindamycin. Make sure you tell yourdoctor if you have any other medical problems, especially:

• History of stomach or intestinal disease (especially colitis, includingcolitis caused by antibiotics, or enteritis)?These conditions may increasethe chance of side effects that affect the stomach and intestines

Proper Use of This Medicine

Before applyingthis medicine, thoroughly wash the affected areas with warm water and soap,rinse well, and pat dry.

When applying the medicine, use enough to cover the affected area lightly. You should apply the medicine to the whole area usuallyaffected by acne, not just to the pimples themselves. This will helpkeep new pimples from breaking out.

You should avoid washing the acne-affected areas too often. This may dryyour skin and make your acne worse. Washing with a mild, bland soap 2 or 3times a day should be enough, unless you have oily skin. If you have any questionsabout this, check with your doctor.

Topical clindamycin will not cure your acne. However, to help keep youracne under control, keep using this medicine for thefull time of treatment, even if your symptoms begin to clear up aftera few days. You may have to continue using this medicine every day for monthsor even longer in some cases. If you stop using this medicine too soon, yoursymptoms may return. It is important that you do notmiss any doses.

For patients using the topical foam form ofclindamycin:

• After washing or shaving, it is best to wait 30 minutes before applyingthis medicine. The alcohol in it may irritate freshly washed or shaved skin.
• This medicine contains alcohol and is flammable. Do not use near heat, near open flame, or while smoking.
• To apply this medicine:
  • Do not dispense clindamycin topical foam directly onto your handsbecause the foam will begin to melt on contact with warm skin.
  • Remove the clear cap. Align the black mark with the nozzle of theactuator.
  • Hold the can upright and press firmly to dispense. Dispense amountthat will cover the affected area(s) directly into the cap or onto a coolsurface.
  • The can may be placed under cold running water if the can seems warmor the foam seems runny.
  • A small amount of topical foam should be picked up with your fingertipsand massaged gently into the affected areas until the foam disappears.
  • Unused medicine that was removed from the can should be throw away.
  • Since this medicine contains alcohol, it will sting or burn. In addition,it has an unpleasant taste if it gets on the mouth or lips. Therefore, do not get this medicine in the eyes, nose, or mouth, or onother mucous membranes. Spread the medicine away from these areas whenapplying. If this medicine does get in the eyes, wash them out immediately,but carefully, with large amounts of cool tap water. If your eyes still burnor are painful, check with your doctor.
• It is important that you do not use this medicine more often thanyour doctor ordered. It may cause your skin to become too dry or irritated.

For patients using the topical solution formof clindamycin:

• After washing or shaving, it is best to wait 30 minutes before applyingthis medicine. The alcohol in it may irritate freshly washed or shaved skin.
• This medicine contains alcohol and is flammable. Do not use near heat, near open flame, or while smoking.
• To apply this medicine:
  • This medicine comes in a bottle with an applicator tip, which maybe used to apply the medicine directly to the skin. Use the applicator witha dabbing motion instead of a rolling motion (not like a roll-on deodorant,for example). Tilt the bottle and press the tip firmly against your skin.If needed, you can make the medicine flow faster from the applicator tip byslightly increasing the pressure against the skin. If the medicine flows toofast, use less pressure. If the applicator tip becomes dry, turn the bottleupside down and press the tip several times to moisten it.
  • Since this medicine contains alcohol, it will sting or burn. In addition,it has an unpleasant taste if it gets on the mouth or lips. Therefore, do not get this medicine in the eyes, nose, or mouth, or onother mucous membranes. Spread the medicine away from these areas whenapplying. If this medicine does get in the eyes, wash them out immediately,but carefully, with large amounts of cool tap water. If your eyes still burnor are painful, check with your doctor.
• It is important that you do not use this medicine more often thanyour doctor ordered. It may cause your skin to become too dry or irritated.

For patients using the topical suspension formof clindamycin:

• Shake well before applying.

Dosing?The dose of topical clindamycin will be differentfor different patients. Follow your doctor's orders orthe directions on the label. The following information includes onlythe average doses of topical clindamycin. If your doseis different, do not change it unless your doctor tells you to do so.

The number of doses you use each day, the time allowedbetween doses, and the length of time you use the medicine depend on the medicalproblem for which you are using clindamycin.

• For topical dosage form (foam):
  • For acne:
    • Adults and children 12 years of age and over?Apply once a dayto areas affected by acne.
    • Infants and children up to 12 years of age?Use and dose mustbe determined by your doctor.
• For topical dosage forms (gel, solution,and suspension):
  • For acne:
    • Adults and children 12 years of age and over?Apply two timesa day to areas affected by acne.
    • Infants and children up to 12 years of age?Use and dose mustbe determined by your doctor.

Missed dose?If you miss a dose of this medicine, apply it assoon as possible. However, if it is almost time for your next dose, skip themissed dose and go back to your regular dosing schedule.

Storage?To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be surethat any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If youracne does not improve within about 6 weeks, or if it becomes worse, checkwith your health care professional. However, treatment of acne may take upto 8 to 12 weeks before full improvement is seen.

If your doctor has ordered another medicine to be applied to the skin alongwith this medicine, it is best to apply them at different times. This mayhelp keep your skin from becoming too irritated. Also, if the medicines areused at or near the same time, they may not work properly.

For patients using the topical solution formof clindamycin:

• This medicine may cause the skin to become unusually dry, even withnormal use. If this occurs, 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 may make your diarrhea worse or make it last longer.
• For mild diarrhea, only diarrhea medicine containing attapulgite(e.g., Kaopectate, Diasorb) may be taken. Other kinds of diarrhea medicine(e.g., Imodium A.D. or Lomotil) should not be taken. They may make your conditionworse or make it last longer.
• If you have any questions about this or if mild diarrhea continuesor gets worse, check with your health care professional.

You may continue to use cosmetics (make-up) while you are using this medicinefor acne. However, it is best to use only ?water-base? cosmetics.Also, it is best not to use cosmetics too heavily or too often. They may makeyour acne worse. If you have any questions about this, check with your doctor.

Side Effects of This Medicine

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 mayneed medical attention.

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

Rare

Abdominal or stomach cramps, pain, and bloating (severe); diarrhea (watery and severe), which may also be bloody; fever; increased thirst; nausea or vomiting; unusual tirednessor weakness; weight loss (unusual)?these sideeffects may also occur up to several weeks after you stop using this medicine

Also, check with your doctor as soon as possible if any of the followingside effects occur:

Less common

Skin rash, itching, redness, swelling, or other sign of irritationnot present before use of this medicine

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

More common

Dryness, scaliness, or peeling of skin (for the topical solution)

Less common

Abdominal pain; diarrhea (mild); headache; irritation or oiliness ofskin; stinging or burning feeling of skin

Other side effects not listed abovemay also occur in some patients. If you notice any other effects, check withyour doctor.