Clindamycin/Benzoyl peroxide

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Contents

[edit] BRAND NAMES

  • International: Duac

[edit] STRUCTURE

[edit] MECHANISM OF ACTION

Clindamycin binds to the 50S ribosomal subunits of susceptible bacteria and prevents elongation of peptide chains by interfering with peptidyl transfer, thereby suppressing protein synthesis.

Benzoyl peroxide is a potent oxidizing agent.

[edit] INDICATIONS

  • Topical treatment of acne vulgaris.

[edit] DOSAGE

Topical Clindamycin/Benzoyl peroxide Gel should be applied once daily, in the evening or as directed by the physician, to affected areas after the skin is gently washed, rinsed with warm water and patted dry.

[edit] CONTRAINDICATIONS

  • Hypersensitivity to any of the components or to lincomycin.
  • History of regional enteritis, ulcerative colitis, pseudomembranous colitis, or antibiotic-associated colitis.

[edit] WARNINGS AND PRECAUTIONS

Orally and parenterally administered clindamycin has been associated with severe colitis which may result in patient death. use of the topical formulation of clindamycin results in absorption of the antibiotic from the skin surface. diarrhea, bloody diarrhea, and colitis (including pseudomembranous colitis) have been reported with the use of topical and systemic clindamycin. studies indicate a toxin(s) produced by clostridia is one primary cause of antibiotic-associated colitis. the colitis is usually characterized by severe persistent diarrhea and severe abdominal cramps and may be associated with the passage of blood and mucus. endoscopic examination may reveal pseudomembranous colitis. stool culture for clostridium difficile and stool assay for clostridium difficile toxin may be helpful diagnostically.

When significant diarrhea occurs, the drug should be discontinued. large bowel endoscopy should be considered to establish a definitive diagnosis in cases of severe diarrhea. antiperistaltic agents such as opiates and diphenoxylate with atropine may prolong and/or worsen the condition. diarrhea, colitis and pseudomembranous colitis have been observed to begin up to several weeks following cessation of oral and parenteral therapy with clindamycin.

Mild cases of pseudomembranous colitis usually respond to drug discontinuation alone. in moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation and treatment with an antibacterial drug clinically effective against clostridium difficile colitis.

[edit] INTERACTIONS

  • Concomitant topical acne therapy should be used with caution because a possible cumulative irritancy effect may occur, especially with the use of peeling, desquamating, or abrasive agents.

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category C (US). Topical Clindamycin/Benzoyl peroxide should be given to a pregnant woman only if clearly needed.
  • Nursing women: a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.

[edit] SIDE EFFECTS

Very common side effects:

At site of application:

  • Dry skin
  • Skin peeling
  • Redness of your skin, especially during the first few weeks of use.

These side effects are generally mild.


Common side effects:

  • Headache

At the site of application:

  • Skin burning sensation
  • Itching
  • Skin pain
  • Sensitivity to sunlight


Uncommon side effects:

At the site of application:

  • Tingling (paraesthesia)
  • Red, itchy skin, rash (dermatitis, erythematous rash)
  • Worsening of acne


Rare side effects:

  • Allergic reactions
  • nausea, vomiting, diarrhoea, including bloody diarrhoea, stomach pain

At the site of application:

  • Skin reactions, discoloration of the skin
  • Raised itchy rash (hives)

[edit] RELATED LINKS

Acne Treatments

[edit] BIBLIOGRAPHY

[edit] REFERENCES

Acne
Oral antibiotics Clindamycin (Oral route)   Doxycycline   Erythromycin (Oral route)   Josamycin   Lymecycline   Minocycline   Tetracycline
Topical antibiotics Clindamycin (Topical)   Erythromycin (Topical)
Topical retinoids Adapalene   Tazarotene   Tretinoin
Oral retinoids Isotretinoin (Oral)
Oral contraceptives Estradiol valerate/Dienogest   Ethinyl Estradiol/Cyproterone acetate
Topical Antibacterial/Keratolytic Benzoyl peroxide   Hydrogen Peroxide Cream
Topical combination products Clindamycin/Benzoyl peroxide   Adapalene/Benzoyl peroxide   Clindamycin/Tretinoin   Miconazole/Benzoyl peroxide   Erythromycin/Benzoyl peroxide   Erythromycin/Isotretinoin