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Indications and Dosage
Topical/Cutaneous
Acne vulgaris Adult: As gel (containing clindamycin phosphate 1% w/w, 1.2% w/w and benzoyl peroxide 3% w/w, 5% w/w): Apply thinly onto affected area once daily at night after cleansing. Max: 12 wk of continuous use.
Child: ≥12 yr Same as adult dose. |
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Contraindications
Hypersensitivity to clindamycin, lincomycin, or benzoyl peroxide. History of regional enteritis, ulcerative colitis, pseudomembranous or antibiotic-associated colitis.
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Special Precautions
Atopic patients.
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Adverse Reactions
Significant: Anaphylaxis, allergic reaction.
Dermatologic: Erythema, peeling, burning sensation, dryness, desquamation, itching, irritation, stinging, discolouration, exfoliation, contact dermatitis, rash, urticaria. Potentially Fatal: Clostridium difficile-associated colitis manifested by severe persistent diarrhoea, severe abdominal cramps, stool w/ blood and mucous. |
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Topical: C
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Patient Counseling Information
Avoid unnecessary sun exposure. May cause discolouration of hair and dyed fabrics.
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Overdosage
Symptom: Severe irritation. Management: Symptomatic treatment.
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Drug Interactions
Clindamycin is antagonised by erythromycin. Clindamycin may enhance the action of other neuromuscular blocking agents. Benzoyl peroxide may cause temporary discolouration of skin and facial hair w/ topical sulfone preparations. May cause cumulative irritation or dermatitis w/ other topical acne preparations (e.g. tretinoin, isotretinoin, tazarotene).
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Action
Description: Clindamycin is a semisynthetic lincosamide which is mainly bacteriostatic but may also be bactericidal depending on drug concentration, infection site, and organism. It inhibits bacterial protein synthesis by binding to the 50S ribosomal subunits, thereby blocking the peptide bond formation of susceptible organisms. Benzoyl peroxide has mild keratolytic effect and an antimicrobial activity which is attributed to its oxidising effect. Both are active against Propionibacterium acnes, an organism associated w/ acne vulgaris.
Pharmacokinetics: Absorption: Clindamycin: Minimal absorption (approx 4-5%) through the skin. Benzoyl peroxide: Approx 5% is absorbed through the skin. Metabolism: Benzoyl peroxide: Metabolised in the skin to benzoic acid. Excretion: Benzoyl peroxide: Via urine. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Clindamycin, CID=446598, https://pubchem.ncbi.nlm.nih.gov/compound/Clindamycin (accessed on Jan. 21, 2020)  Source: National Center for Biotechnology Information. PubChem Database. Benzoyl peroxide, CID=7187, https://pubchem.ncbi.nlm.nih.gov/compound/Benzoyl-peroxide (accessed on Jan. 21, 2020) |
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Storage
Store below 25°C. Do not freeze.
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MIMS Class
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ATC Classification
D10AF51 - clindamycin, combinations ; Belongs to the class of topical antiinfective preparations used in the treatment of acne.
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References
Anon. Benzoyl Peroxide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/03/2017. Anon. Clindamycin (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/03/2017. Anon. Clindamycin and Benzoyl Peroxide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/03/2017. Buckingham R (ed). Benzoyl Peroxide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/03/2017. Buckingham R (ed). Clindamycin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/03/2017. Clindamycin Phosphate and Benzoyl Peroxide Gel (Prasco Laboratories). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 03/03/2017. Joint Formulary Committee. Benzoyl Peroxide with Clindamycin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/03/2017. McEvoy GK, Snow EK, Miller J et al (eds). Clindamycin Phosphate (Topical). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 03/03/2017.
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