Adult: 600 mg 1-2 times daily. Child: ≥1 mth 10-20 mg/kg daily in divided doses.
Intravenous Severe anaerobic infections
Adult: 0.6-1 g 2-3 times daily, by slow IV infusion over at least 1 hr. Max: 8 g/day. Child: ≥1 mth 10-20 mg/kg daily in divided doses.
Oral Severe anaerobic infections
Adult: 500 mg 3-4 times daily. Child: ≥1 mth 30-60 mg/kg daily in divided doses.
Subconjunctival Severe anaerobic infections
Adult: Inject 75 mg (0.25 mL) as a single dose, to maintain sufficient minimum inhibitory concentrations (MICs) in the ocular fluid levels for at least 5 hr.
Renal Impairment
Severe: Reduce to 25-30% of the usual dose.
Administration
Should be taken on an empty stomach. Take w/ full glass of water on an empty stomach 1 hr before or 2 hr after meals.
Reconstitution
Intravenous:
Prior to IV admin, dilute each g in at least 100 mL compatible IV soln.
Incompatibility
Parenteral:
Ampicillin, novobiocin, kanamycin and phenytoin.
Contraindications
Hypersensitivity to lincomycin or clindamycin.
Special Precautions
Patient w/ history of GI disease particularly colitis, history of asthma or significant allergies. Severe renal and/or hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Nausea, vomiting, diarrhoea, abdominal pain, tenesmus, glossitis, stomatitis, pruritus ani; rash, vaginitis, leucopenia, neutropenia, agranulocytosis, eosinophilia, thrombocytopaenic purpura; transient increases in serum bilirubin, alkaline phosphatase, and AST, jaundice, headache, myalgia, tinnitus, dizziness, vertigo, azotemia, oliguria, proteinuria, hypotension, syncope; reversible increases in serum creatine kinase (CK) and creatine phosphokinase (CPK); induration, and sterile abscess on inj site w/ IM admin. Rarely, erythema multiforme resembling Stevens-Johnson syndrome, exfoliative and vesiculobullous dermatitis, cardiopulmonary arrest, aplastic anaemia, pancytopenia; thrombophlebitis, erythema, pain and swelling w/ IV admin. Potentially Fatal:Clostridium difficile-associated diarrhoea and colitis, serious anaphylactoid reactions.
Periodically perform LFTs, kidney function tests and blood cell counts during prolonged therapy.
Drug Interactions
May potentiate effects of neuromuscular blocking agents (e.g. pancuronium, tubocurarine). Reduced GI absorption w/ kaolin. May antagonise the effect of erythromycin.
Food Interaction
Food reduces the rate and extent of absorption.
Action
Description: Lincomycin exerts bacteriostatic and bactericidal effects by binding to 50S ribosome subunit. This results in inhibition of protein synthesis, specifically peptide-bond formation, in susceptible organisms. Pharmacokinetics: Absorption: Rapidly absorbed from the GI tract (approx 20-35%). Time to peak plasma concentration: W/in 2-4 hr. Food reduces rate and extent of absorption. Distribution: Widely distributed into tissues including bone and body fluids; poor diffusion into the CSF. Crosses the placenta and enters breast milk. Metabolism: Partially metabolised in the liver. Excretion: Via bile, urine, faeces (as unchanged drug and metabolites). Plasma half-life: Approx 5 hr.
Chemical Structure
Lincomycin Source: National Center for Biotechnology Information. PubChem Database. Lincomycin, CID=3000540, https://pubchem.ncbi.nlm.nih.gov/compound/Lincomycin (accessed on Jan. 22, 2020)
Anon. Lincomycin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 17/06/2014.Buckingham R (ed). Lincomycin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 16/06/2014.Lincocin Injection, Solution (Pharmacia and Upjohn Company). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 16/06/2014.Lincocin Injection. U.S. FDA. https://www.fda.gov/. Accessed 15/10/2014.McEvoy GK, Snow EK, Miller J et al (eds). Lincomycin HCl. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 16/06/2014.
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