Instructions for Clindamycin
Release:
caps. 150 mg: 16 pcs.
solution for intravenous and intramuscular administration of 300 mg / 2 ml: amp. 10 pieces.
Description Clindamycin:
The solution for intravenous and intramuscular administration is transparent, colorless or slightly yellowish.
1 ml 1 amp.
clindamycin (as phosphate) 150 mg 300 mg
Excipients : benzyl alcohol, disodium edetate, water d / i.
2 ml - ampoules (5) - blister packs (2) - cardboard packs.
Clinical and pharmacological groups Clindamycin
Active substancecin:
Clindamycin (as phosphate)
Pharmaco-therapeutic group Clindamycin:
lincosamide
Storage conditions
List B.
Store the solution for intravenous and intramuscular administration in a dark place at a temperature of 15 ° to 25 ° C.
Store capsules at temperatures between 15 ° and 25 ° C.
Keep out of the reach of children.
pharmachologic effect Clindamycin:
Clindamycin is a drug from the group - lincosamides, has a broad spectrum of action, bacteriostatic, binds to the 50S ribosome subunit and inhibits protein synthesis in microorganisms. Active against Staphylococcus spp. (including Staphylococcus epidermidis producing penicillinase), Streptococcus spp. (excluding Enterococcus spp.), Streptococcus pneumoniae, anaerobic and microaerophilic Gram-positive cocci (including Peptococcus spp. and Peptostreptococcus spp.), Corynebacterium diphtheriae, Clostridium perfringens, Clostridium tetani., Bspp. spp. (including Bacteroides fragilis and Bacteroides melaningenicus), anaerobic gram-positive, non-spore-forming bacilli (including Propionibacterium spp., Eubacterium spp., Actinomyces spp.).
Most strains of Clostridium perfringens are sensitive to clindamycin, however, other types of Clostridia (Clostridium sporogenes, Clostridium tertium) are resistant to the drug Clindamycin, therefore, antibiogram determination is recommended for infections caused by Clostridium spp.
In terms of the mechanism of action and antimicrobial spectrum, it is close to lincomycin (in relation to some types of microorganisms, especially in relation to bacteroids and non-spore-forming anaerobes, it is 2-10 times more active).
Indications Clindamycin:
infectious and inflammatory diseases caused by microorganisms sensitive to clindamycin;
infections of the upper respiratory tract and infections of the ENT organs (pharyngitis, tonsillitis, sinusitis, otitis media), lower respiratory tract infections (pneumonia, including aspiration, lung abscess, pleural empyema, bronchitis), scarlet fever, diphtheria;
infections of the urogenital tract (chlamydia, endometritis, vaginal infections, tubo-ovarian inflammation);
infections of the skin and soft tissues (infected wounds, abscesses, boils, panaritium), abdominal cavity (peritonitis, abscess), oral cavity;
acute and chronic osteomyelitis;
septicemia (primarily anaerobic);
bacterial endocarditis;
prevention of peritonitis and intra-abdominal abscesses after intestinal perforation or as a result of traumatic infection (in combination with aminoglycosides).
Method of application, course and dosage
Inside, adults and children over 15 years old (average child weight 50 kg and above) with diseases of moderate severity are prescribed 1 capsule (150 mg) 4 times / day (every 6 hours).
For severe infections in adults and children over 15 years of age, a single dose can be increased to 2-3 capsules (300-450 mg).
For children from 8 to 15 years old, the method of using the capsules is shown in the table.
Child's age Average severity of the disease Severe disease Maximum daily dose
From 8 to 12 years old (average weight of a child is from 25 to 40 kg) 1 capsule 4 times / day No more than 600 mg / day (4 capsules)
From 12 to 15 years old (average weight of a child is from 40 to 50 kg) 1 capsule 3 times / day 2 capsules 3 times / day No more than 900 mg / day (6 capsules)
For intramuscular and intravenous administration, the recommended dose for adults is 300 mg 2 times / day. In severe infections - up to 1.2-2.7 g / day, divided into 3-4 injections. It is not recommended to prescribe a single intramuscular dose exceeding 600 mg. The maximum single dose for intravenous administration is 1.2 g for 1 hour.
Children over 3 years old - 15-25 mg / kg / day, divided into 3-4 equal doses. In severe infections, the daily dose can be increased to 25-40 mg / kg of body weight, divided into 3-4 identical injections.
Patients with severe hepatic and / or renal insufficiency do not need to adjust the dosage regimen if the drug is prescribed with an interval of at least 8 hours.
For intravenous administration, the drug is diluted to a concentration not exceeding 6 mg / ml; the diluted solution is injected intravenously drip for 10-60 minutes.
It is not recommended to inject the drug intravenously in a jet.
Dilution and duration of infusion are recommended to be performed according to the dosage - volume of solvent - duration of infusion (respectively): 300 mg - 50 ml - 10 minutes; 600 mg - 100 ml - 20 min; 900 mg - 150 ml - 30 min; 1200 mg - 200 ml - 45 min. The following solutions can be used as a solvent: 0.9% sodium chloride solution and 5% dextrose solution.
Overdose Clindamycin:
In case of an overdose, side effects may increase.
Treatment: symptomatic therapy, there is no specific antidote. Hemodialysis and peritoneal dialysis are ineffective.
Drug interactions Clindamycin:
enhances (mutually) the effect of rifampicin, aminoglycosides streptomycin, gentamicin (especially in the treatment of osteomyelitis and prevention of peritonitis after intestinal perforation).
Strengthens the action of competitive muscle relaxants, and also enhances muscle relaxation caused by n-anticholinergic antagonists.
Incompatible with ampicillin, barbiturates, aminophylline, calcium gluconate and magnesium sulfate.
Shows antagonism with erythromycin and chloramphenicol.
Simultaneous use with solutions containing a complex of B vitamins, aminoglycosides, phenytoin is not recommended.
Concomitant administration with antidiarrheal drugs increases the risk of developing pseudomembranous colitis.
With simultaneous use with opioid (narcotic) analgesics, it is possible to increase the respiratory depression caused by them (up to apnea).
Application during pregnancy and lactation
Contraindicated.
Side effect Clindamycin:
From the digestive system: dyspepsia (abdominal pain, nausea, vomiting, diarrhea), esophagitis, jaundice, liver dysfunction, hyperbilirubinemia, dysbiosis, pseudomembranous enterocolitis.F
rom the musculoskeletal system: rarely - impaired neuromuscular conduction.
From the side of hematopoiesis: leukopenia, neutropenia, agranulocytosis, thrombocytopenia.
Allergic reactions: rarely - maculopapular rash, urticaria, itching; in some cases, exfoliative and vesiculobullous dermatitis, eosinophilia, anaphylactoid reactions.
From the side of the cardiovascular system: with a rapid intravenous injection - a decrease in blood pressure, up to collapse; dizziness, weakness.
Local reactions: irritation, soreness (at the site of intramuscular injection), thrombophlebitis (at the site of intravenous injection).
Others: development of superinfection.
Contraindications for use Clindamycin:
myasthenia gravis;
bronchial asthma;
ulcerative colitis (history);
rare hereditary diseases such as: galactose intolerance, lactase deficiency or glucose-galactose malabsorption (for capsules);
pregnancy;
lactation period;
children under 3 years of age - for solution for i / v and i / m administration (due to the lack of data on the safety of benzyl alcohol use);
children under 8 years of age for capsules (the average weight of a child is less than 25 kg);
hypersensitivity.
Clindamycin is used with caution in patients with severe hepatic and / or renal insufficiency, in elderly patients.
special instructions Clindamycin:
Pseudomembranous colitis can appear both while taking clindamycin and 2-3 weeks after stopping treatment (3-15% of cases); manifested by diarrhea, leukocytosis, fever, abdominal pain (sometimes accompanied by the release of blood and mucus with feces).
If these phenomena occur in mild cases, it is sufficient to discontinue treatment and use ion-exchange resins (colestyramine, colestipol), in severe cases, it is shown to compensate for the loss of fluid, electrolytes and protein, the appointment of vancomycin by mouth or metronidazole.
Do not use drugs that inhibit intestinal motility.
The safety of using the drug in children under 3 years of age has not been established. With long-term therapy, children need periodic monitoring of the blood count and the functional state of the liver.
When prescribing the drug Clindamycin in high doses, it is necessary to control the plasma concentration of clindamycin.
Patients with severe hepatic impairment need to monitor liver function (liver enzymes).
Application for impaired renal function
Clindamycin is used with caution in patients with severe renal failure.
Application for violations of liver function Clindamycin:
Clindamycin is used with caution in patients with severe hepatic impairment.
Terms of sale
The drug is available with a prescription.
Use in elderly patients
Clindamycin is used with caution in elderly patients.
Application in children
Contraindicated Clindamycin:
children under 3 years of age - for solution for i / v and i / m administration (due to the lack of data on the safety of benzyl alcohol use);
children under 8 years of age for capsules (average weight of a child is less than 25 kg).
Nosology (ICD codes)
Diphtheria
Scarlet fever
Other sepsis
Chlamydial infections of the lower urinary tract
Chlamydial infections of the pelvic organs and other genitourinary organs
Chlamydial pharyngitis
Suppurative and unspecified otitis media
Acute and subacute endocarditis
Acute nasopharyngitis (runny nose)
Acute sinusitis
Acute pharyngitis
Acute tonsillitis
Acute laryngitis and tracheitis
Bacterial pneumonia, not elsewhere classified
Mycoplasma pneumoniae pneumonia
Chlamydial pneumonia
Acute bronchitis
Chronic rhinitis, nasopharyngitis and pharyngitis
Chronic sinusitis
Chronic tonsillitis
Peritonsillar abscess
Chronic laryngitis and laryngotracheitis
Chronic bronchitis, unspecified
Gingivitis and periodontal disease
Stomatitis and related lesions
Acute peritonitis (including abscess)
Impetigo
Skin abscess, boil and carbuncle
Phlegmon
Pyoderma
Osteomyelitis
Salpingitis and oophoritis
Inflammatory disease of the uterus, except for the cervix (including endometritis, myometritis, metritis, pyometra, uterine abscess)
Inflammatory disease of the cervix (including cervicitis, endocervicitis, exocervicitis)
Acute parametritis and pelvic cellulite
Post-traumatic wound infection, not elsewhere classified
