CLINDAMYCIN PALMITATE

Details

Stereochemistry	ABSOLUTE
Molecular Formula	C34H63ClN2O6S
Molecular Weight	663.392
Optical Activity	UNSPECIFIED
Defined Stereocenters	9 / 9
E/Z Centers	0
Charge	0

SHOW SMILES / InChI

Structure Search

SMILES

[H][C@@](NC(=O)[C@@H]1C[C@@H](CCC)CN1C)([C@H](C)Cl)[C@@]2([H])O[C@H](SC)[C@H](OC(=O)CCCCCCCCCCCCCCC)[C@@H](O)[C@H]2O

InChI

InChIKey=OYSKUZDIHNKWLV-PRUAPSLNSA-N

InChI=1S/C34H63ClN2O6S/c1-6-8-9-10-11-12-13-14-15-16-17-18-19-21-27(38)42-32-30(40)29(39)31(43-34(32)44-5)28(24(3)35)36-33(41)26-22-25(20-7-2)23-37(26)4/h24-26,28-32,34,39-40H,6-23H2,1-5H3,(H,36,41)/t24-,25+,26-,28+,29+,30-,31+,32+,34+/m0/s1

HIDE SMILES / InChI

Description
Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdfhttp://www.accessdata.fda.gov/drugsatfda_docs/label/2016/050441s072,050639s033lbl.pdf
Curator's Comment: description was created based on several sources, including: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050537s035,050600s013,050615s012lbl.pdf | http://www.rxlist.com/clindamycin-phosphate-topical-solution-drug.htm

Clindamycin phosphate is the prodrug of clindamycin with no antimicrobial activity in vitro but can be rapidly converted in vivo to the parent drug, clindamycin, by phosphatase ester hydrolysis. It is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria: Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by anaerobes; Skin and skin structure infections; Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes; Intra-abdominal infections; Septicemia; Bone and joint infections. Orally and parenterally administered clindamycin has been associated with severe colitis, which may end fatally. Abdominal pain, gastrointestinal disturbances, gram-negative folliculitis, eye pain and contact dermatitis have also been reported in association with the use of topical formulations of clindamycin. Clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents

CNS Activity

Originator

Approval Year

Targets

Primary Target	Pharmacology	Condition	Potency
Bacterial 70S ribosome 179 Target ID: CHEMBL2363135 Sources: https://www.ncbi.nlm.nih.gov/pubmed/12860123	Inhibitor 8297
Bacterial 70S ribosome 179 Target ID: CHEMBL2363135 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf	Inhibitor 8297

Conditions

Condition	Modality	Highest Phase	Product
Serious soft tissue infections 6 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf	Curative	Approved 8429	CLEOCIN HYDROCHLORIDE Approved Use Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin Injection, USP is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of antibiotic-associated pseudomembranous colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin). Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. Indicated surgical procedures should be performed in conjunction with antibiotic therapy. Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible strains of the designated organisms in the conditions listed below: Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by anaerobes, Streptococcus pneumoniae, other streptococci (except E. faecalis), and Staphylococcus aureus. Skin and skin structure infections caused by Streptococcus pyogenes, Staphylococcus aureus, and anaerobes. Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes. Intra-abdominal infections including peritonitis and intra-abdominal abscess caused by susceptible anaerobic organisms. Septicemia caused by Staphylococcus aureus, streptococci (except Enterococcus faecalis), and susceptible anaerobes. Bone and joint infections including acute hematogenous osteomyelitis caused by Staphylococcus aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections due to susceptible organisms. To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin and other antibacterial drugs, clindamycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Launch Date 1970
Serious respiratory tract infections 6 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf	Curative	Approved 8429	CLEOCIN HYDROCHLORIDE Approved Use Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin Injection, USP is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of antibiotic-associated pseudomembranous colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin). Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. Indicated surgical procedures should be performed in conjunction with antibiotic therapy. Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible strains of the designated organisms in the conditions listed below: Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by anaerobes, Streptococcus pneumoniae, other streptococci (except E. faecalis), and Staphylococcus aureus. Skin and skin structure infections caused by Streptococcus pyogenes, Staphylococcus aureus, and anaerobes. Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes. Intra-abdominal infections including peritonitis and intra-abdominal abscess caused by susceptible anaerobic organisms. Septicemia caused by Staphylococcus aureus, streptococci (except Enterococcus faecalis), and susceptible anaerobes. Bone and joint infections including acute hematogenous osteomyelitis caused by Staphylococcus aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections due to susceptible organisms. To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin and other antibacterial drugs, clindamycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Launch Date 1970
Serious skin infections 6 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf	Curative	Approved 8429	CLEOCIN HYDROCHLORIDE Approved Use Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin Injection, USP is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of antibiotic-associated pseudomembranous colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin). Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. Indicated surgical procedures should be performed in conjunction with antibiotic therapy. Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible strains of the designated organisms in the conditions listed below: Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by anaerobes, Streptococcus pneumoniae, other streptococci (except E. faecalis), and Staphylococcus aureus. Skin and skin structure infections caused by Streptococcus pyogenes, Staphylococcus aureus, and anaerobes. Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes. Intra-abdominal infections including peritonitis and intra-abdominal abscess caused by susceptible anaerobic organisms. Septicemia caused by Staphylococcus aureus, streptococci (except Enterococcus faecalis), and susceptible anaerobes. Bone and joint infections including acute hematogenous osteomyelitis caused by Staphylococcus aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections due to susceptible organisms. To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin and other antibacterial drugs, clindamycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Launch Date 1970
Sepsis 71 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf	Curative	Approved 8429	CLEOCIN HYDROCHLORIDE Approved Use Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin Injection, USP is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of antibiotic-associated pseudomembranous colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin). Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. Indicated surgical procedures should be performed in conjunction with antibiotic therapy. Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible strains of the designated organisms in the conditions listed below: Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by anaerobes, Streptococcus pneumoniae, other streptococci (except E. faecalis), and Staphylococcus aureus. Skin and skin structure infections caused by Streptococcus pyogenes, Staphylococcus aureus, and anaerobes. Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes. Intra-abdominal infections including peritonitis and intra-abdominal abscess caused by susceptible anaerobic organisms. Septicemia caused by Staphylococcus aureus, streptococci (except Enterococcus faecalis), and susceptible anaerobes. Bone and joint infections including acute hematogenous osteomyelitis caused by Staphylococcus aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections due to susceptible organisms. To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin and other antibacterial drugs, clindamycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Launch Date 1970
Intra-abdominal infections 49 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf	Curative	Approved 8429	CLEOCIN HYDROCHLORIDE Approved Use Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin Injection, USP is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of antibiotic-associated pseudomembranous colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin). Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. Indicated surgical procedures should be performed in conjunction with antibiotic therapy. Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible strains of the designated organisms in the conditions listed below: Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by anaerobes, Streptococcus pneumoniae, other streptococci (except E. faecalis), and Staphylococcus aureus. Skin and skin structure infections caused by Streptococcus pyogenes, Staphylococcus aureus, and anaerobes. Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes. Intra-abdominal infections including peritonitis and intra-abdominal abscess caused by susceptible anaerobic organisms. Septicemia caused by Staphylococcus aureus, streptococci (except Enterococcus faecalis), and susceptible anaerobes. Bone and joint infections including acute hematogenous osteomyelitis caused by Staphylococcus aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections due to susceptible organisms. To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin and other antibacterial drugs, clindamycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Launch Date 1970
Infections of the female pelvis 6 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf	Curative	Approved 8429	CLEOCIN HYDROCHLORIDE Approved Use Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin Injection, USP is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of antibiotic-associated pseudomembranous colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin). Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. Indicated surgical procedures should be performed in conjunction with antibiotic therapy. Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible strains of the designated organisms in the conditions listed below: Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by anaerobes, Streptococcus pneumoniae, other streptococci (except E. faecalis), and Staphylococcus aureus. Skin and skin structure infections caused by Streptococcus pyogenes, Staphylococcus aureus, and anaerobes. Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes. Intra-abdominal infections including peritonitis and intra-abdominal abscess caused by susceptible anaerobic organisms. Septicemia caused by Staphylococcus aureus, streptococci (except Enterococcus faecalis), and susceptible anaerobes. Bone and joint infections including acute hematogenous osteomyelitis caused by Staphylococcus aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections due to susceptible organisms. To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin and other antibacterial drugs, clindamycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Launch Date 1970
Infections of the genital tract 6 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf	Curative	Approved 8429	CLEOCIN HYDROCHLORIDE Approved Use Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin Injection, USP is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of antibiotic-associated pseudomembranous colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin). Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin. Indicated surgical procedures should be performed in conjunction with antibiotic therapy. Clindamycin Injection, USP is indicated in the treatment of serious infections caused by susceptible strains of the designated organisms in the conditions listed below: Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by anaerobes, Streptococcus pneumoniae, other streptococci (except E. faecalis), and Staphylococcus aureus. Skin and skin structure infections caused by Streptococcus pyogenes, Staphylococcus aureus, and anaerobes. Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes. Intra-abdominal infections including peritonitis and intra-abdominal abscess caused by susceptible anaerobic organisms. Septicemia caused by Staphylococcus aureus, streptococci (except Enterococcus faecalis), and susceptible anaerobes. Bone and joint infections including acute hematogenous osteomyelitis caused by Staphylococcus aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections due to susceptible organisms. To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin and other antibacterial drugs, clindamycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Launch Date 1970
Acne vulgaris 34 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050537s035,050600s013,050615s012lbl.pdf	Curative	Approved 8429	CLEOCIN T Approved Use Clindamycin Phosphate is indicated in the treatment of acne vulgaris. Launch Date 1980
Lower respiratory tract infections 51 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2008/050441s053,050639s015lbl.pdf	Curative	Approved 8429	CLEOCIN PHOSPHATE Approved Use Lower respiratory tract infections including pneumonia, empyema, and lung abscess caused by anaerobes, Streptococcus pneumoniae, other streptococci (except E. faecalis), and Staphylococcus aureus. Launch Date 1972
Skin and skin structure infections 80 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/050441s072,050639s033lbl.pdf	Curative	Approved 8429	CLEOCIN PHOSPHATE Approved Use Skin and skin structure infections caused by Streptococcus pyogenes, Staphylococcus aureus, and anaerobes. Launch Date 1972
Gynecological infections 8 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/050441s072,050639s033lbl.pdf	Curative	Approved 8429	CLEOCIN PHOSPHATE Approved Use Gynecological infections including endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, and postsurgical vaginal cuff infection caused by susceptible anaerobes. Launch Date 1972
Intra-abdominal infections 49 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/050441s072,050639s033lbl.pdf	Curative	Approved 8429	CLEOCIN PHOSPHATE Approved Use Intra-abdominal infections including peritonitis and intra-abdominal abscess caused by susceptible anaerobic organisms. Launch Date 1972
Sepsis 71 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/050441s072,050639s033lbl.pdf	Curative	Approved 8429	CLEOCIN PHOSPHATE Approved Use Septicemia caused by Staphylococcus aureus, streptococci (except Enterococcus faecalis), and susceptible anaerobes. Launch Date 1972
Bone and joint infections 27 Sources: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/050441s072,050639s033lbl.pdf	Curative	Approved 8429	CLEOCIN PHOSPHATE Approved Use Bone and joint infections including acute hematogenous osteomyelitis caused by Staphylococcus aureus and as adjunctive therapy in the surgical treatment of chronic bone and joint infections due to susceptible organisms. Launch Date 1972

C_max

Value	Dose	Co-administered	Analyte	Population
3.1 μg/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10475141/	600 mg single, oral dose: 600 mg route of administration: Oral experiment type: SINGLE co-administered:		CLINDAMYCIN plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN
0.92 ng/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/050803Orig1s000ClinPharmR.pdf	0.03 g 1 times / day steady-state, topical dose: 0.03 g route of administration: Topical experiment type: STEADY-STATE co-administered:		CLINDAMYCIN plasma	Homo sapiens population: UNHEALTHY age: CHILD sex: FEMALE / MALE food status: UNKNOWN

AUC

Value	Dose	Co-administered	Analyte	Population
12.2 μg × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10475141/	600 mg single, oral dose: 600 mg route of administration: Oral experiment type: SINGLE co-administered:		CLINDAMYCIN plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN
13.54 ng × h/mL DRUG LABEL https://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/050803Orig1s000ClinPharmR.pdf	0.03 g 1 times / day steady-state, topical dose: 0.03 g route of administration: Topical experiment type: STEADY-STATE co-administered:		CLINDAMYCIN plasma	Homo sapiens population: UNHEALTHY age: CHILD sex: FEMALE / MALE food status: UNKNOWN

T_1/2

Value	Dose	Co-administered	Analyte	Population
2.3 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/10475141/	600 mg single, oral dose: 600 mg route of administration: Oral experiment type: SINGLE co-administered:		CLINDAMYCIN plasma	Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: UNKNOWN

Doses

Dose	Population	Adverse events
5 g 7 times / day multiple, vaginal Recommended Dose: 5 g, 7 times / day Route: vaginal Route: multiple Dose: 5 g, 7 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/11689755 Page: p.571	unhealthy, 16 - 51 n = 79 Health Status: unhealthy Condition: Bacterial Vaginosis Age Group: 16 - 51 Sex: F Population Size: 79 Sources: https://pubmed.ncbi.nlm.nih.gov/11689755 Page: p.571	Disc. AE: Vaginal pain or burning... AEs leading to discontinuation/dose reduction: Vaginal pain or burning (1.2%) Sources: https://pubmed.ncbi.nlm.nih.gov/11689755 Page: p.571
1200 mg 4 times / day multiple, intravenous Recommended Dose: 1200 mg, 4 times / day Route: intravenous Route: multiple Dose: 1200 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	Disc. AE: Diarrhea, Clostridium difficile, Anaphylactic shock... AEs leading to discontinuation/dose reduction: Diarrhea, Clostridium difficile Anaphylactic shock Hypersensitivity reaction (severe) Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
300 mg 4 times / day multiple, intramuscular Recommended Dose: 300 mg, 4 times / day Route: intramuscular Route: multiple Dose: 300 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	Disc. AE: Diarrhea, Clostridium difficile, Anaphylactic shock... AEs leading to discontinuation/dose reduction: Diarrhea, Clostridium difficile Anaphylactic shock Hypersensitivity reaction (severe) Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
300 mg 4 times / day multiple, intravenous Recommended Dose: 300 mg, 4 times / day Route: intravenous Route: multiple Dose: 300 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	Disc. AE: Diarrhea, Clostridium difficile, Anaphylactic shock... AEs leading to discontinuation/dose reduction: Diarrhea, Clostridium difficile Anaphylactic shock Hypersensitivity reaction (severe) Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
450 mg 4 times / day multiple, oral Recommended Dose: 450 mg, 4 times / day Route: oral Route: multiple Dose: 450 mg, 4 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf Page: p.1	Disc. AE: Diarrhea, Clostridium difficile, Reaction skin... AEs leading to discontinuation/dose reduction: Diarrhea, Clostridium difficile Reaction skin (severe) Toxic epidermal necrolysis (grade 3-5) Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf Page: p.1

AEs

AE	Significance	Dose	Population
Vaginal pain or burning	1.2% Disc. AE	5 g 7 times / day multiple, vaginal Recommended Dose: 5 g, 7 times / day Route: vaginal Route: multiple Dose: 5 g, 7 times / day Sources: https://pubmed.ncbi.nlm.nih.gov/11689755 Page: p.571	unhealthy, 16 - 51 n = 79 Health Status: unhealthy Condition: Bacterial Vaginosis Age Group: 16 - 51 Sex: F Population Size: 79 Sources: https://pubmed.ncbi.nlm.nih.gov/11689755 Page: p.571
Anaphylactic shock	Disc. AE	1200 mg 4 times / day multiple, intravenous Recommended Dose: 1200 mg, 4 times / day Route: intravenous Route: multiple Dose: 1200 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
Diarrhea, Clostridium difficile	Disc. AE	1200 mg 4 times / day multiple, intravenous Recommended Dose: 1200 mg, 4 times / day Route: intravenous Route: multiple Dose: 1200 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
Hypersensitivity reaction	severe Disc. AE	1200 mg 4 times / day multiple, intravenous Recommended Dose: 1200 mg, 4 times / day Route: intravenous Route: multiple Dose: 1200 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
Anaphylactic shock	Disc. AE	300 mg 4 times / day multiple, intramuscular Recommended Dose: 300 mg, 4 times / day Route: intramuscular Route: multiple Dose: 300 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
Diarrhea, Clostridium difficile	Disc. AE	300 mg 4 times / day multiple, intramuscular Recommended Dose: 300 mg, 4 times / day Route: intramuscular Route: multiple Dose: 300 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
Hypersensitivity reaction	severe Disc. AE	300 mg 4 times / day multiple, intramuscular Recommended Dose: 300 mg, 4 times / day Route: intramuscular Route: multiple Dose: 300 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
Anaphylactic shock	Disc. AE	300 mg 4 times / day multiple, intravenous Recommended Dose: 300 mg, 4 times / day Route: intravenous Route: multiple Dose: 300 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
Diarrhea, Clostridium difficile	Disc. AE	300 mg 4 times / day multiple, intravenous Recommended Dose: 300 mg, 4 times / day Route: intravenous Route: multiple Dose: 300 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
Hypersensitivity reaction	severe Disc. AE	300 mg 4 times / day multiple, intravenous Recommended Dose: 300 mg, 4 times / day Route: intravenous Route: multiple Dose: 300 mg, 4 times / day Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=7a6967b3-5563-4bed-9eee-d400f800e799&type=display
Diarrhea, Clostridium difficile	Disc. AE	450 mg 4 times / day multiple, oral Recommended Dose: 450 mg, 4 times / day Route: oral Route: multiple Dose: 450 mg, 4 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf Page: p.1
Toxic epidermal necrolysis	grade 3-5 Disc. AE	450 mg 4 times / day multiple, oral Recommended Dose: 450 mg, 4 times / day Route: oral Route: multiple Dose: 450 mg, 4 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf Page: p.1
Reaction skin	severe Disc. AE	450 mg 4 times / day multiple, oral Recommended Dose: 450 mg, 4 times / day Route: oral Route: multiple Dose: 450 mg, 4 times / day Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf Page: p.1	unhealthy Health Status: unhealthy Condition: Infections due to susceptible strains of streptococci, pneumococci, and staphylococci Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/050162s092s093lbl.pdf Page: p.1

Overview

CYP3A4	CYP2C9	CYP2D6	hERG
substrate 1737 inhibitor 1587	inhibitor 1767	inhibitor 1852

OverviewOther

Other Inhibitor	Other Substrate	Other Inducer
CYP1A2 1524 CYP2C19 1478 CYP2E1 882	CYP1A2 1054 CYP2A6 543 CYP2B6 664 CYP2C8 693 CYP2C18 138 CYP2C19 991 CYP2E1 667 CYP3A5 395 CYP4A11 119

Drug as perpetrator

Target	Modality	Activity
CYP3A4 1925	inhibitor 3277 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 1.0	moderate [Inhibition 100 uM]
CYP1A2 1692	inhibitor 3277 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 7;9	no
CYP2C19 1553	inhibitor 3277 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 7;9	no
CYP2C9 1819	inhibitor 3277 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 7;9	no
CYP2D6 1891	inhibitor 3277 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 7;9	no
CYP2E1 970	inhibitor 3277 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 7;9	no

Drug as victim

Target	Modality	Activity	Clinical evidence
CYP3A4 1737	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/050162s098s099lbl.pdf#page=3; https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	major	likely (co-administration study) Comment: inhibitors of CYP3A4 and CYP3A5 may increase plasma concentrations of clindamycin and inducers of these isoenzymes may reduce plasma concentrations of clindamycin Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/050162s098s099lbl.pdf#page=3; https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0
CYP3A5 395	substrate 3367 Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/050162s098s099lbl.pdf#page=3; https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	minor	likely (co-administration study) Comment: inhibitors of CYP3A4 and CYP3A5 may increase plasma concentrations of clindamycin and inducers of these isoenzymes may reduce plasma concentrations of clindamycin Sources: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/050162s098s099lbl.pdf#page=3; https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0
CYP1A2 1054	substrate 3367 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	not determined
CYP2A6 543	substrate 3367 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	not determined
CYP2B6 664	substrate 3367 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	not determined
CYP2C18 138	substrate 3367 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	not determined
CYP2C19 991	substrate 3367 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	not determined
CYP2C8 693	substrate 3367 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	not determined
CYP2E1 667	substrate 3367 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	not determined
CYP4A11 119	substrate 3367 Sources: https://pubmed.ncbi.nlm.nih.gov/12814964/ Page: 5.0	not determined

Sourcing

Vendor/Aggregator	ID	URL
ChEBI	CHEBI:3745	https://www.ebi.ac.uk/chebi/searchId.do?chebiId=CHEBI:3745
eMolecules	2749645	https://www.emolecules.com/cgi-bin/more?vid=2749645

PubMed

Title	Date	PubMed
A simple, efficient and inexpensive program for preventing prematurity.	2001	11447924
Occurrence of metronidazole and imipenem resistance among Bacteroides fragilis group clinical isolates in Hungary.	2001	11426861
Efficacy of clindamycin vaginal ovule (3-day treatment) vs. clindamycin vaginal cream (7-day treatment) in bacterial vaginosis.	2001	11368263
Clinical features of patients with invasive Eikenella corrodens infections and microbiological characteristics of the causative isolates.	2001 Apr	11399011
Chronic granulomatous disease: a case report.	2001 Apr	11393130
Thoracic spondylitis mimicking idiopathic scoliosis: a case report.	2001 Apr	11360774
Severe babesiosis in Long Island: review of 34 cases and their complications.	2001 Apr 15	11283800
Clindamycin suspension and endocarditis prophylaxis.	2001 Apr 28	11352383
Laparoscopic management of adnexal masses.	2001 Apr-Jun	11394427
A combination benzoyl peroxide and clindamycin topical gel compared with benzoyl peroxide, clindamycin phosphate, and vehicle in the treatment of acne vulgaris.	2001 Feb	11236229
Folliculitis decalvans.	2001 Jan	11260200
Emerging erythromycin resistance among group B streptococci in Korea.	2001 Jan	11245325
Antibiotic sensitivity of Propionibacterium acnes isolates from patients with acne vulgaris in a tertiary dermatological referral centre in Singapore.	2001 Jan	11242619
The efficacy and safety of a combination benzoyl peroxide/clindamycin topical gel compared with benzoyl peroxide alone and a benzoyl peroxide/erythromycin combination product.	2001 Jan-Feb	11281433
Lipid analysis of follicular casts from cyanoacrylate strips as a new method for studying therapeutic effects of antiacne agents.	2001 Jul	11453902
A rare case of primary group A streptococcal peritonitis.	2001 Jul	11450776
Cutaneous botryomycosis of the cervicofacial region.	2001 Jul	11400249
Comparison of in-vitro activities of SCH27899 and other antibiotics against Mycoplasma pneumoniae.	2001 Jun	11455504
The emergence of erythromycin-resistant Streptococcus pyogenes in Seoul, Korea.	2001 Jun	11455497
Transfusion-transmitted babesiosis in Ontario: first reported case in Canada.	2001 Jun 12	11450217
Infection of hamsters with epidemiologically important strains of Clostridium difficile.	2001 Jun 15	11372028
A meta-analysis of salvage therapy for Pneumocystis carinii pneumonia.	2001 Jun 25	11427101
[Antibiotic prophylaxis in oncologic pharyngolaryngeal surgery: ceftriaxone versus clindamycin and gentamycin].	2001 Mar	11428270
[Ocular parasitoses and mycoses: cases diagnosed in the Central University Hospital of Sfax between 1996 and 1999].	2001 Mar	11346972
Prevalence and phenotypes of erythromycin-resistant Streptococcus pneumoniae in Shanghai, China.	2001 Mar	11337187
A 2-step non-surgical procedure and systemic antibiotics in the treatment of rapidly progressive periodontitis.	2001 Mar	11327054
Persistence of Plasmodium falciparum in the placenta after apparently effective quinidine/clindamycin therapy.	2001 Mar	11324359
[The therapeutic approach to necrotizing fasciitis].	2001 Mar	11319371
[Cellulitis and necrotizing fasciitis: microbiology and pathogenesis].	2001 Mar	11319369
Antimicrobial resistance in viridans group streptococci among patients with and without the diagnosis of cancer in the USA, Canada and Latin America.	2001 Mar	11318814
In vitro activity and pharmacodynamics of azithromycin and clarithromycin against Streptococcus pneumoniae based on serum and intrapulmonary pharmacokinetics.	2001 Mar	11318076
Antimicrobial susceptibilities of Erysipelothrix rhusiopathiae isolated from pigs with swine erysipelas in Japan, 1988-1998.	2001 Mar	11315521
Antibiotic-resistant bacteria in pediatric chronic sinusitis.	2001 Mar	11303824
Tufted hair folliculitis after scalp injury.	2001 Mar	11270300
Dose-escalation, phase I/II study of azithromycin and pyrimethamine for the treatment of toxoplasmic encephalitis in AIDS.	2001 Mar 30	11316995
[Dermo-hypodermitis and necrotizing fasciitis].	2001 Mar 31	11345864
The treatment of babesiosis.	2001 Mar 8	11236790
Serotyping and antimicrobial susceptibility of group B Streptococcus over an eight-year period in southern Taiwan.	2001 May	11453594
Clinical inquiries. What are the most effective treatments for bacterial vaginosis in nonpregnant women?	2001 May	11350701
Antibiotic resistance patterns of group B streptococci in late third-trimester rectovaginal cultures.	2001 May	11349176
Vaginal clindamycin in preventing preterm birth and peripartal infections in asymptomatic women with bacterial vaginosis: a randomized, controlled trial.	2001 May	11339909
High prevalence of carriage of antibiotic-resistant Streptococcus pneumoniae in children in Kampala Uganda.	2001 May	11337227
When to suspect and how to monitor babesiosis.	2001 May 15	11388711
Worldwide prevalence of antimicrobial resistance in Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis in the SENTRY Antimicrobial Surveillance Program, 1997-1999.	2001 May 15	11320449
Sensitive and specific determination of clindamycin in human serum and bone tissue applying liquid chromatography-atmospheric pressure chemical ionization-mass spectrometry.	2001 May 5	11393698
Multi-laboratory assessment of the linezolid spectrum of activity using the Kirby-Bauer disk diffusion method: Report of the Zyvox Antimicrobial Potency Study (ZAPS) in the United States.	2001 May-Jun	11448565
Intravitreal clindamycin and dexamethasone for toxoplasmic retinochoroiditis.	2001 May-Jun	11371084
Isolation and antimicrobial susceptibility testing of fecal strains of the archaeon Methanobrevibacter smithii.	2001 May-Jun	11306786
Prevalence of serotypes and molecular epidemiology of Streptococcus pneumoniae strains isolated from children in Beijing, China: identification of two novel multiply-resistant clones.	2001 Spring	11310804
Erythromycin and amoxicillin?	2001 Winter	11324196

Patents

Sample Use Guides

In Vivo Use Guide

150 to 300 mg every 6 hours (Serious infections), 300 to 450 mg every 6 hours (More severe infections), 8 to 16 mg/kg/day divided into three or four equal doses (Serious infections in pediatric patients), 16 to 20 mg/kg/day divided into three or four equal doses (More severe infections in pediatric patients).

Route of Administration: Oral

In Vitro Use Guide

MIC=0.03-0.12 ug/ml (Aerobic Pathogens), MIC=0.06-0.25 ug/ml (Anaerobes).

Name

Type

Language

CLINDAMYCIN PALMITATE

Common Name

English

L-THREO-.ALPHA.-D-GALACTO-OCTOPYRANOSIDE, METHYL 7-CHLORO-6,7,8-TRIDEOXY-6-(((1-METHYL-4-PROPYL-2-PYRROLIDINYL)CARBONYL)AMINO)-1-THIO-2-HEXADECANOATE, (2S-TRANS)-

Common Name

English

METHYL 7-CHLORO-6,7,8-TRIDEOXY-6-(1-METHYL-TRANS-4-PROPYL-L-2-PYRROLIDINECARBOXAMIDO)-1-THIO-L-THREO-.ALPHA.-D-GALACTO-OCTOPYRANOSIDE 2-PALMITATE

Common Name

English

Code System Code Type Description

FDA UNII

C501Z28AFG