Clindamycin

Identification

Summary

Clindamycin is a lincosamide antibiotic used to treat serious infections caused by susceptible anaerobic, streptococcal, staphylococcal, and pneumococcal bacteria.

Brand Names
Acanya, Benzaclin, Biacna, Cleocin, Cleocin-T, Clindacin, Clindagel, Clindesse, Clindoxyl, Dalacin, Dalacin C, Duac, Evoclin, Neuac, Onexton, Veltin, Ziana
Generic Name
Clindamycin
DrugBank Accession Number
DB01190
Background

Clindamycin is a semi-synthetic lincosamide antibiotic used in the treatment of a variety of serious infections due to susceptible microorganisms14,13 as well as topically for acne vulgaris.12 It has a relatively narrow spectrum of activity that includes anaerobic bacteria as well as gram-positive cocci and bacilli and gram-negative bacilli.8 Interestingly, clindamycin appears to carry some activity against protozoans, and has been used off-label in the treatment of toxoplasmosis, malaria, and babesiosis.9

Clindamycin is derived from, and has largely replaced, lincomycin, a naturally occurring lincosamide and the eponymous member of this antibiotic class, due to its improved properties over the parent compound. The name lincomycin is derived from Lincoln, Nebraska, where it was first isolated from Streptomyces lincolnensis found in a soil sample.8

Type
Small Molecule
Groups
Approved, Vet approved
Structure
Thumb
Weight
Average: 424.98
Monoisotopic: 424.179871
Chemical Formula
C18H33ClN2O5S
Synonyms
  • 7-CDL
  • 7(S)-Chloro-7-deoxylincomycin
  • Clindamicina
  • Clindamycin
  • Clindamycine
  • Clindamycinum
  • Methyl 7-chloro-6,7,8-trideoxy-6-(1-methyl-trans-4-propyl-L-2-pyrrolidinecarboxamido)-1-thio-L-threo-alpha-D-galacto-octopyranoside
External IDs
  • U-21,251
  • U-21251

Pharmacology

Indication

In oral and parenteral formulations, clindamycin is indicated for the treatment of serious infections caused by susceptible anaerobic bacteria, as well as susceptible staphylococci, streptococci, and pneumococci.14,15 Used topically, it is indicated for the treatment of acne vulgaris12,18,16 and is available in combination with benzoyl peroxide10 or tretinoin11 for this purpose. Clindamycin is also indicated as a vaginal cream13 or suppository17 for the treatment of bacterial vaginosis in non-pregnant females.

Clindamycin is used for antimicrobial prophylaxis against Viridans group streptococcal infections in susceptible patients undergoing oral, dental, or upper respiratory surgery, and may be used for prophylaxis against bacterial endocarditis in penicillin-allergic patients at high risk of these infections.20

Pharmacology
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Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Clindamycin exerts its bacteriostatic effect via inhibition of microbial protein synthesis.8 Clindamycin has a relatively short Tmax and half-life necessitating administration every six hours to ensure adequate antibiotic concentrations.20

Clostridium difficile associated diarrhea (CDAD) has been observed in patients using clindamycin, ranging in severity from mild diarrhea to fatal colitis and occasionally occurring over two months following cessation of antibiotic therapy.15 Overgrowth of C. difficile resulting from antibiotic use, along with its production of A and B toxins, contributes to morbidity and mortality in these patients. Because of the associated risks, clindamycin should be reserved for serious infections for which the use of less toxic antimicrobial agents are inappropriate.15

Clindamycin is active against a number of gram-positive aerobic bacteria, as well as both gram-positive and gram-negative anaerobes.14 Resistance to clindamycin may develop, and is generally the result of base modification within the 23S ribosomal RNA. Cross-resistance between clindamycin and lincomycin is complete, and may also occur between clindamycin and macrolide antibiotics (e.g. erythromycin) due to similarities in their binding sites.14

As antimicrobial susceptibility patterns are geographically distinct, local antibiograms should be consulted to ensure adequate coverage of relevant pathogens prior to use.

Mechanism of action

Clindamycin inhibits bacterial protein synthesis by binding to 23S RNA of the 50S subunit of the bacterial ribosome.14 It impedes both the assembly of the ribosome and the translation process.20 The molecular mechanism through which this occurs is thought to be due to clindamycin's three-dimensional structure, which closely resembles the 3'-ends of L-Pro-Met-tRNA and deacylated-tRNA during the peptide elongation cycle - in acting as a structural analog of these tRNA molecules, clindamycin impairs peptide chain initiation and may stimulate dissociation of peptidyl-tRNA from bacterial ribosomes.8

The mechanism through which topical clindamycin treats acne vulgaris is unclear, but may be related to its activity against Propionibacterium acnes, a bacteria that has been associated with acne.12

TargetActionsOrganism
A50S ribosomal protein L1
inhibitor
Staphylococcus aureus (strain NCTC 8325)
Absorption

Oral bioavailability is nearly complete, at approximately 90%, and peak serum concentrations (Cmax) of, on average, 2.50 µg/mL are reached at 0.75 hours (Tmax).15 The AUC following an orally administered dose of 300mg was found to be approximately 11 µg•hr/mL.20 Systemic exposure from the administration of vaginal suppository formulations is 40-fold to 50-fold lower than that observed following parenteral administration17 and the Cmax observed following administration of vaginal cream formulations was 0.1% of that observed following parenteral administration.13

Volume of distribution

Clindamycin is widely distributed in the body, including into bone, but does not distribute into cerebrospinal fluid. The volume of distribution has been variably estimated between 43-74 L.7,6

Protein binding

Clindamycin protein binding is concentration-dependent and ranges from 60-94%. It is bound primarily to alpha-1-acid glycoprotein in the serum.20

Metabolism

Clindamycin undergoes hepatic metabolism mediated primarily by CYP3A4 and, to a lesser extent, CYP3A5.15 Two inactive metabolites have been identified - an oxidative metabolite, clindamycin sulfoxide, and an N-demethylated metabolite, N-desmethylclindamycin.15

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Route of elimination

Approximately 10% of clindamycin bioactivity is excreted in the urine and 3.6% in the feces, with the remainder excreted as inactive metabolites.15

Half-life

The elimination half-life of clindamycin is about 3 hours in adults and 2.5 hours in children.15,14 Half-life is increased to approximately 4 hours in the elderly.15,14

Clearance

The plasma clearance of clindamycin is estimated to be 12.3-17.4 L/h, and is reduced in patients with cirrhosis and altered in those with anemia.6,7

Adverse Effects
Medicalerrors
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Toxicity

The oral LD50 in mice and rats is 2540 mg/kg and 2190 mg/kg, respectively.19

While no cases of overdose have been reported, symptoms are expected to be consistent with the adverse effect profile of clindamycin and may therefore include abdominal pain, nausea, vomiting, and diarrhea. During clinical trials, one 3-year-old child was given a dose of 100 mg/kg daily for 5 days and showed only mild abdominal pain and diarrhea.20 Activated charcoal may be of value to remove unabsorbed drug, but hemodialysis and peritoneal dialysis are ineffective.20 General supportive measures are recommended in cases of clindamycin overdose.20

Pathways
PathwayCategory
Clindamycin Action PathwayDrug action
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbametapirThe serum concentration of Clindamycin can be increased when it is combined with Abametapir.
AbataceptThe metabolism of Clindamycin can be increased when combined with Abatacept.
AcalabrutinibThe metabolism of Clindamycin can be decreased when combined with Acalabrutinib.
AcenocoumarolThe risk or severity of bleeding can be increased when Clindamycin is combined with Acenocoumarol.
AcetaminophenThe metabolism of Clindamycin can be increased when combined with Acetaminophen.
AcetophenazineAcetophenazine may increase the neurotoxic activities of Clindamycin.
AcetyldigitoxinThe serum concentration of Acetyldigitoxin can be increased when it is combined with Clindamycin.
AdalimumabThe metabolism of Clindamycin can be increased when combined with Adalimumab.
AlfentanilThe serum concentration of Clindamycin can be increased when it is combined with Alfentanil.
AlimemazineClindamycin may increase the neurotoxic activities of Alimemazine.
Interactions
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Food Interactions
  • Take with a full glass of water. Clindamycin may cause esophageal irritation if the dosage form becomes lodged.
  • Take with or without food. Food does not appreciably alter the absorption of clindamycin.

Products

Products
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Product Ingredients
IngredientUNIICASInChI Key
Clindamycin hydrochlorideT20OQ1YN1W21462-39-5AUODDLQVRAJAJM-XJQDNNTCSA-N
Clindamycin palmitate hydrochlorideVN9A8JM7M725507-04-4GTNDZRUWKHDICY-DJHAJVGHSA-N
Clindamycin phosphateEH6D7113I824729-96-2UFUVLHLTWXBHGZ-MGZQPHGTSA-N
Product Images
International/Other Brands
Clinimycin (Hayat) / Dalacin C (Pfizer) / Dalacin T Topical Solution (Pfizer) / Zindaclin (Crawford)
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
CleocinSuppository100 mg/1VaginalPharmacia and Upjohn Company LLC1999-08-13Not applicableUS flag
CleocinCream20 mg/1gVaginalPhysicians Total Care, Inc.1992-08-112010-06-30US flag
CleocinSuppository100 mg/1VaginalPhysicians Total Care, Inc.2003-12-302013-06-30US flag
CleocinSuppository100 mg/1VaginalU.S. Pharmaceuticals1999-08-13Not applicableUS flag
CleocinCream20 mg/1gVaginalPharmacia and Upjohn Company LLC1992-08-11Not applicableUS flag
Cleocin HydrochlorideCapsule75 mg/1OralPharmacia and Upjohn Company LLC1970-05-22Not applicableUS flag00009 0331 02 nlmimage10 070803d0
Cleocin HydrochlorideCapsule300 mg/1OralPharmacia and Upjohn Company LLC1970-05-22Not applicableUS flag
Cleocin HydrochlorideCapsule300 mg/1OralRedPharm Drug, Inc.1970-05-22Not applicableUS flag
Cleocin HydrochlorideCapsule150 mg/1OralPharmacia and Upjohn Company LLC1970-05-22Not applicableUS flag
Cleocin PhosphateInjection, solution150 mg/1mLIntramuscular; IntravenousPharmacia and Upjohn Company LLC2014-04-10Not applicableUS flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Ag-clindamycinCapsule300 mgOralAngita Pharma Inc.2020-01-27Not applicableCanada flag
Ag-clindamycinCapsule150 mgOralAngita Pharma Inc.2020-02-27Not applicableCanada flag
Apo-clindamycinCapsule300 mgOralApotex Corporation2002-02-20Not applicableCanada flag
Apo-clindamycinCapsule150 mgOralApotex Corporation2002-02-20Not applicableCanada flag
Auro-clindamycinCapsule150 mgOralAuro Pharma Inc2015-03-02Not applicableCanada flag
Auro-clindamycinCapsule300 mgOralAuro Pharma Inc2015-03-02Not applicableCanada flag
Ava-clindamycinCapsule150 mgOralAvanstra Inc2011-08-222014-08-21Canada flag
Ava-clindamycinCapsule300 mgOralAvanstra Inc2011-08-222014-08-21Canada flag
CleocinCapsule300 mg/1OralAdvanced Rx Pharmacy of Tennessee, LLC2009-08-26Not applicableUS flag
CleocinGranule, for solution75 mg/5mLOralPhysicians Total Care, Inc.2007-11-28Not applicableUS flag
Over the Counter Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
คลินดาลิน เจลGel1 %w/wTopicalบริษัท สามัคคีเภสัช จำกัด จำกัด1999-09-13Not applicableThailand flag
คลินดาแมน เจลGel1 %w/wTopicalบริษัท ที. แมน ฟาร์มา จำกัด2005-12-20Not applicableThailand flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
AcanyaClindamycin phosphate (10 mg/1g) + Benzoyl peroxide (25 mg/1g)GelTopicalBausch Health US, LLC2010-07-26Not applicableUS flag
AcanyaClindamycin phosphate (10 mg/1mL) + Benzoyl peroxide (25 mg/1g)KitTopicalDow Pharmaceuticals Sciences2009-02-032014-04-30US flag
ACNOIC PLUS�Clindamycin (1 g) + Adapalene (0.1 g) + Benzoyl peroxide (5 g)GelTopicalLABORATORIO FRANCO COLOMBIANO LAFRANCOL S.A.S.2017-07-312018-03-13Colombia flag
ADAPCLIN�Clindamycin phosphate (1 g) + Adapalene (0.1 g)GelTopicalCOLOMPACK S.A.2019-03-19Not applicableColombia flag
BenzaclinClindamycin phosphate (10 mg/1g) + Benzoyl peroxide (50 mg/1g)GelTopicalDermik Laboratories2009-06-012012-04-30US flag
BenzaclinClindamycin (1 % w/w) + Benzoyl peroxide (5 % w/w)GelTopicalBausch Health, Canada Inc.2004-05-04Not applicableCanada flag
BenzaclinClindamycin phosphate (10 mg/1g) + Benzoyl peroxide (50 mg/1g)GelTopicalPhysicians Total Care, Inc.2009-08-27Not applicableUS flag
BenzaclinClindamycin phosphate (10 mg/1g) + Benzoyl peroxide (50 mg/1g)GelTopicalBausch Health US LLC2000-12-21Not applicableUS flag
BENZALIN TOPIKAL JEL, 25 GRClindamycin phosphate (1 %) + Benzoyl peroxide (5 %)GelTopicalFARMA-TEK İLAÇ SAN. VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
BENZALIN TOPIKAL JEL, 50 GRClindamycin phosphate (1 %) + Benzoyl peroxide (5 %)GelTopicalFARMA-TEK İLAÇ SAN. VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
Adapalene 0.1% / Benzoyl Peroxide 2.5% / Clindamycin 1%Clindamycin phosphate (1 g/100g) + Adapalene (0.1 g/100g) + Benzoyl peroxide (2.5 g/100g)GelTopicalSincerus Florida, LLC2019-05-10Not applicableUS flag
Adapalene 0.3% / Benzoyl Peroxide 2.5% / Clindamycin 1%Clindamycin phosphate (1 g/100g) + Adapalene (0.3 g/100g) + Benzoyl peroxide (2.5 g/100g)GelTopicalSincerus Florida, LLC2019-05-01Not applicableUS flag
Benzoyl Peroxide 2.5% / Clindamycin 1% / Niacinamide 2% / Tretinoin 0.025%Clindamycin phosphate (1 g/100g) + Benzoyl peroxide (2.5 g/100g) + Nicotinamide (2 g/100g) + Tretinoin (0.025 g/100g)GelTopicalSincerus Florida, LLC2019-05-22Not applicableUS flag
Benzoyl Peroxide 2.5% / Clindamycin 1% / Niacinamide 4%Clindamycin phosphate (1 g/100g) + Benzoyl peroxide (2.5 g/100g) + Nicotinamide (4 g/100g)GelTopicalSincerus Florida, LLC2019-05-01Not applicableUS flag
Benzoyl Peroxide 2.5%, Clindamycin Phosphate 1%, Niacinamide 2% / Tretinoin 0.05%Clindamycin phosphate (1 g/100g) + Benzoyl peroxide (2.5 g/100g) + Nicotinamide (2 g/100g) + Tretinoin (0.05 g/100g)GelTopicalSincerus Florida, LLC2019-05-04Not applicableUS flag
Benzoyl Peroxide 5% / Clindamycin 1% / Niacinamide 2% / Spironolactone 2%Clindamycin phosphate (1 g/100g) + Benzoyl peroxide (5 g/100g) + Nicotinamide (2 g/100g) + Spironolactone (2 g/100g)GelTopicalSincerus Florida, LLC2019-05-11Not applicableUS flag
Benzoyl Peroxide 5% / Clindamycin 1% / Niacinamide 2% / Spironolactone 2% / Tretinoin 0.025%Clindamycin phosphate (1 g/100g) + Benzoyl peroxide (5 g/100g) + Nicotinamide (2 g/100g) + Spironolactone (2 g/100g) + Tretinoin (0.025 g/100g)GelTopicalSincerus Florida, LLC2019-05-04Not applicableUS flag
Benzoyl Peroxide 5% / Clindamycin 1% / Niacinamide 2% / Spironolactone 2% / Tretinoin 0.05%Clindamycin phosphate (1 g/100g) + Benzoyl peroxide (5 g/100g) + Nicotinamide (2 g/100g) + Spironolactone (2 g/100g) + Tretinoin (0.05 g/100g)GelTopicalSincerus Florida LLC2019-05-03Not applicableUS flag
Benzoyl Peroxide 5% / Clindamycin 1% / Niacinamide 2% / Tretinoin 0.05%Clindamycin phosphate (1 g/100g) + Benzoyl peroxide (5 g/100g) + Nicotinamide (2 g/100g) + Tretinoin (0.05 g/100g)GelTopicalSincerus Florida, LLC2019-05-01Not applicableUS flag
Benzoyl Peroxide 5% / Clindamycin 1% / Niacinamide 2% / Tretinoin 0.1%Clindamycin phosphate (1 g/100g) + Benzoyl peroxide (5 g/100g) + Nicotinamide (2 g/100g) + Tretinoin (0.1 g/100g)GelTopicalSincerus Florida, LLC2019-05-04Not applicableUS flag

Categories

ATC Codes
D10AF01 — ClindamycinJ01FF01 — ClindamycinD10AF51 — Clindamycin, combinationsG01AA10 — Clindamycin
Drug Categories
Classification
Not classified
Affected organisms
  • Streptococcus pyogenes
  • Streptococcus pneumoniae
  • Streptococcus agalactiae
  • Clostridium perfringens
  • Staphylococcus aureus
  • Staphylococcus epidermidis
  • Streptococcus mitis
  • Streptococcus oralis
  • Streptococcus anginosus
  • Propionibacterium acnes
  • Finegoldia magna
  • Fusobacterium nucleatum
  • Fusobacterium necrophorum
  • Peptostreptococcus anaerobius
  • Prevotella melaninogenica
  • Actinomyces israelii
  • Clostridium clostridioforme
  • Eggerthella lenta
  • Parvimonas micra
  • Prevotella bivia
  • Prevotella intermedia

Chemical Identifiers

UNII
3U02EL437C
CAS number
18323-44-9
InChI Key
KDLRVYVGXIQJDK-AWPVFWJPSA-N
InChI
InChI=1S/C18H33ClN2O5S/c1-5-6-10-7-11(21(3)8-10)17(25)20-12(9(2)19)16-14(23)13(22)15(24)18(26-16)27-4/h9-16,18,22-24H,5-8H2,1-4H3,(H,20,25)/t9-,10+,11-,12+,13-,14+,15+,16+,18+/m0/s1
IUPAC Name
(2S,4R)-N-[(1S,2S)-2-chloro-1-[(2R,3R,4S,5R,6R)-3,4,5-trihydroxy-6-(methylsulfanyl)oxan-2-yl]propyl]-1-methyl-4-propylpyrrolidine-2-carboxamide
SMILES
[H][C@@](NC(=O)[C@@H]1C[C@@H](CCC)CN1C)([C@H](C)Cl)[C@@]1([H])O[C@H](SC)[C@H](O)[C@@H](O)[C@H]1O

References

Synthesis Reference

Donald E. Ayer, Carl A. Schlagel, Gordon L. Flynn, "Topical clindamycin preparations." U.S. Patent US4018918, issued January, 1971.

US4018918
General References
  1. Daum RS: Clinical practice. Skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus. N Engl J Med. 2007 Jul 26;357(4):380-90. [Article]
  2. Klempner MS, Styrt B: Clindamycin uptake by human neutrophils. J Infect Dis. 1981 Nov;144(5):472-9. [Article]
  3. Lamont RF: Can antibiotics prevent preterm birth--the pro and con debate. BJOG. 2005 Mar;112 Suppl 1:67-73. [Article]
  4. Plaisance KI, Drusano GL, Forrest A, Townsend RJ, Standiford HC: Pharmacokinetic evaluation of two dosage regimens of clindamycin phosphate. Antimicrob Agents Chemother. 1989 May;33(5):618-20. [Article]
  5. Wynalda MA, Hutzler JM, Koets MD, Podoll T, Wienkers LC: In vitro metabolism of clindamycin in human liver and intestinal microsomes. Drug Metab Dispos. 2003 Jul;31(7):878-87. doi: 10.1124/dmd.31.7.878. [Article]
  6. Leigh DA: Antibacterial activity and pharmacokinetics of clindamycin. J Antimicrob Chemother. 1981 Jun;7 Suppl A:3-9. doi: 10.1093/jac/7.suppl_a.3. [Article]
  7. Bouazza N, Pestre V, Jullien V, Curis E, Urien S, Salmon D, Treluyer JM: Population pharmacokinetics of clindamycin orally and intravenously administered in patients with osteomyelitis. Br J Clin Pharmacol. 2012 Dec;74(6):971-7. doi: 10.1111/j.1365-2125.2012.04292.x. [Article]
  8. Spizek J, Rezanka T: Lincosamides: Chemical structure, biosynthesis, mechanism of action, resistance, and applications. Biochem Pharmacol. 2017 Jun 1;133:20-28. doi: 10.1016/j.bcp.2016.12.001. Epub 2016 Dec 7. [Article]
  9. Spizek J, Rezanka T: Lincomycin, clindamycin and their applications. Appl Microbiol Biotechnol. 2004 May;64(4):455-64. doi: 10.1007/s00253-003-1545-7. Epub 2004 Feb 5. [Article]
  10. FDA Approved Drug Products: Onexton (clindamycin phosphate/benzoyl peroxide) topical gel [Link]
  11. FDA Approved Drug Products: Ziana (clindamycin phosphate/tretinoin) topical gel [Link]
  12. FDA Approved Drug Products: Evoclin (clindamycin phosphate) topical foam [Link]
  13. FDA Approved Drug Products: Clindesse (clindamycin phosphate) vaginal cream [Link]
  14. FDA Approved Drug Products: Clindamycin in 0.9% NaCl for intravenous injection [Link]
  15. FDA Approved Drug Products: Cleocin (clindamycin hydrochloride) oral capsules [Link]
  16. FDA Approved Drug Products: Cleocin T (clindamycin phosphate) topical gel/solution/lotion [Link]
  17. FDA Approved Drug Products: Cleocin (clindamycin phosphate) vaginal suppositories [Link]
  18. Health Canada Product Monograph: Clindets (clindamycin phosphate) topical swabs [Link]
  19. CaymanChem: Clindamycin MSDS [Link]
  20. Health Canada Product Monograph: Clindamycin oral capsules [Link]
  21. INVIMA Product Characteristics: Tensonorm (miconazole/clindamycin) vaginal ovules [Link]
Human Metabolome Database
HMDB0015321
KEGG Drug
D00277
KEGG Compound
C06914
PubChem Compound
446598
PubChem Substance
46506073
ChemSpider
393915
RxNav
2582
ChEBI
3745
ChEMBL
CHEMBL1753
ZINC
ZINC000004038341
Therapeutic Targets Database
DAP000409
PharmGKB
PA449035
PDBe Ligand
CLY
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Clindamycin
PDB Entries
1jzx / 1yjn / 3jz0 / 4v7v
FDA label
Download (151 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedNot AvailableBacterial Endophthalmitis / Endophthalmitis / Prophylaxy of Post Traumatic Endophthalmitis1
4CompletedPreventionArrhythmia1
4CompletedPreventionBacterial Vaginosis (BV) / Infants, Premature / Pregnant State / Premature Births1
4CompletedPreventionEmpyema / Pleural Effusions / Pleuritis1
4CompletedPreventionPregnant State1
4CompletedTreatmentAbscesses / Folliculitis / Infection caused by staphylococci / Staphylococcal Skin Infections1
4CompletedTreatmentAcne3
4CompletedTreatmentAcne Vulgaris18
4CompletedTreatmentAcne Vulgaris / Postinflammatory Hyperpigmentation1
4CompletedTreatmentAmputation, Wound / Wound Infections1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
  • Accra Pac Inc.
  • Aidarex Pharmacuticals LLC
  • Ameri-Pac Inc.
  • Amerisource Health Services Corp.
  • Apotheca Inc.
  • APP Pharmaceuticals
  • A-S Medication Solutions LLC
  • Aurobindo Pharma Ltd.
  • Baxter International Inc.
  • Bedford Labs
  • Ben Venue Laboratories Inc.
  • Bryant Ranch Prepack
  • Cardinal Health
  • Catalent Pharma Solutions
  • Contract Pharm
  • Corepharma LLC
  • Coria Laboratories
  • Coupler Enterprises Inc.
  • Dermik Labs
  • Direct Dispensing Inc.
  • Dispensing Solutions
  • Diversified Healthcare Services Inc.
  • Dow Pharmaceutical Sciences
  • DPT Laboratories Ltd.
  • E. Fougera and Co.
  • Galderma Laboratories
  • Gallipot
  • Greenstone LLC
  • H.J. Harkins Co. Inc.
  • Heartland Repack Services LLC
  • Hospira Inc.
  • Innoviant Pharmacy Inc.
  • Inyx Usa Ltd.
  • Kaiser Foundation Hospital
  • Keltman Pharmaceuticals Inc.
  • Kleen Test Products Corp.
  • KV Pharmaceutical Co.
  • Lake Erie Medical and Surgical Supply
  • Lannett Co. Inc.
  • Liberty Pharmaceuticals
  • Major Pharmaceuticals
  • Mckesson Corp.
  • Medisca Inc.
  • Murfreesboro Pharmaceutical Nursing Supply
  • Mylan
  • Novopharm Ltd.
  • Nucare Pharmaceuticals Inc.
  • Nycomed Inc.
  • Ohm Laboratories Inc.
  • Paddock Labs
  • Palmetto Pharmaceuticals Inc.
  • Patheon Inc.
  • PCA LLC
  • PD-Rx Pharmaceuticals Inc.
  • Perrigo Co.
  • Pfizer Inc.
  • Pharmaceutical Utilization Management Program VA Inc.
  • Pharmacia Inc.
  • Pharmaderm
  • Pharmedix
  • Physician Partners Ltd.
  • Physicians Total Care Inc.
  • Preferred Pharmaceuticals Inc.
  • Prepackage Specialists
  • Prepak Systems Inc.
  • Quality Care
  • Ranbaxy Laboratories
  • Rebel Distributors Corp.
  • Redpharm Drug
  • Remedy Repack
  • Resource Optimization and Innovation LLC
  • Sandoz
  • Sanofi-Aventis Inc.
  • Sirius Labs
  • Southwood Pharmaceuticals
  • Spectrum Pharmaceuticals
  • St Mary's Medical Park Pharmacy
  • Stat Rx Usa
  • Stiefel Labs
  • Taro Pharmaceuticals USA
  • Teva Pharmaceutical Industries Ltd.
  • Ther-Rx Corp.
  • Tya Pharmaceuticals
  • UDL Laboratories
  • Unimed Pharmaceuticals Inc.
  • Watson Pharmaceuticals
  • Wockhardt Ltd.
Dosage Forms
FormRouteStrength
KitTopical
GelTopical1 g
Capsule, coatedOral300 mg
GelTopical
GelTopical10 MG/G
Granule, for solutionOral75 mg/5mL
SuppositoryVaginal
SuppositoryVaginal100 mg/1
Granule, for suspensionOral
Injection, solutionIntramuscular; Intravenous12 mg/1mL
Injection, solutionIntramuscular; Intravenous18 mg/1mL
Injection, solutionIntramuscular; Intravenous6 mg/1mL
LotionTopical1 g
Injection, solution
SolutionIntramuscular; Intravenous
SolutionIntramuscular
KitIntravenous
KitIntramuscular; Intravenous150 mg/1mL
TabletVaginal150 mg
TabletVaginal25 mg
TabletVaginal75 mg
CreamTopical2 g
TabletVaginal100 mg
Tablet, film coatedOral150 MG
CapsuleOral
Tablet, film coatedOral
KitTopical10 mg/1
SwabTopical10 mg/1
InjectionParenteral
GelTopical10 mg/1mL
Tablet, film coatedOral450 MG
Tablet, film coatedOral600 MG
SuspensionTopical10 mg/1mL
SolutionIntravenous600 mg
SolutionTopical1 g
CreamVaginal2 g
Capsule, coatedOral384.62 mg
SolutionIntramuscular; Intravenous150 mg
SolutionIntramuscular; Intravenous600 mg
SolutionIntravenous0.6 g
InjectionParenteral600 mg
InjectionIntramuscular; Intravenous600 mg
SolutionParenteral300 mg
SolutionIntramuscular600 mg
InjectionIntravenous150 mg/1mL
InjectionIntravenous300 mg/50mL
InjectionIntravenous600 mg/50mL
InjectionIntravenous900 mg/50mL
Injection, solutionIntravenous150 mg/1mL
Injection, solution, concentrateIntramuscular; Intravenous150 mg/1mL
Injection, solution, concentrateIntravenous150 mg/1mL
Injection, solutionParenteral
CreamTopical
LotionTopical
SolutionTopical
CapsuleOral600 mg/1
CapsuleOral150 mg/1
CapsuleOral300 mg/1
CapsuleOral75 mg/1
Capsule, gelatin coatedOral150 mg/1
Capsule, gelatin coatedOral300 mg/1
Capsule, gelatin coatedOral75 mg/1
Injection, solutionIntravenous12 mg/1mL
Injection, solutionIntravenous18 mg/1mL
Injection, solutionIntravenous6 mg/1mL
SolutionIntravenous300 mg / 50 mL
SolutionIntravenous600 mg / 50 mL
SolutionIntravenous900 mg / 50 mL
LiquidIntramuscular; Intravenous150 mg / mL
SolutionIntravenous150 mg / mL
SolutionIntravenous12 mg / mL
SolutionIntravenous18 mg / mL
SolutionIntravenous6 mg / mL
SolutionOral75 mg/5mL
Powder, for solutionOral75 mg/5mL
CreamVaginal20 mg/1g
GelTopical1 g/10mL
GelTopical10 mg/1g
Injection, solutionIntramuscular; Intravenous150 mg/1mL
Injection, solutionIntravenous300 mg/50mL
Injection, solutionIntravenous600 mg/50mL
Injection, solutionIntravenous900 mg/50mL
LotionTopical10 mg/1mL
SolutionTopical10 mg/1mL
SolutionTopical11.9 mg/1mL
SolutionTopical10 mg/01mL
CreamVaginal100 mg/5g
SwabTopical1 %
Cream
SolutionTopical
LotionTopical
CreamVaginal
SolutionOral
Granule, for solutionOral75 mg / 5 mL
Injection, solutionIntramuscular; Intravenous
SolutionIntramuscular; Intravenous150 mg/1ml
SolutionIntramuscular; Intravenous150 mg / mL
Solution
EmulsionTopical
SolutionTopical60 ML
SwabCutaneous
SolutionTopical1 % w/v
CreamVaginal2 %
CreamVaginal20 mg / g
SolutionIntramuscular; Intravenous300 mg
SolutionParenteral600 mg
Capsule, liquid filledVaginal100 mg
Aerosol, foamTopical10 mg/1g
TabletVaginal
CreamVaginal
InsertVaginal
CreamVaginal2 g
CapsuleOral150 mg
GelTopical1 %
InsertVaginal100 mg
CapsuleOral300 MG
Cream
SuppositoryVaginal100 mg
InjectionIntramuscular; Intravenous
Capsule, liquid filledVaginal
CapsuleVaginal
GelTopical
Injection, solution150 mg/1ml
GelTopical1 %w/w
Solution150 mg/1ml
Tablet, film coatedOral300 mg
Prices
Unit descriptionCostUnit
Clindagel 1% Gel 75ml Bottle324.48USD bottle
Evoclin 1% Foam 100 gm Can306.79USD can
Clindamycin Phosphate 1% Foam 100 gm Can286.04USD can
Evoclin 1% Foam 50 gm Can207.67USD can
Clindagel 1% Gel 40ml Bottle203.42USD bottle
Clindamycin Phosphate 1% Foam 50 gm Can186.9USD can
Clindamycin Phos-Benzoyl Perox 1-5% Gel 50 gm Jar176.42USD jar
Cleocin-T 1% Gel 60 gm Tube112.84USD tube
Cleocin-T 1% Lotion 60ml Bottle86.09USD bottle
Cleocin-T 60 1% Swab Box82.6USD box
Cleocin 2% Cream 40 gm Tube81.56USD tube
Cleocin 3 100 mg Suppository Box80.05USD box
Cleocin 75 mg/5ml Solution 100ml Bottle78.7USD bottle
Clindamycin hcl crystals74.9USD g
Clindamycin Phosphate 1% Gel 60 gm Tube71.42USD tube
Cleocin-T 1% Solution 60ml Bottle69.29USD bottle
Cleocin-T 1% Gel 30 gm Tube62.98USD tube
Clindamycin Phosphate 2% Cream 40 gm Tube54.99USD tube
Clindamycin Phosphate 60 1% Swab Box47.74USD box
Clindamycin Phosphate 1% Lotion 60ml Bottle46.92USD bottle
Clindesse 2% vaginal cream39.08USD g
Clindamycin Phosphate 1% Gel 30 gm Tube33.41USD tube
Clindamycin Phosphate 1% Solution 60ml Bottle24.07USD bottle
Clindamycin phosphate powdr21.42USD g
Clindamycin Phosphate 1% Solution 30ml Bottle14.99USD bottle
Cleocin hcl 300 mg capsule9.11USD capsule
Clindamycin phos crystals7.73USD g
Evoclin 1% foam4.9USD g
Clindagel 1% gel4.89USD ml
Cleocin 150 mg capsule4.66USD capsule
Dalacin C Phosphate 150 mg/ml4.53USD ml
Clindamycin hcl 300 mg capsule3.98USD capsule
Clindamycin phosphate 1% foam3.59USD g
Clindamycin 150 mg/ml3.48USD ml
Clindamycin (60 & 120 Ml) 150 mg/ml3.41USD ml
Cleocin hcl 150 mg capsule2.79USD capsule
Cleocin hcl 75 mg capsule2.28USD capsule
Dalacin C 300 mg Capsule2.12USD capsule
Cleocin 2% vaginal cream1.97USD g
Clindamycin 150 mg/ml addvan1.97USD ml
Cleocin phos 150 mg/ml vial1.91USD ml
Cleocin t 1% gel1.81USD g
Clindamycin ph 300 mg/2 ml vial1.74USD ml
Clindamax 2% vaginal cream1.37USD g
Clindamycin 2% vaginal cream1.27USD g
Clindamycin hcl 150 mg capsule1.21USD capsule
Clindets 1% pledgets1.1USD each
Dalacin C 150 mg Capsule1.06USD capsule
Apo-Clindamycin 300 mg Capsule1.02USD capsule
Mylan-Clindamycin 300 mg Capsule1.02USD capsule
Novo-Clindamycin 300 mg Capsule1.02USD capsule
Clindamycin ph 9 g/60 ml vial0.93USD ml
Apo-Clindamycin 150 mg Capsule0.51USD capsule
Mylan-Clindamycin 150 mg Capsule0.51USD capsule
Novo-Clindamycin 150 mg Capsule0.51USD capsule
Clinda-derm 1% solution0.4USD ml
Cleocin 900 mg-d5w-galaxy0.37USD ml
Cleocin 600 mg-d5w-galaxy0.3USD ml
Dalacin C Palmitate 15 mg/ml Solution0.14USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US5266329No1993-11-302010-11-30US flag
US5993856No1999-11-302017-11-17US flag
US6387383No2002-05-142020-08-03US flag
US7374747No2008-05-202026-08-09US flag
US7141237No2006-11-282024-01-23US flag
US8288434No2012-10-162029-08-05US flag
US8663699No2014-03-042029-06-03US flag
US8895070No2014-11-252029-06-03US flag
US9078870No2015-07-142029-06-03US flag
US6495157No2002-12-172020-07-20US flag
US6899890No2005-05-312023-04-27US flag
US9504704No2016-11-292029-06-03US flag
US9561208No2017-02-072029-06-03US flag
US9789057No2017-10-172026-12-02US flag
US10137142No2018-11-272029-06-03US flag
US10220049No2019-03-052029-06-03US flag
US10624918No2009-06-032029-06-03US flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)141-143CCanadian labeling
water solubilityWater solubleCanadian labeling
logP2.16HANSCH,C ET AL. (1995)
pKa7.6Canadian labeling
Predicted Properties
PropertyValueSource
Water Solubility3.1 mg/mLALOGPS
logP1.76ALOGPS
logP1.04ChemAxon
logS-2.1ALOGPS
pKa (Strongest Acidic)12.41ChemAxon
pKa (Strongest Basic)7.55ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count6ChemAxon
Hydrogen Donor Count4ChemAxon
Polar Surface Area102.26 Å2ChemAxon
Rotatable Bond Count7ChemAxon
Refractivity105.72 m3·mol-1ChemAxon
Polarizability44.82 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET Features
PropertyValueProbability
Human Intestinal Absorption+0.8143
Blood Brain Barrier-0.9697
Caco-2 permeable-0.8236
P-glycoprotein substrateSubstrate0.7653
P-glycoprotein inhibitor INon-inhibitor0.7311
P-glycoprotein inhibitor IIInhibitor0.7894
Renal organic cation transporterNon-inhibitor0.8784
CYP450 2C9 substrateNon-substrate0.8214
CYP450 2D6 substrateNon-substrate0.9116
CYP450 3A4 substrateSubstrate0.6762
CYP450 1A2 substrateNon-inhibitor0.9045
CYP450 2C9 inhibitorNon-inhibitor0.9071
CYP450 2D6 inhibitorNon-inhibitor0.9231
CYP450 2C19 inhibitorNon-inhibitor0.9025
CYP450 3A4 inhibitorNon-inhibitor0.8876
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9107
Ames testNon AMES toxic0.6967
CarcinogenicityNon-carcinogens0.9172
BiodegradationNot ready biodegradable0.994
Rat acute toxicity2.3192 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9887
hERG inhibition (predictor II)Non-inhibitor0.59
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available

Targets

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Kind
Protein
Organism
Staphylococcus aureus (strain NCTC 8325)
Pharmacological action
Yes
Actions
Inhibitor
Curator comments
Note: The above was chosen as a representative target protein in a representative bacterium, and does not encompass all proteins/bacteria affected by this agent.
General Function
Binds directly to 23S rRNA. The L1 stalk is quite mobile in the ribosome, and is involved in E site tRNA release.
Specific Function
Rna binding
Gene Name
rplA
Uniprot ID
Q2G0P0
Uniprot Name
50S ribosomal protein L1
Molecular Weight
24708.165 Da
References
  1. FDA Approved Drug Products: Cleocin (clindamycin hydrochloride) oral capsules [Link]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inhibitor
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Wynalda MA, Hutzler JM, Koets MD, Podoll T, Wienkers LC: In vitro metabolism of clindamycin in human liver and intestinal microsomes. Drug Metab Dispos. 2003 Jul;31(7):878-87. doi: 10.1124/dmd.31.7.878. [Article]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Oxygen binding
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP3A5
Uniprot ID
P20815
Uniprot Name
Cytochrome P450 3A5
Molecular Weight
57108.065 Da
References
  1. Wynalda MA, Hutzler JM, Koets MD, Podoll T, Wienkers LC: In vitro metabolism of clindamycin in human liver and intestinal microsomes. Drug Metab Dispos. 2003 Jul;31(7):878-87. doi: 10.1124/dmd.31.7.878. [Article]

Carriers

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Not Available
Specific Function
Functions as transport protein in the blood stream. Binds various ligands in the interior of its beta-barrel domain. Also binds synthetic drugs and influences their distribution and availability in...
Gene Name
ORM1
Uniprot ID
P02763
Uniprot Name
Alpha-1-acid glycoprotein 1
Molecular Weight
23511.38 Da
References
  1. Health Canada Product Monograph: Clindamycin oral capsules [Link]

Transporters

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Curator comments
Clindamycin's has been demonstrated to be a substrate of chicken P-glycoprotein, but in vivo human data is lacking. It is unclear whether this relationship extends to human P-glycoprotein.
General Function
Xenobiotic-transporting atpase activity
Specific Function
Energy-dependent efflux pump responsible for decreased drug accumulation in multidrug-resistant cells.
Gene Name
ABCB1
Uniprot ID
P08183
Uniprot Name
Multidrug resistance protein 1
Molecular Weight
141477.255 Da
References
  1. Zhang Y, Huang J, Liu Y, Guo T, Wang L: Using the lentiviral vector system to stably express chicken P-gp and BCRP in MDCK cells for screening the substrates and studying the interplay of both transporters. Arch Toxicol. 2018 Jun;92(6):2027-2042. doi: 10.1007/s00204-018-2209-9. Epub 2018 May 3. [Article]
  2. Zhang Y, Guo L, Huang J, Sun Y, He F, Zloh M, Wang L: Inhibitory Effect of Berberine on Broiler P-glycoprotein Expression and Function: In Situ and In Vitro Studies. Int J Mol Sci. 2019 Apr 22;20(8). pii: ijms20081966. doi: 10.3390/ijms20081966. [Article]

Drug created on June 13, 2005 13:24 / Updated on July 29, 2021 06:27