Dalatic Capsule
Clindamycin
300mg
Drug International Ltd.
| Pack size | 14's Pack |
|---|---|
| Retail Price | 15.05 |
Indications
Serious respiratory tract infections, empyema, anaerobic pneumonitis, lung abscess, serious skin and soft tissue infections, bone and joint Infections, septicemia, intra-abdominal infections, peritonitis, intra-abdominal abscess, gynecological Infections, endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis, postsurgical vaginal cuff infection, dental infections
Adult Dose
Adult:
Clindamycin is indicated in the treatment of serious infections caused by susceptible anaerobic bacteria. Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci.
Oral
Serious Infections: 150 mg - 300 mg every 6 hours.
More severe infections: 300 mg - 450 mg every 6 hours.
Max: 1.8 g/day.
Prophylaxis of endocarditis 600 mg 1 hr before dental procedure.
IV/IM Injections
Serious infections due to aerobic gram-positive cocci and the more susceptible anaerobes (NOT generally including Bacteroides fragilis, Peptococcus species and Clostridioides species other than Clostridium perfringens):
600–1200 mg/day in 2, 3 or 4 equal doses by IV/IM.
More severe infections, particularly those due to proven or suspected Bacteroides fragilis, Peptococcus species, or Clostridium species other than Clostridium perfringens:
1200–2700 mg/day in 2, 3 or 4 equal doses by IV/IM.
Surgical Prophylaxis
900 mg PO/IV 1 hr prior to procedure; may redose q6hr if necessary
Single intramuscular injections of > 600 mg not recommended
Alternatively, drug may be administered in the form of a single rapid infusion of first dose followed by continuous IV infusion as follows
To maintain serum levels >4mcg/mL, administer a rapid infusion at 10 mg/min for 30 min followed by maintenance infusion of 0.75 mg/min
To maintain serum levels >5 mcg/mL, administer a rapid infusion at 15 mg/min for 30 min followed by maintenance infusion of 1 mg/min
To maintain serum levels >6 mcg/mL, administer a rapid infusion at 20 mg/min for 30 min followed by maintenance infusion of 1.25 mg/min
Child Dose
Child
Oral
Powder for oral solution:
Serious infections: 8-12 mg/kg/day divided into 3 or 4 equal doses.
Severe infections: 13-16 mg/kg/day divided into 3 or 4 equal doses.
More severe infections: 17-25 mg/kg/day divided into 3 or 4 equal doses.
In pediatric patients weighing 10 kg or less, 1/2 teaspoon (37.5 mg) three times a day should be considered the minimum recommended dose.
IV/IM Injections
Child 1 Month of Age to 16 Years: 20 to 40 mg/kg/day in 3 or 4 equal doses by IV/IM.
Alternative Pediatric Patients Dosing: 350 mg/m2/day for serious infections and 450 mg/m2/day for more severe infections.
Neonates (Less than 1 Month of Age): 15 to 20 mg/kg/day in 3 to 4 equal doses by IV/IM.
The lower effective dosage may be adequate for small prematures.
IM: No more than 600 mg per injection
Administration
Cap: May be taken with or without food. Swallow whole w/ a full glass of water & in an upright position.
Granules: Should be taken with food.
IV Preparation
Dilute 300 and 600 mg in 50 mL of D5W
Dilute 900 mg in 50-100 mL of D5W
Dilute 1200 mg in 100 mL of D5W
IV Administration
Intermittent IV infusion
Infuse over 10-60 min at a rate not exceeding 30 mg/min
300 mg doses infuse over 10 min
600 mg doses infuse over 20 min
900 mg doses infuse over 30 min
1200 mg doses infuse over 60 min; no more than 1200 mg of drug should be given by IV infusion in 1 hr
Continuous IV infusion
May give continuous IV infusion instead of intermittent after first dose has been given by rapid IV infusion
Contra Indications
Hypersensitivity to clindamycin, lincomycin, or formulation components
Precautions
Clostridium difficile-associated diarrhea (CDAD) has been reported and may range in severity from mild diarrhea to fatal colitis
C difficile produces toxins A and B, which contribute to CDAD; hypertoxin-producing C difficile strains increase morbidity and mortality (more likely to be refractory to antimicrobial therapy and may require colectomy)
If CDAD suspected or confirmed, ongoing antibiotic use not directed against C difficile may need to be discontinued
Administration
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Patient Handout
Formulary
Dosing & Uses
Adult
Pediatric
Dosage Forms & Strengths
capsule
75mg
150mg
300mg
injectable solution
150mg/mL
oral solution
75mg/5mL
intravenous ready-to-use solution
300 mg/50mL (5% dextrose)
600 mg/50mL (5% dextrose)
900 mg/50mL (5% dextrose)
Infections
Aerobic gram-positive cocci and the more susceptible anaerobes (NOT generally including Bacteroides fragilis, Peptococcus species and Clostridium species other than Clostridium perfringens)
600–1200 mg/day IV/IM divided BID/QID
More severe infections, particularly those due to proven or suspected Bacteroides fragilis, Peptococcus species, or Clostridium species other than Clostridium perfringens: 1200–2700 mg/day IV/IM divided BID/QID
For more serious infections, these doses may have to be increased; in life-threatening situations due to either aerobes or anaerobes these doses may be increased; doses of as much as 4800 mg qDay given IV to adults
Single intramuscular injections of > 600 mg not recommended
Alternatively, drug may be administered in the form of a single rapid infusion of first dose followed by continuous IV infusion as follows
To maintain serum levels >4mcg/mL, administer a rapid infusion at 10 mg/min for 30 min followed by maintenance infusion of 0.75 mg/min
To maintain serum levels >5 mcg/mL, administer a rapid infusion at 15 mg/min for 30 min followed by maintenance infusion of 1 mg/min
To maintain serum levels >6 mcg/mL, administer a rapid infusion at 20 mg/min for 30 min followed by mai
Pregnancy-Lactation
Not Classi
Pregnancy
In clinical trials with pregnant women, systemic administration of clindamycin during the second and third trimesters, has not been associated with increased frequency of congenital abnormalities
Clindamycin should be used during first trimester of pregnancy only if clearly needed; there are no adequate and well-controlled studies in pregnant women during first trimester of pregnancy. Because animal reproduction studies are not always predictive of the human response, this drug should be used during pregnancy only if clearly needed
Lactation
Clindamycin has been reported to appear in breast milk in range of 0.5 to 3.8 mcg/mL; clindamycin has potential to cause adverse effects on breastfed infant's gastrointestinal flora; if oral or intravenous clindamycin is required by nursing mother, it is not a reason to discontinue breastfeeding, but alternate drug may be preferred; monitor infant for possible adverse effects on gastrointestinal flora, such as diarrhea, candidiasis (thrush, diaper rash) or rarely, blood in stool indicating possible antibiotic-associated colitis
The developmental and health benefits of breastfeeding should be considered along with mother's clinical need for clindamycin and any potential adverse effects on breastfed child from clindamycin or from underlying maternal condition
Interactions
May enhance the action of neuromuscular blocking agents (e.g. atracurium).
May antagonise the effects of parasympathomimetics.
May competitively inhibit the effects of macrolides, ketolides, streptogramins, linezolid and chloramphenicol. Increased coagulation tests (prothrombin time/INR) and/or bleeding w/ vit K antagonists (e.g. warfarin, acenocoumarol, fluindione).
Neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents.
Monitor for adverse reactions when strong CYP3A4 and/or CYP3A5 inhibitors are coadministered with clindamycin.
In the presence of strong CYP3A4 and/or CYP3A5 inducers such as rifampicin, monitor for loss of effectiveness
Contraindicated (0)
Serious (11)
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Adverse Effects
Frequency Not Defined
Abdominal pain
Agranulocytosis
Eosinophilia (transient)
Diarrhea
Fungal overgrowth
Pseudomembranous colitis
Hypersensitivity
Stevens-Johnson syndrome
Rashes
Urticaria
Hypotension
Nausea
Vomiting
Sterile abscess at IM site
Thrombophlebitis
Granulocytopenia
Neutropenia
Thrombocytopenia
Polyarthritis
Renal dysfunction
Potentially Fatal: Gasping syndrome (neonates); pseudomembranous colitis.
Mechanism of Action
Clindamycin inhibits protein synthesis by reversibly binding to the 50S subunit of the ribosomal thus blocking the transpeptidation or translocation reactions of susceptible organisms resulting to stunted cell growth.
Note
Dalatic 300mg Capsule manufactured by Drug International Ltd.. Its generic name is Clindamycin.