Clindamycin

CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

Oral: 150–450 mg every 6 hours, Endocarditis prophylaxis: 600 mg 1 hour before procedureIV/IM: 0.6–4.8 g daily in 2–4 divided doses,Prophylaxis: 300 mg 15 minutes before procedure then 150 mg 6 hours later

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :461.4 (as hydrochloride); 505 (as phosphate)

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :>90

%Excreted unchanged in urine &nbsp &nbsp : 10

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.6–1.2

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :2–3/3–5

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function. See ‘Other Information’

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function

HDF/high flux &nbsp :Unknown dialysability. Dose as in normal renal function

CAV/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsCiclosporin: may cause reduced ciclosporin levelsErythromycin: antagonism demonstrated in vitro; manufacturers recommend that the two drugs should not be administered concurrentlyMuscle relaxants: enhanced neuromuscular blockade

ADMINISTRATION

Reconstition

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Route

Oral, IV, IM

Rate of Administration

10–60 minutes

Comments

Dilute prior to IV administration: up to 900 mg, in at least 50 mL of diluent; over 900 mg, in 100 mL of diluent. Compatible with sodium chloride 0.9% or glucose 5%Administration of more than 1200 mg in a single 1 hour infusion is not recommendedDoses greater than 600 mg should be given as IV infusions

OTHER INFORMATION

Capsules should be swallowed whole with a glass of waterPseudomembranous colitis may occur Periodic kidney and liver function tests should be carried out during prolonged therapyDosage may require reduction in patients with severe renal impairment due to prolonged half-life

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