RiteMED Clindamycin Drug Interactions

Neuromuscular Blocking Agents: Clindamycin has been shown to have neuromuscular blocking properties that may enhance the neuromuscular blocking actions of other agents such as ether, tubocurarine and pancuronium, with a potential danger of respiratory depression. Clindamycin should be used with caution in patients receiving such agents, and such patients should be observed for prolongation of neuromuscular blockade.
Aminoglycosides: Clindamycin has been reported to antagonize the bactericidal activity of aminoglycosides in vitro. However, in vivo antagonism has not been demonstrated, and Clindamycin has been administered successfully in conjunction with an aminoglycoside with no apparent decrease in activity.
Ampicillin: Clindamycin has been reported to diminish the activity of Ampicillin in vitro against Staphylococcus aureus.
Erythromycin: Antagonism of bactericidal activity in vitro has been demonstrated between Clindamycin and Erythromycin due to competition between the two drugs for the ribosomal binding site.
Neostigmine and Physostigmine: Clindamycin has been reported to antagonize the effect of anticholinesterases neostigmine and physostigmine.
Estrogens: Clindamycin may possibly reduce the contraceptive effect of estrogen. Though the risk is small, additional contraceptive precautions are recommended during concomitant use and for seven days after discontinuation of clindamycin.
Vaccines: Oral typhoid vaccine is inactivated by concomitant administration of antibacterials. Thus, clindamycin should be avoided for three days before and after oral typhoid vaccination.
Vitamin K antagonists: Increased coagulation test results (prothrombin time/international normalized ratio) and/or bleeding have been reported in patients treated with clindamycin in combination with a vitamin K antagonist (e.g. warfarin, acenocoumarol and fluindione). Coagulation tests, therefore, should be monitored regularly in patients treated with vitamin K antagonists.
Interference with Laboratory Tests: Abnormalities in liver function tests have been observed.