What Are the Side Effects of Clindamycin?

Published August 2nd, 2021 by Nicole Salata, PharmD, MSHI
Fact Checked by
Chris Riley
Medically Reviewed:
Dr. Angel Rivera

Like all medications, clindamycin has a wide array of side effects; these vary in how often they occur, common vs. rare, and how serious they are, mild to severe. Before talking about side effects, though, it is important to understand what clindamycin is and its possible uses. People taking clindamycin, as well as any medical treatment, should know that the use of this medicine carries the risk of potential side effects. Please seek medical help should you experience any adverse reactions.

What is Clindamycin?

Clindamycin is a lincosamide antibiotic – this means that it most closely resembles lincomycin, another, older antibiotic. The lincosamide class, or group, of antibiotics, is different from all other types of antibiotics. 

As a medicine, it works in several different ways: it is an antibiotic that helps cure bacterial infections, as previously mentioned; it is also an anti-protozoal, which means it works against some types of parasites known as protozoa; finally, clindamycin works as an anti-inflammatory, reducing inflammation in some types of infections.

How is Clindamycin Used?

Clindamycin is used across a wide variety of infection types and works against a large number of different bacteria. It should be noted that it is only used against bacterial infections in patients and not in viral infections. Because it is used in so many different ways, it is available in many different forms. 

Clindamycin comes in three different versions, or salt forms. A salt form is simply how the drug is prepared to be stable, and the type of salt is usually the word after the drug, as in omeprazole SODIUM, or clindamycin HYDROCHLORIDE. The main difference between these salt forms is to make the medication stable for different uses, and all of them are easily converted by the body to active clindamycin. The three salt forms are: clindamycin hydrochloride (clindamycin HCl), clindamycin phosphate, and clindamycin palmitate hydrochloride (HCl). 

  • Clindamycin HCl is the form present in capsules, which are to be taken by mouth and used to treat infections not available for topical treatment or so widespread, topically, that they are considered systemic (affecting the whole body).
  • Clindamycin phosphate is a more stabilized form and is used in most topical formulations, including gels, lotions, solutions, vaginal gel, and vaginal ovules. It is also used in intramuscular (IM) and intravenous (IV) injections. For more information on this salt form, see the article on clindamycin phosphate. 
  • Clindamycin palmitate HCl is used in the liquid oral suspension. Mostly used in children and those who cannot swallow capsules, this oral solution salt form not only helps keep the medication more stable, but it can also improve the flavor. 

All dosage forms require a prescription from a doctor or healthcare provider, and none of them keep the medication stable forever. All medications come with an expiration date, after which it is not safe to use the medication. 

What are the Side Effects of Clindamycin?

Since clindamycin can be introduced to the body in several different ways, using several different dosage forms, the side effects may be more likely with specific methods of application or products. Below is a list of common side effects grouped by type, along with which dosage forms they are most commonly associated with, whether it be clindamycin oral, topical, or IV/IM. This is not a comprehensive list; any further inquiries about clindamycin's adverse effects should be discussed with a doctor or pharmacist. 

  • Digestive System 
  • Nausea, vomiting, constipation, acid reflux, flatulence, diarrhea, abdominal pain, and cramping. These side effects are possible with all dosage forms but are usually stronger or more common when taking an oral dose. 
  • A serious condition called colitis is possible, which has symptoms of fever, abdominal pain, cramping, bloating, and diarrhea with blood, pus, or mucus. Any condition resembling colitis should be immediately reported to a physician. 
  • Skin
  • Rash, itching, burning, redness, dryness, peeling skin, and hives. These side effects are possible with all formulations but are more common with topical formulations. 
  • Some serious skin conditions are possible, and any skin reaction should always be reported to a physician.
  • Dizziness and vertigo are possible side effects and should be treated with caution due to the possibility of falling or impaired driving. This is possible with all dosage forms. 
  • Metallic taste is a possible side effect, most common with oral formulations, but possible with all formulations. While it persists during treatment with clindamycin, it usually resolves once treatment is completed or stopped. 
  • Pain is a possible side effect. Pain may be general, focused in the joints, focused in the upper or lower abdomen, or show up as a headache. These side effects are possible with all dosage forms. 
  • Other possible but rare side effects can occur from any of the dosage forms:
  • kidney problems
  • liver problems
  • allergic reactions or anaphylaxis
  • severe skin reactions, requiring hospitalization
  • nose bleeds
  • others

This is not a comprehensive list of side effects, but it addresses the most common and most likely side effects, as well as some of the rare but serious side effects. While some side effects are more prevalent with specific formulations, most, if not all, are possible with all dosage forms. Any specific concerns or questions regarding medical advice should always be referred to a medical professional or your health care provider. Should any severe reactions occur and you experience a medical emergency, please seek immediate medical attention.

References and Sources: 

Algra RJ, Rosen T, Waisman M. Topical Clindamycin in Acne Vulgaris: Safety and Stability. Archives of Dermatology. 1977;113(10):1390-1391. doi:10.1001/archderm.1977.01640100068011

CUNLIFFE WJ, C'OTTERILL JA, WILLIAMSON B. THE EFFECT OF CLINDAMYCIN IN     ACNE-A CLINICAL AND LABORATORY INVESTIGATION. British Journal of Dermatology. 1972;87(1):37-41. doi:https://doi.org/10.1111/j.1365-2133.1972.tb05095.x

Dawson AL, Dellavalle RP. Acne vulgaris. BMJ : British Medical Journal. 2013;346:f2634. doi:10.1136/bmj.f2634

Dhawan VK, Thadepalli H. Clindamycin: A Review of Fifteen Years of Experience. Reviews of Infectious Diseases. 1982;4(6):1133-1153. doi:10.1093/clinids/4.6.1133

Fletcher SM, Stark D, Harkness J, Ellis J. Enteric Protozoa in the Developed World: a Public Health Perspective. Clinical Microbiology Reviews. 2012;25(3):420-449.  doi:doi:10.1128/CMR.05038-11

Frankel RI. Clindamycin--efficacy and toxicity. The Western journal of medicine. 1975;122(6):526-530.

Friedman GD, Gérard MJ, Ury HK. Clindamycin and Diarrhea. JAMA. 1976;236(22):2498-2500. doi:10.1001/jama.1976.03270230020020

Hoberman LJ, Eigenbrodt EH, Kilman WJ, Hughes LR, Nogaard RP, Fordtran JS. Colitis associated with oral clindamycin therapy. The American Journal of Digestive Diseases.     1976/01/01 1976;21(1):1-17. doi:10.1007/BF01074133

Murphy PB, Bistas KG, Le JK. Clindamycin. StatPearls Publishing, Treasure Island (FL); 2020.

Smieja M. Current Indications for the Use of Clindamycin: A Critical Review. Canadian Journal of Infectious Diseases. 1900/01/01 1998;9:538090. doi:10.1155/1998/538090

Spížek J, Řezanka T. Lincomycin, clindamycin and their applications. Applied Microbiology and Biotechnology. 2004/05/01 2004;64(4):455-464. doi:10.1007/s00253-003-1545-7

Swartzberg JE, Maresca RM, Remington JS. Clinical Study of Gastrointestinal Complications Associated with Clindamycin Therapy. The Journal of Infectious Diseases. 1977;135(Supplement):S99-S103. doi:10.1093/infdis/135.Supplement.S99

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