Adults

For serious infections: 150-300 mg every 6 hours. For very severe infections: 300-450 mg every 6 hours. Administer orally with a full glass of water.

Elderly

No specific dose adjustment is generally required for elderly patients with normal renal and hepatic function. However, monitoring of renal and hepatic function is advisable.

Renal_impairment

No dose adjustment is necessary for patients with mild to moderate renal impairment. In patients with severe renal impairment, the dosage interval may need to be extended.

Onset

Antibiotic effects typically begin shortly after absorption, though clinical improvement depends on the infection type and severity.

Excretion

Approximately 10% of the active drug is excreted in the urine and 4% in the feces (via bile), while the remainder is excreted as inactive metabolites.

Half life

The elimination half-life is approximately 2-3 hours in adults with normal renal and hepatic function. It may be prolonged in patients with severe renal or hepatic impairment.

Absorption

Clindamycin is rapidly and almost completely absorbed (about 90%) from the gastrointestinal tract after oral administration. Peak plasma concentrations are usually attained within 45-60 minutes.

Metabolism

Clindamycin is extensively metabolized in the liver to active (N-demethyl clindamycin) and inactive metabolites. Major metabolic pathways involve N-demethylation and sulfoxidation.

Erythromycin

Antagonism between clindamycin and erythromycin has been demonstrated in vitro; therefore, these drugs should not be co-administered.

Kaolin-pectin

Kaolin-pectin may decrease the absorption of orally administered clindamycin. Administer clindamycin at least 2 hours before kaolin-pectin.

Oral Contraceptives

Concomitant use with clindamycin may theoretically decrease the efficacy of oral contraceptives; advise patients to use an alternative method of birth control.

Neuromuscular blocking agents

Clindamycin has neuromuscular blocking properties and may enhance the action of other neuromuscular blocking agents, potentially leading to increased respiratory depression.