Version May 2024
Acne vulgaris:
Topical:
Clindamycin 1.2%/benzoyl peroxide 2.5%: Apply pea-sized amount to affected area once daily; use >12 weeks has not been studied.
Clindamycin 1.2%/benzoyl peroxide 3.75%: Apply pea-sized amount to affected area once daily; use >12 weeks has not been studied.
Clindamycin 1%/benzoyl peroxide 5%: Apply to affected area twice daily (morning and evening).
Clindamycin 1.2%/benzoyl peroxide 5%: Apply to affected area once daily in the evening.
Rosacea (off-label use): Topical: Clindamycin 1%/benzoyl peroxide 5%: Apply to affected area once daily for 12 weeks (Ref).
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Clindamycin and benzoyl peroxide: Pediatric drug information")
Acne vulgaris: Topical: Children ≥7 years and Adolescents: Limited data available in ages <12 years (Ref):
Clindamycin 1.2%/benzoyl peroxide 2.5%: Apply pea-sized amount to affected area once daily; use >12 weeks has not been studied
Clindamycin 1.2%/benzoyl peroxide 3.75%: Apply pea-sized amount to affected area once daily; use >12 weeks has not been studied
Clindamycin 1%/benzoyl peroxide 5%: Apply to affected area twice daily (morning and evening)
Inflammatory acne: Topical: Children ≥12 years and Adolescents: Clindamycin 1.2%/Benzoyl peroxide 5%: Apply to affected area once daily in the evening
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Also see individual agents.
>10%:
Dermatologic: Application site scaling (≤21%), local dryness (≤16%)
Local: Application site erythema (<31%), local desquamation (2% to 19%), application site itching (≤17%)
1% to 10%:
Dermatologic: Stinging of the skin (application site: ≤7%), sunburn (local; 1%)
Local: Application site burning (≤10%), application site reaction (3%)
<1%, postmarketing, and/or case reports: Anaphylaxis, application site irritation, application site pain, contact dermatitis, hypersensitivity reaction, local discoloration, local skin exfoliation, skin rash, urticaria
Hypersensitivity to benzoyl peroxide, clindamycin, lincomycin, or any component of the formulation; history of regional enteritis, ulcerative colitis, pseudomembranous colitis or antibiotic-associated colitis
Concerns related to adverse effects:
• Bleaching effects: Benzoyl peroxide may bleach hair, colored fabric, or carpeting.
• Diarrhea: Systemic absorption may occur after topical use of clindamycin. C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis have been reported and have been observed >2 months postantibiotic treatment. Use of parenteral and systemic clindamycin has resulted in severe colitis (including fatalities). Discontinue drug if significant diarrhea, abdominal cramps, or passage of blood and mucus occurs.
• Hypersensitivity: Anaphylaxis and allergic reactions have been reported, may occur within minutes to a day or longer, and differ from local skin irritation.
• Skin irritation: Use concomitant topical acne therapy with caution; cumulative irritancy may occur, especially with the use of peeling, desquamating, or abrasive agents.
Concurrent drug therapy issues:
• Sulfone products: Concomitant use of benzoyl peroxide with sulfone products (eg, dapsone, sulfacetamide) may cause temporary discoloration (yellow/orange) of facial hair and skin. Application of products at separate times during the day or washing off benzoyl peroxide prior to application of other products may avoid skin discoloration (Dubina 2009).
Other warnings/precautions:
• Appropriate use: For external use only; not for vaginal or ophthalmic use. Avoid contact with mucous membranes. Inform patients to use skin protection and minimize prolonged exposure to sun and avoid tanning beds or sun lamps.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Gel, External:
Acanya: Clindamycin phosphate 1.2% and benzoyl peroxide 2.5% (50 g) [contains propylene glycol]
BenzaClin: Clindamycin phosphate 1% and benzoyl peroxide 5% (25 g [DSC])
BenzaClin with Pump: Clindamycin phosphate 1% and benzoyl peroxide 5% (35 g [DSC], 50 g [DSC])
Neuac: Clindamycin phosphate 1.2% and benzoyl peroxide 5% (45 g) [contains methylparaben, propylparaben]
Onexton: Clindamycin phosphate 1.2% and benzoyl peroxide 3.75% (3.5 g, 50 g) [contains propylene glycol]
Generic: Clindamycin phosphate 1% and benzoyl peroxide 5% (25 g, 35 g, 50 g); Clindamycin phosphate 1.2% and benzoyl peroxide 2.5% (50 g); Clindamycin phosphate 1.2% and benzoyl peroxide 3.75% (50 g); Clindamycin phosphate 1.2% and benzoyl peroxide 5% (45 g)
Kit, External:
Neuac: Clindamycin phosphate 1.2% and benzoyl peroxide 5% [DSC] [contains cetyl alcohol, edetate (edta) disodium, methylparaben, propylparaben]
May be product dependent
Gel (Acanya External)
1.2-2.5% (per gram): $12.66
Gel (Clindamycin Phos-Benzoyl Perox External)
1-5% (per gram): $1.92 - $9.46
1.2-2.5% (per gram): $3.00 - $12.03
1.2-3.75% (per gram): $13.89 - $15.62
1.2-5% (per gram): $1.57 - $4.52
Gel (Neuac External)
1.2-5% (per gram): $17.66
Gel (Onexton External)
1.2-3.75% (per gram): $17.36
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Gel, External:
BenzaClin: Clindamycin phosphate 1% and benzoyl peroxide 5% (50 g)
Clindoxyl: Clindamycin phosphate 1% and benzoyl peroxide 5% (45 g) [contains edetate (edta) disodium, methylparaben]
Clindoxyl ADV: Clindamycin phosphate 1% and benzoyl peroxide 3% (5 g, 45 g) [contains edetate (edta) disodium]
Generic: Clindamycin phosphate 1% and benzoyl peroxide 5% (45 g, 50 g)
Skin should be clean and dry before applying. For external use only; avoid applying to inside nose, mouth, eyes, vagina, mucous membranes, and on areas of broken skin.
For external use only; not for oral, ophthalmic, or intravaginal use.
Topical: Skin should be clean and dry before applying. Apply thin layer to affected areas avoiding contact with eyes, lips, inside of nose, mouth, all mucous membranes, and areas of broken skin.
Acne vulgaris: Topical treatment of acne vulgaris.
Rosacea
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). Risk X: Avoid combination
Aminolevulinic Acid (Topical): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). Risk C: Monitor therapy
Dapsone (Topical): Benzoyl Peroxide may enhance the adverse/toxic effect of Dapsone (Topical). Specifically, the use of these agents in combination may cause skin and facial hair to temporarily turn a tan or yellow/orange color. Risk C: Monitor therapy
Erythromycin (Systemic): May diminish the therapeutic effect of Clindamycin (Topical). Management: Consider avoiding the concomitant use of systemic erythromycin and topical clindamycin when treating acne vulgaris. This recommendation does not appear to apply to intravaginal use of clindamycin for the treatment of bacterial vaginosis. Risk D: Consider therapy modification
Erythromycin (Topical): May diminish the therapeutic effect of Clindamycin (Topical). Management: Consider avoiding use of topical erythromycin and topical clindamycin at the same application site when treating acne vulgaris. This recommendation does not appear to apply to intravaginal use of clindamycin for the treatment of bacterial vaginosis. Risk D: Consider therapy modification
Methoxsalen (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Methoxsalen (Systemic). Risk C: Monitor therapy
Neuromuscular-Blocking Agents: Clindamycin (Topical) may enhance the neuromuscular-blocking effect of Neuromuscular-Blocking Agents. Risk C: Monitor therapy
Porfimer: Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. Risk C: Monitor therapy
Verteporfin: Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. Risk C: Monitor therapy
Topical therapy is preferred for the treatment of acne during pregnancy. The combination of topical clindamycin with benzoyl peroxide is recommended for mild to moderate inflammatory acne in pregnant women (Chien 2016).
Refer to individual monographs for additional information.
It is not known if clindamycin or benzoyl peroxide are present in breast milk following topical administration.
According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother. Avoid direct infant contact with treated skin.
Refer to individual monographs for additional information.
Benzoyl peroxide: Releases free-radical oxygen, which oxidizes bacterial proteins in the sebaceous follicles, decreasing the number of anaerobic bacteria and decreasing irritating-type free fatty acids.
Clindamycin: Reversibly binds to 50S ribosomal subunits preventing peptide bond formation thus inhibiting bacterial protein synthesis; bacteriostatic or bactericidal depending on drug concentration, infection site, and organism.
See individual agents.
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