Can clindamycin cause yeast infection. Clindamycin and Yeast Infections: Understanding the Risks and Precautions

23.07.202323.06.2023 by alexxlab

Can clindamycin cause yeast infections? What special precautions should be taken when using clindamycin vaginally? Explore the answers to these questions and more in this comprehensive article.

Содержание

The Relationship Between Clindamycin and Yeast Infections

Clindamycin, a lincomycin antibiotic, is commonly prescribed to treat bacterial vaginosis, an infection caused by an overgrowth of harmful bacteria in the vagina. However, it’s important to understand that clindamycin cannot be used to treat vaginal irritation caused by yeast infections or sexually transmitted diseases such as chlamydia and trichomoniasis.

One of the potential side effects of using clindamycin vaginally is the development of a yeast infection. This is because the antibiotic can also kill the “good” bacteria in the vagina, allowing the naturally occurring yeast to overgrow. This can lead to symptoms such as white patches in the mouth, thick white vaginal discharge, and burning, itching, and swelling of the vagina.

Precautions When Using Vaginal Clindamycin

When using vaginal clindamycin, it’s crucial to follow the precautions outlined by your healthcare provider. Some important things to keep in mind include:

Inform your doctor and pharmacist about any allergies, medical conditions, or medications you are currently taking, as this information may affect your treatment plan.
Do not swallow the cream or suppositories, and do not apply the cream to any other part of your body. Be careful not to get the cream in your eyes.
Use vaginal clindamycin exactly as directed, completing the full course of treatment even if you feel better. Stopping too soon can lead to incomplete treatment and the development of antibiotic-resistant bacteria.
Avoid having vaginal intercourse or using vaginal products such as tampons or douches during your treatment with vaginal clindamycin.
Certain ingredients in vaginal clindamycin may weaken latex or rubber contraceptive devices such as condoms and vaginal diaphragms. Do not use these devices during your treatment and for a specified time afterward, depending on the brand of clindamycin you are using.

Dosage and Administration of Vaginal Clindamycin

Vaginal clindamycin is available in the form of suppositories and creams, and the recommended dosage and duration of treatment can vary depending on the specific brand. Generally, the vaginal suppositories are used once a day, preferably at bedtime, for 3 days in a row. Most brands of the vaginal cream are used once a day, preferably at bedtime, for 3 or 7 days in a row. One brand of vaginal cream (ClindesseÂ®) is usually used as a single dose, given at any time of day.

It’s important to follow the directions on your prescription label carefully and use vaginal clindamycin exactly as directed by your healthcare provider. If you have any questions or concerns about the dosage or administration of your medication, be sure to discuss them with your doctor or pharmacist.

Potential Side Effects of Vaginal Clindamycin

In addition to the risk of developing a yeast infection, vaginal clindamycin may cause other side effects. Some common side effects include:

White patches in the mouth
Thick, white vaginal discharge
Burning, itching, and swelling of the vagina
Burning, irritation, and discomfort in the vaginal area

If you experience any of these side effects, especially if they are severe or persistent, be sure to inform your healthcare provider. They may be able to provide guidance or adjust your treatment plan as needed.

Interactions and Contraindications

Before using vaginal clindamycin, it’s important to inform your doctor and pharmacist about any other medications, vitamins, or supplements you are currently taking. Certain interactions may occur, particularly with the antibiotic erythromycin (E.E.S., E-Mycin, Erythrocin, others).

Additionally, your healthcare provider may advise you not to use vaginal clindamycin if you have a history of inflammatory bowel disease (IBD) or severe diarrhea caused by an antibiotic. These conditions may increase the risk of complications from the use of clindamycin.

Proper Storage and Disposal

Vaginal clindamycin should be stored at room temperature, away from heat, moisture, and direct light. Do not refrigerate or freeze the medication. When it’s time to dispose of any unused or expired vaginal clindamycin, follow the instructions provided by your healthcare provider or pharmacist, or check with your local waste management authorities for guidance on proper disposal methods.

By understanding the potential risks and precautions associated with the use of vaginal clindamycin, you can work closely with your healthcare provider to ensure the safe and effective treatment of your bacterial vaginosis while minimizing the risk of complications, such as yeast infections.

Clindamycin Vaginal: MedlinePlus Drug Information

pronounced as (klin” da mye’ sin)

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Vaginal clindamycin is used to treat bacterial vaginosis (an infection caused by an overgrowth of harmful bacteria in the vagina). Clindamycin is in a class of medications called lincomycin antibiotics. It works by slowing or stopping the growth of bacteria. Vaginal clindamycin cannot be used to treat vaginal irritation caused by yeast infections or by sexually transmitted diseases such as chlamydia and trichomoniasis.

Vaginal clindamycin comes as a suppository to place in the vagina and a cream to apply to the inside of the vagina. The vaginal suppositories are usually used once a day, preferably at bedtime, for 3 days in a row. Most brands of the vaginal cream are used once a day, preferably at bedtime, for 3 days in a row or for 7 days in a row. One brand of vaginal cream (Clindesse^®) is usually used as a single dose, given at any time of day. If you are using more than one dose of vaginal clindamycin, use it at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use vaginal clindamycin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

This medication is for vaginal use only. Do not swallow the cream or suppositories, and do not apply the cream to any other part of your body. Be careful not to get the cream in your eyes. If you do get the cream in your eyes, rinse your eyes with plenty of cool water.

Your medication will come with directions for use. Read these directions and follow them carefully. Ask your doctor or pharmacist if you have any questions about how to use vaginal clindamycin.

Use vaginal clindamycin until you finish the prescription, even if you feel better. If you stop using vaginal clindamycin too soon or skip doses, your infection may not be completely treated and the bacteria may become resistant to antibiotics.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before using vaginal clindamycin,

tell your doctor and pharmacist if you are allergic to clindamycin, lincomycin (Lincocin), or any other medications
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention erythromycin (E.E.S., E-Mycin, Erythrocin, others). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you have or have ever had inflammatory bowel disease (IBD; condition in which the lining of all or part of the intestine is swollen, irritated, or has sores) or severe diarrhea caused by an antibiotic. Your doctor may tell you not to use vaginal clindamycin.
tell your doctor if you have or have ever had any other medical condition.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding.
you should know that certain ingredients in vaginal clindamycin may weaken latex or rubber contraceptive devices such as condoms and vaginal diaphragms. Do not use these devices during your treatment and for at least 72 hours after your treatment with most vaginal clindamycin products. If you are using Clindesse^® brand vaginal gel, you should not use these devices for at least 5 days after your treatment.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are using vaginal clindamycin.
you should know that you should not have vaginal intercourse or use vaginal products such as tampons or douches during your treatment with vaginal clindamycin.

Unless your doctor tells you otherwise, continue your normal diet.

Use the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

Vaginal clindamycin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

white patches in the mouth
thick, white vaginal discharge
burning, itching, and swelling of the vagina
burning, painful urination
vaginal pain
constipation
nausea
headache
back pain

Some side effects can be serious.

If you experience any of these symptoms, call your doctor immediately:

stomach pain or cramping
diarrhea
watery or bloody stools
fever
blisters
rash
hives
itching
difficulty breathing or swallowing

Vaginal clindamycin may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat (above 86 °F) and moisture (not in the bathroom). Do not freeze.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www. poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

Cleocin^® Vaginal Suppository
Clindesse^® Vaginal Cream

Last Revised – 10/15/2016

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Clindamycin vaginal Uses, Side Effects & Warnings

Generic name: clindamycin vaginal [ klin-da-MYE-sin ]
Dosage forms: vaginal cream (2%), vaginal suppository (100 mg)
Drug classes: Topical acne agents, Vaginal anti-infectives

Medically reviewed by Drugs.com on Sep 28, 2022. Written by Cerner Multum.

What is clindamycin vaginal?

Clindamycin vaginal (for use in the vagina) is an antibiotic that is used to treat vaginal infections caused by bacteria.

Clindamycin vaginal may also be used for purposes not listed in this medication guide.

Warnings

You should not use clindamycin vaginal if you have an intestinal disorder such as colitis or Crohn’s disease.

Before taking this medicine

You should not use clindamycin vaginal if you are allergic to clindamycin or lincomycin, or if you have:

Tell your doctor if you have ever had any type of intestinal disorder.

Tell your doctor if you are pregnant or breastfeeding.

Clindamycin vaginal may contain ingredients that can weaken a condom and cause it to break. An unintended pregnancy could result. Avoid using a condom as a birth control method while you are using clindamycin vaginal and for at least 72 hours (3 days) after your treatment ends.

Clindamycin vaginal is not for use in girls who have not yet begun having menstrual periods.

How should I use clindamycin vaginal?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Do not take by mouth. This medicine is for use only in the vagina.

Clindamycin vaginal is usually used at bedtime for 3 to 7 nights in a row.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Wash your hands with soap and water before and after applying this medicine.

Apply clindamycin vaginal using only the disposable applicators provided with the medicine. Use a new applicator each time you use the medicine, then throw the applicator away. Do not clean or reuse a disposable applicator.

Clindamycin vaginal can cause burning or irritation if you accidentally get it in your eyes. If this does happen, rinse with plenty of cool water.

Use this medicine for the full prescribed length of time, even if your symptoms quickly improve. Skipping doses can increase your risk of infection that is resistant to medication. Clindamycin vaginal will not treat a yeast infection.

Call your doctor if your symptoms do not improve, or if they get worse while using clindamycin vaginal.

Do not share this medicine with another person, even if they have the same symptoms you have.

Store at room temperature away from moisture and heat.

Keep the tube of vaginal cream tightly closed when not in use.

What happens if I miss a dose?

Use the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.

It is best to use clindamycin vaginal only at bedtime, or while you will be resting or lying down.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using clindamycin vaginal?

Avoid having sexual intercourse or using vaginal products such as tampons, lubricants, or douches while you are using this medication.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor before using anti-diarrhea medicine.

Clindamycin vaginal side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Clindamycin vaginal may cause serious side effects. Stop using clindamycin vaginal and call your doctor at once if you have:

Common side effects of clindamycin vaginal may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Clindamycin vaginal dosing information

Usual Adult Dose for Acne:

Recommended dose: Apply a thin film to the affected area(s) 2 times a day

Comment:
-More than 1 pledget may be used at the same time (e.g., larger surface areas).

Use:
-Treatment of acne vulgaris

Usual Adult Dose for Bacterial Vaginosis:

Non-pregnant patients:
Vaginal cream: 1 applicatorful intravaginally once at bedtime for 3 consecutive days
Vaginal suppository: Insert 1 suppository intravaginally once a day at bedtime for 3 to 7 consecutive days

Pregnant patients:
-Vaginal cream: 1 applicatorful intravaginally once at bedtime for 7 consecutive days

Comment:
-A diagnosis of bacterial vaginosis should be confirmed prior to initiating therapy.

Uses:
-Treatment of bacterial vaginosis in non-pregnant women
-Treatment of bacterial vaginosis in non-pregnant women and pregnant women in the second or third trimester

Usual Pediatric Dose for Acne:

12 years and older:
Recommended dose: Apply a thin film to the affected area(s) 2 times a day

Comment:
-More than 1 pledget may be used at the same time (e.g., larger surface areas).

Use:
-Treatment of acne vulgaris

What other drugs will affect clindamycin vaginal?

Medicine used in the vagina is not likely to be affected by other drugs you use. But many drugs can interact with each other. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Banbakt: instruction, price, analogues | vaginal suppositories Gledpharm Ltd

Pharmacological properties
Indications Banbact
Application Banbact
Contraindications
Side effects
Special instructions
Interactions
Overdose
Storage conditions
Diagnosis
Recommended alternatives
Trade names

pharmacodynamics . Mechanism of action . Clindamycin is a lincosamide antibiotic that inhibits bacterial protein synthesis by acting on bacterial ribosomes. The antibiotic binds predominantly to the 50S-ribosome subunit and influences the process of protein chain initiation. Although clindamycin phosphate is inactive in vitro , in vivo it is rapidly hydrolyzed to form clindamycin, which has an antibacterial effect.

In vitro sensitivity . Standard principles for susceptibility testing of potential bacterial vaginal pathogens have not been defined: Gardnerella vaginalis , Mobiluncus spp . or Mycoplasma hominis . However, clindamycin as an antimicrobial agent in vitro is active against the following registered strains of microorganisms associated with bacterial vaginosis: Bacteroides spp. , Gardnerella vaginalis , Mobiluncus spp. , Mycoplasma hominis , Peptostreptococcus spp .

The above microorganisms are sensitive to the action of clindamycin, as evidenced by their MIC values ₉₀ (minimum inhibitory concentration at which 90% of strains are inhibited). No geographic or temporal variations were noted.

Original clindamycin data on susceptibility of bacteria associated with bacterial vaginosis.

Microorganism	IPC ₅₀	IPC ₉₀	% sensitive
Bacteroides bivius	<0.015	0.031	100
Bacteroides disiens	1.0	2.0	100
Bacteroides melaninogenicus	<0.015	0.031	100
Bacteroides asaccharolyticus	<0.015	<0.015	100
Peptostreptococcus anaerobius	0. 03	0.25	100
Peptostreptococcus asaccharolyticus	<0.015	0.25	100
Mobiluncus curtisii	0.125	0.125	92
Mobiluncus mulieris	0.03	0.06	100
Gardnerella vaginalis	0.125	0.5	100

Cross-resistance has been demonstrated between clindamycin and lincomycin.

Antagonism has been found between clindamycin and erythromycin in vitro . The clinical significance of this observation is unknown.

Pharmacokinetics . Absorption . Clindamycin phosphate is rapidly hydrolyzed in the body to form clindamycin, which exhibits antibacterial activity. Studies of the original clindamycin have shown that about 30% (6–70%) of the drug enters the systemic circulation when administered intravaginally. The mean AUC after 3 days of suppository use is 3.2 μg h/mL (0.42–11 μg h/mL). C_max in the blood is observed on the 3rd day within 5 hours (within 1-10 hours) after the use of suppositories and averages 0.27 μg / ml (0.03-0.67 μg / ml). The average T _½ after the use of suppositories is 11 hours (within 4-35 hours), it is considered that it is limited by the rate of absorption. Systemic absorption of clindamycin in the form of suppositories is 7 times higher than with the same dose of clindamycin in the form of a vaginal cream. In general, the systemic exposure of clindamycin in the form of vaginal suppositories is 2-20 times lower than the therapeutic dose of clindamycin hydrochloride and 40-50 times lower than the therapeutic dose of parenteral clindamycin phosphate.

treatment of bacterial vaginosis (previous names: hemophilic vaginitis, gardnerella vaginitis, nonspecific vaginitis, corynebacterium vaginitis or anaerobic vaginosis).

one suppository intravaginally once a day at night for 3 consecutive days.

Release the suppository from the contour packaging and insert into the vagina in the supine position with knees bent and legs pulled up to the chest with the help of the middle finger as deeply as possible, but so as not to cause discomfort.

Use in elderly patients . The use of clindamycin vaginal suppositories in patients over 65 years of age has not been studied.

Use in patients with impaired renal function . The use of clindamycin vaginal suppositories in patients with impaired renal function has not been studied.

Attention should be paid to official recommendations regarding the appropriate use of antibacterial agents.

Children . The safety and efficacy of clindamycin vaginal suppositories in children have not been established.

hypersensitivity to clindamycin, lincomycin or any of the excipients of the drug.

History of antibiotic-associated colitis.

infections and infestations: fungal infections, infections caused by fungi of the genus Candida.

From the side of the nervous system: headache.

From the gastrointestinal tract: abdominal pain, diarrhea, nausea, vomiting, pseudomembranous colitis*.

From the skin and subcutaneous tissue: itching (not at the site of application), rash.

From the side of the musculoskeletal system and connective tissue: pain in the side.

From the side of the kidneys and urinary system: pyelonephritis, dysuria.

From the genital organs and mammary glands: vulvovaginal candidiasis, vulvovaginal pain, vulvovaginal disorders, vaginal infections, vaginal discharge, menstrual irregularities.

General disorders and administration site disorders: application site pain, itching (application site), local edema, pain, fever.

*This phenomenon is typical for the entire class of antibacterial agents.

Report suspected adverse reactions . It is essential to report suspected adverse reactions after drug registration. This ensures constant monitoring of the benefit-risk ratio of the drug.

Before or immediately after the start of the use of clindamycin in the form of vaginal suppositories, it may be necessary to conduct a laboratory test for the presence of other infectious agents, including Trichomonas vaginalis , Candida albicans , Chlamydia trachomatis and gonococci.

The use of clindamycin vaginal suppositories may cause overgrowth of non-susceptible organisms, including yeasts.

Clindamycin, like other antibacterial agents, can cause diarrhea and, in some cases, pseudomembranous colitis, which can be mild or life-threatening.

If severe or prolonged diarrhea develops while using Banbact, it should be discontinued, appropriate diagnostic procedures should be carried out and, if necessary, antibiotic treatment should be prescribed. Drugs that suppress peristalsis are contraindicated in this case. If there is a history of antibiotic-induced colitis, Banbact should be used with caution. In such cases, it is recommended that the benefits of treating bacterial vaginosis be carefully weighed against the potential risk of pseudomembranous colitis.

Caution is advised when administering clindamycin vaginal suppositories to patients with inflammatory bowel disease, particularly Crohn’s disease or ulcerative colitis.

As with any vaginal infection, sexual intercourse is not recommended while using Banbact. Vaginal suppository base may reduce the strength of latex condoms and contraceptive diaphragms (see INTERACTIONS). It is not recommended to use such drugs within 72 hours after taking the drug, since their contraceptive effectiveness and protective properties against sexually transmitted diseases may be reduced.

During the period of use of Banbakt, the use of other products intended for intravaginal administration (such as tampons, douches) is not recommended.

Special precautions for handling and disposal . Do not use this medicine if the package that contains the vaginal suppositories is damaged, opened or leaking.

Use during pregnancy or lactation

Pregnancy . Reproductive toxicity has been demonstrated in animal studies.

Use during the first trimester of pregnancy is not recommended as there are no adequate well-controlled studies on the use of the drug in pregnant women during this period.

Intravaginal use of clindamycin phosphate suppositories in the second trimester of pregnancy, as well as systemic use of clindamycin in the second and third trimesters did not lead to any pathological effects on the part of the fetus, so it can be used in case of emergency.

Breastfeeding period . It is not known whether clindamycin passes into breast milk after vaginal use. However, the appearance of clindamycin in breast milk after oral or parenteral administration has been reported. Consideration should be given to stopping breastfeeding or interrupting/discontinuing therapy with Banbact, given the benefit of breastfeeding for the child and the benefit of treatment for the mother.

Fertility . In animal studies, no effect on fertility has been identified.

The ability to influence the reaction rate when driving vehicles or operating other mechanisms . No effect or little effect.

there are no data on the simultaneous use of clindamycin in the form of vaginal suppositories with other drugs for intravaginal administration (see SPECIAL INSTRUCTIONS).

When used systemically, clindamycin phosphate has neuromuscular blocking properties that may potentiate and prolong the action of other neuromuscular blockers. Therefore, it should be used with caution in patients taking such agents (see OVERDOSE and Pharmacokinetics).

The use of latex condoms is not recommended during treatment with the drug in the form of vaginal suppositories.

No cases of overdose of clindamycin vaginal suppositories have been reported.

Clindamycin phosphate, which is contained in the preparation and applied intravaginally, can be absorbed in an amount sufficient to develop systemic effects.

In case of overdose, general symptomatic and supportive treatment is indicated, if necessary.

In case of accidental ingestion, effects comparable to oral therapeutic concentrations of clindamycin may occur.

in original packaging at temperatures not exceeding 25°C.

Chlamydia pelvic inflammatory disease (A56.1+)	ICD N74.4
Vulvovaginitis	ICD N77.1
Gardnerellosis	ICD N76.1
Other non-inflammatory diseases of the vagina	ICD N89.8
Acute vaginitis	ICD N76.0

100 mg No. 3 for the strip.

CLINDAMYCINUM G01A A10

Sperco Ukraine

COMPOSITION AND FORM OF RELEASE:

supp. vaginal. 100 mg strip, no. 3

Clindamycin

100 mg

Other ingredients: lipophilic base.

No. UA/5924/01/01 from 12/15/2011 to 12/15/2016

PHARMACOLOGICAL PROPERTIES:

Pharmacodynamics. Clindamycin belongs to the lincosamide group of antibiotics. Suppresses protein synthesis in a microbial cell by binding to the 50S subunits of ribosomes. With local intravaginal application, it exhibits a bactericidal effect. Clindamycin is active against many gram-positive and gram-negative anaerobes, gram-positive aerobes. Shows high activity against microorganisms that cause bacterial vaginosis: Gardnerella vaginalis, Mobiluncus spp., Mycoplasma spp., Ureaplasma spp., Chlamydia trachomatis, Peptostreptococcus spp., Bacteroides spp., Haemophylus spp., Corynebacterium spp.

Pharmacokinetics. Clindamycin phosphate is rapidly hydrolyzed in the body to form clindamycin, which exhibits antibacterial activity. With intravaginal use, about 30% of clindamycin enters the systemic circulation, no accumulation has been detected with prolonged use. T _½ for vaginal application is 1.5-2.6 hours.

INDICATION:

treatment of bacterial vaginosis (previously known as haemophilus vaginitis, gardnerella vaginitis, nonspecific vaginitis, corynebacterium vaginitis, or anaerobic vaginosis).

APPLICATION:

intravaginally 1 suppository 1 time per day at night for 3 consecutive days. Suppositories are released from the contour packaging and injected deep into the vagina in the supine position with knees bent, pulled up to the chest, or in a squatting position. Attention should be paid to official recommendations on the appropriate use of antibacterial agents.

CONTRAINDICATIONS:

hypersensitivity to lincomycin, clindamycin or other components of the drug that contain solid fat. Regional enteritis, ulcerative colitis and antibiotic-associated colitis in history.

SIDE EFFECTS:

These adverse reactions occur in less than 10% of patients.
From the genitourinary system: vulvovaginal disorders, vulvovaginal irritations, vaginal pain, vaginal candidiasis, menstrual irregularities, vaginal discharge, dysuria, pyelonephritis, vaginitis/vaginal infections.
General and administration site disorders: injection site pain, fever, generalized pain, localized edema, lateral abdominal pain, headache.
Infections and infestations: vaginal candidiasis, fungal infections.
From the gastrointestinal tract: nausea, vomiting, diarrhea, abdominal cramps.
From the skin and mucous membranes: itching (not at the injection site), rash, itching (at the injection site). The following adverse reactions, which are medically significant, were observed with systemic use of clindamycin in less than 0.01% of patients.
From the blood and lymphatic system: temporary neutropenia (leukopenia), agranulocytosis, thrombocytopenia.
From the immune system: anaphylactoid reactions.
Hepatobiliary disorders: jaundice.
Skin and subcutaneous tissue disorders: Stevens-Johnson syndrome-like erythema multiforme, toxic epidermal necrolysis.

SPECIAL INSTRUCTIONS:

Before or immediately after starting the use of clindamycin vaginal suppositories, it may be necessary to conduct a laboratory test for the presence of other infectious agents, including Trichomonas vaginalis, Candida albicans, Chlamydia trachomatis and gonococci.
The use of clindamycin vaginal suppositories may cause the growth of non-susceptible organisms, including yeasts.
The use of clindamycin, as with other antibacterial agents, can cause diarrhea and, in some cases, pseudomembranous colitis, which can be mild or life-threatening. If severe or prolonged diarrhea develops during the use of Milagin, then this drug should be discontinued, appropriate diagnostic procedures should be carried out and, if necessary, antibiotic treatment should be prescribed. Drugs that inhibit peristalsis are contraindicated in this case. If there is a history of colitis caused by antibiotics, Milagin should be used with caution. In such cases, it is recommended that the benefits of treating bacterial vaginosis be carefully weighed against the potential risk of pseudomembranous colitis.
Patients should be warned that during therapy with Milagin, one should refrain from sexual intercourse, and also not to use products intended for intravaginal administration (for example, tampons, douches).
This product contains ingredients that may reduce the strength of latex or rubber products such as condoms or contraceptive vaginal diaphragms. Therefore, the use of such products during and for 72 hours after treatment with Milagin is not recommended. Almost 30% (6.5-70%) of the dose of clindamycin is absorbed into the systemic circulation after the use of vaginal suppositories.
Pregnancy and breastfeeding. In the first trimester of pregnancy, Milagin is not recommended due to lack of research.
Intravaginal use of clindamycin phosphate suppositories in the second trimester of pregnancy, as well as systemic use of clindamycin in the second and third trimesters did not lead to any pathological effects on the part of the fetus, so it can be used if clearly necessary.
It is not known if clindamycin is excreted into breast milk after intravaginal use. When considering the appointment of clindamycin in the form of vaginal suppositories during breastfeeding, a balanced assessment of the risk-benefit ratio should be made.
Children. Data on the use of the drug in pediatric practice are not available.
The ability to influence the reaction rate when driving vehicles or working with other mechanisms. No effect.

INTERACTIONS:

no data on co-administration with other drugs for intravaginal administration.
It is not recommended to use latex condoms during treatment with the drug. There are no data on the effect of the drug on latex diaphragms.