benzoyl peroxide + clindamycin phosphate: clinical use

Prescribing considerations

• Confirm inflammatory mild to moderate acne and consider antibacterial stewardship.
• Avoid mucosae, broken skin and sunburn; use cautiously on sensitive areas.
• Use cautiously with regional enteritis, ulcerative colitis, previous antibiotic-associated colitis or atopy.
• Consider recent topical or systemic clindamycin or erythromycin exposure because resistant flora may already be present.
• Counsel about photosensitivity precautions and bleaching of hair and coloured materials.
• Not recommended below 12 years because safety and efficacy have not been established.

Contraindications and cautions

• Hypersensitivity to clindamycin, lincomycin, benzoyl peroxide or any formulation excipient.

Monitoring

• Assess local redness, dryness, peeling, itching and burning; stop for severe local irritation.
• Advise immediate discontinuation and assessment for significant diarrhoea or abdominal cramps.
• Review clinical response and continuing need for topical antibiotic exposure.
• No routine laboratory monitoring is specified in the product information.

Clinical pharmacology

Clindamycin binds bacterial 50S ribosomal subunits and inhibits protein synthesis. Benzoyl peroxide is bactericidal against acne-associated organisms and mildly keratolytic. Percutaneous clindamycin exposure is low; absorbed benzoyl peroxide is converted to benzoic acid and eliminated mainly after conjugation.

Formulation and product differences

• The product is a white to slightly yellow homogeneous gel with visible fine particles.
• Its excipients include carbomer, dimeticone, glycerol, hydrated colloidal silica and poloxamer.
• Before dispensing it is refrigerated and must not be frozen; afterwards, follow the label and leaflet storage and discard instructions.

Gel

Route: Cutaneous

Strengths: 10 mg/g + 30 mg/g, 10 mg/g + 50 mg/g