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clindamycin/benzoyl peroxide (BenzaClin, Acanya, Duac, Onexton)

 

Classes: Acne Agents, Topical Combos

Dosing and uses of BenzaClin, Acanya (clindamycin/benzoyl peroxide)

 

Adult dosage forms and strengths

clindamycin/benzoyl peroxide

topical geL

  • 1%/5% (BenzaClin)
  • 1.2%/2.5% (Acanya)
  • 1.2%/3.75% (Onexton)
  • 1.2%/5% (Duac)

 

Acne Vulgaris

BenzaClin: Apply topically q12hr to affected areas after skin is thoroughly washed and patted dry

DUAC: Apply once daily in the evening to affected areas after the skin is thoroughly washed and patted dry

Acanya, Onexton: Apply pea-sized amount qDay to affected areas after skin is thoroughly washed and patted dry

Limitation of use

  • DUAC Gel has not been demonstrated to have any additional benefit when compared with benzoyl peroxide alone in the same vehicle when used for the treatment of non-inflammatory acne

 

Pediatric dosage forms and strengths

clindamycin/ benzoyl peroxide

topical geL

  • 1%/5% (BenzaClin)
  • 1.2%/2.5% (Acanya)
  • 1.2%/3.75% (Onexton)
  • 1.2%/5% (Duac)

 

Acne Vulgaris

<12 years: Safety and efficacy not established

≥12 years

  • BenzaClin: Apply topically qHS to affected areas after skin is thoroughly washed and patted dry
  • DUAC: Apply once daily in the evening to affected areas after the skin is thoroughly washed and patted dry
  • Acanya, Onexton: Apply pea-sized amount qDay to affected areas after skin is thoroughly washed and patted dry
  • Limitation of use
    • DUAC Gel has not been demonstrated to have any additional benefit when compared with benzoyl peroxide alone in the same vehicle when used for the treatment of non-inflammatory acne

 

BenzaClin, Acanya (clindamycin/benzoyl peroxide) adverse (side) effects

Frequency not defined

Application site pain

Application site exfoliation

Application site irritation

Erythema

Burning

Pruritus

Sunburn

Scaling

Dryness

Diarrhea

Colitis

Peeling

 

Postmarketing reports

Anaphylaxis, as well as allergic reactions leading to hospitalization

Urticaria, application site reactions, including discoloration

 

Warnings

Contraindications

Hypersensitivity to clindamycin, benozyl peroxide, lincomycin or any of the drug components

History of regional enteritis, ulcerative colitis or antibiotic-associated colitis (including pseudomembranous colitis)

 

Cautions

Systemic absorption of clindamycin has been demonstrated following topical use; discontinue immediately if significant diarrhea occurs and consider large bowel endoscopy

May cause irritation, especially when used with concomitant topical acne therapy including peeling, desquamating, or abrasive agents

Should be used with caution in atopic individuals

For external use only; avoid contact with eyes and mucous membranes

Minimize sun expsoure following application

May have bleaching effects on hair or colored fabric

Bacterial of fungal superinfection may result from prolonged use

Concomitant topical acne therapy may result in cumulative irritation, especially with the use of peeling, desquamating, or abrasive agents; if this occurs, discontinue and seek medical advice

Do not use clindamycin and erythromycin containing products together

 

Pregnancy and lactation

Pregnancy category: C

Lactation: Excretion in milk unknown/not recommended

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of BenzaClin, Acanya (clindamycin/benzoyl peroxide)

Mechanism of action

Clindamycin: Antibacterial agent that binds to the 50S ribosomal subunits of susceptible bacteria and prevents elongation of peptide chains by interfering with peptidyl transfer, thereby suppressing protein synthesis; reduces surface fatty acids on skin; exact mechanism of action in treating acne unknown

Benzoyl peroxide: Elicits action by releasing active oxygen; effective in vitro against Propionibacterium acnes, an anaerobe found in sebaceous follicles and comedones; also elicits a keratolytic and desquamative effect which may also contribute to its efficacy