Dosing and uses of Lincocin (lincomycin)
Adult dosage forms and strengths
injectable solution
- 300mg/mL
Susceptible Infections
IM: 600 mg q12-24hr
IV: 600-1000 mg q8-12hr; not to exceed 8 g/day
Renal Impairment, severe: 25-30% of usual dose
Other Indications & Uses
Streptococcus pneumoniae & other streptococci
Pediatric dosage forms and strengths
injectable solution
- 300mg/mL
Susceptible Infections
<1 month old
- Safety & efficacy not established
>1 month old
- IV: 10-20 mg/kg/day divided q8-12hr
- IM: 10 mg/kg q12-24hr
Lincocin (lincomycin) adverse (side) effects
Frequency not defined
Nausea
Vomiting
Diarrhea
Abdominal pain
Tenesmus
Glossitis
Stomatitis
Pruritus
Angioedema
Serum sickness and anaphylactic or anaphylactoid reactions
Rash
Urticaria
Vaginitis
Exfoliative/vesiculobullous dermatitis
Erythema multiforme
Thrombophlebitis
Erythema
Pain
Swelling
Transient increases in serum bilirubin, alkaline phosphatase, & AST (SGOT) concentrations
Jaundice
Transient leukopenia, neutropenia, eosinophilia
Thrombocytopenia
Agranulocytosis
Headache
Myalgia
Tinnitus
Dizziness
Vertigo
Warnings
Black box warnings
Pseudomembranous colitis may range from severe to mild to life-threatening
Reserve use for serious infections only
Do not use this drug in patients with nonbacterial infections
Clostridium difficile-associated diarrhea (CDAD) should be considered in patients who present with diarrhea following antibiotic use; C difficile produces toxins A and B, which contribute to the development of CDAd
Hypertoxin-producing strains of C difficile caused increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy
If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C difficile may need to be discontinued
Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C difficile, and surgical evaluation should be instituted as clinically indicated
Contraindications
Hypersensitivity to lincomycin or clindamycin
Cautions
Not for gram-positive bacteria
Discontinue if persistent diarrhea occurs
History of GI disease (colitis), asthma or allergies
Severe renal and/or hepatic impairment
Parenteral form contains benzyl alcohol, however, AAP states the small amount doesn't proscribe it in neonates
Pregnancy and lactation
Pregnancy category: C
Lactation: excreted in breast milk, discontinue drug or do not nurse
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 Lincocin (lincomycin)
Mechanism of action
Suppresses protein synthesis by binding to 50S ribosome, which in turn affects the process of peptide initiation and causes bacterial cell death.
Absorption
Bioavailability: 20-30%
Peak plasma time: 2-4 hr (PO); 30-60 min (IM)
Peak plasma concentration: 1.8-5.3 mcg/mL (500 mg PO); 9.3-18.5 mcg/mL (600 mg IM)
Distribution
Distributed in many body tissues and fluids (including peritoneal fluid, pleural fluid, synovial fluid, bone, bile, aqueous humor eye), poorly in CSF (but in presence of inflamed meninges, low concentration diffuses), readily crosses the placenta, distributed in milk
Protein Bound: 5 mcg/mL: 72%, 1 mcg/mL: 57%
Metabolism
Hepatic
Elimination
Half-life: 4-6.4 hr
Excretion: 4-14% urine (IV/IM); 1.8-30.3% urine (IV/IM)
Administration
IV Compatibilities
Solution: D5W, D5 in NS, D10W, Ns
Additive: amikacin, cimetidine, cytarabine, heparin, ranitidine
Syringe: doxapram, heparin, penicillin g
IV Incompatibilities
Additive: penicillin G(?), phenytoin
Syringe: ampicillin
IV Preparation
1000 mg should be diluted in 100 mL or more of D5W, D5 in NS, D10W, or Ns
IV Administration
Infusion over 1 hr
