Label: CLINDAMYCIN HYDROCHLORIDE- clindamycin hydrochloride capsule

  • NDC Code(s): 0378-6068-01, 0378-6068-05, 0378-6069-01, 0378-6069-05, view more
    0378-6070-01, 0378-6070-05
  • Packager: Mylan Pharmaceuticals Inc.
  • Category: HUMAN PRESCRIPTION DRUG LABEL
  • DEA Schedule: None
  • Marketing Status: Abbreviated New Drug Application

Drug Label Information

Updated 04/13

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  • SPL UNCLASSIFIED SECTION

    To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin hydrochloride and other antibacterial drugs, clindamycin hydrochloride capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.

    WARNING

    Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin hydrochloride and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile.

    Because clindamycin hydrochloride therapy has been associated with severe colitis which may end fatally, it should be reserved for serious infections where less toxic antimicrobial agents are inappropriate, as described in the INDICATIONS AND USAGE section. It should not be used in patients with nonbacterial infections such as most upper respiratory tract infections.

    C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over 2 months after the administration of antibacterial agents.

    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.

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  • DESCRIPTION

    Clindamycin hydrochloride, USP is the hydrated hydrochloride salt of clindamycin. Clindamycin is a semisynthetic antibiotic produced by a 7(S)-chloro-substitution of the 7(R)-hydroxyl group of the parent compound lincomycin.

    Clindamycin hydrochloride capsules, USP contain clindamycin hydrochloride equivalent to 75 mg, 150 mg or 300 mg of clindamycin.

    Inactive ingredients: corn starch, lactose monohydrate, magnesium stearate and talc. In addition, each of the empty hard gelatin capsules contain the following: FD&C Blue No. 2 (75 mg and 150 mg), red iron oxide (75 mg and 150 mg), FD&C Green No. 3 (150 mg and 300 mg), FD&C Red No. 40 (150 mg and 300 mg), gelatin and titanium dioxide.

    The black imprinting ink contains the following ingredients: black iron oxide, potassium hydroxide, propylene glycol and shellac.

    The structural formula is represented below:

    Clindamycin Hydrochloride Structural Formula

    The chemical name for clindamycin hydrochloride is methyl 7-chloro-6,7,8-trideoxy-6-(1-methyl-trans-4-propyl-L-2-pyrrolidinecarboxamido)-1-thio-L-threo-α-D-galacto-octopyranoside monohydrochloride.

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  • CLINICAL PHARMACOLOGY

    Human Pharmacology

    Absorption

    Serum level studies with a 150 mg oral dose of clindamycin hydrochloride in 24 normal adult volunteers showed that clindamycin was rapidly absorbed after oral administration. An average peak serum level of 2.5 mcg/mL was reached in 45 minutes; serum levels averaged 1.51 mcg/mL at 3 hours and 0.7 mcg/mL at 6 hours. Absorption of an oral dose is virtually complete (90%) and the concomitant administration of food does not appreciably modify the serum concentrations; serum levels have been uniform and predictable from person to person and dose to dose. Serum level studies following multiple doses of clindamycin hydrochloride for up to 14 days show no evidence of accumulation or altered metabolism of drug. Doses of up to 2 grams of clindamycin per day for 14 days have been well tolerated by healthy volunteers, except that the incidence of gastrointestinal side effects is greater with the higher doses.

    Distribution

    Concentrations of clindamycin in the serum increased linearly with increased dose. Serum levels exceed the MIC (minimum inhibitory concentration) for most indicated organisms for at least 6 hours following administration of the usually recommended doses. Clindamycin is widely distributed in body fluids and tissues (including bones). No significant levels of clindamycin are attained in the cerebrospinal fluid, even in the presence of inflamed meninges.

    Excretion

    The average biological half-life is 2.4 hours. Approximately 10% of the bioactivity is excreted in the urine and 3.6% in the feces; the remainder is excreted as bioinactive metabolites.

    Special Populations

    Renal Impairment

    Serum half-life of clindamycin is increased slightly in patients with markedly reduced renal function. Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.

    Use in Elderly

    Pharmacokinetic studies in elderly volunteers (61 to 79 years) and younger adults (18 to 39 years) indicate that age alone does not alter clindamycin pharmacokinetics (clearance, elimination half-life, volume of distribution and area under the serum concentration-time curve) after IV administration of clindamycin phosphate. After oral administration of clindamycin hydrochloride, elimination half-life is increased to approximately 4 hours (range 3.4 to 5.1 h) in the elderly compared to 3.2 hours (range 2.1 to 4.2 h) in younger adults. The extent of absorption, however, is not different between age groups and no dosage alteration is necessary for the elderly with normal hepatic function and normal (age-adjusted) renal function.

    Microbiology

    Clindamycin inhibits bacterial protein synthesis by binding to the 50S subunit of the ribosome. It has activity against Gram-positive aerobes and anaerobes as well as some Gram-negative anaerobes. Clindamycin is bacteriostatic. Cross-resistance between clindamycin and lincomycin is complete. Antagonism in vitro has been demonstrated between clindamycin and erythromycin. Clindamycin inducible resistance has been identified in macrolide-resistant staphylococci and beta-hemolytic streptococci. Macrolide-resistant isolates of these organisms should be screened for clindamycin inducible resistance using the D-zone test.

    Clindamycin has been shown to be active against most of the isolates of the following microorganisms, both in vitro and in clinical infections, as described in the INDICATIONS AND USAGE  section.

    Gram-positive aerobes
         Staphylococcus aureus (methicillin-susceptible strains)
         Streptococcus pneumoniae
    (penicillin-susceptible strains)
         Streptococcus pyogenes

    Anaerobes
         Prevotella melaninogenica
         Fusobacterium necrophorum
         Fusobacterium nucleatum
         Peptostreptococcus anaerobius
         Clostridium perfringens

    At least 90% of the microorganisms listed below exhibit in vitro minimum inhibitory concentrations (MICs) less than or equal to the clindamycin susceptible MIC breakpoint for organisms of a similar type to those shown in Table 1. However, the efficacy of clindamycin in treating clinical infections due to these microorganisms has not been established in adequate and well controlled clinical trials.

    Gram-positive aerobes
         Staphylococcus epidermidis (methicillin-susceptible strains)
         Streptococcus agalactiae
         Streptococcus anginosus
         Streptococcus oralis
         Streptococcus mitis

    Anaerobes
         Prevotella intermedia
         Prevotella bivia
         Propionibacterium acnes
         Micromonas (“Peptostreptococcus”) micros
         Finegoldia (“Peptostreptococcus”) magna
         Actinomyces israelii
         Clostridium clostridioforme
         Eubacterium lentum

    Susceptibility Testing Methods

    When available, the clinical microbiology laboratory should provide cumulative in vitro susceptibility test results for antimicrobial drugs used in local hospitals and practice areas to the physician as periodic reports that describe the susceptibility profile of nosocomial and community-acquired pathogens. These reports should aid the physician in selecting the most effective antimicrobial.

    Dilution Techniques

    Quantitative methods are used to determine antimicrobial minimum inhibitory concentrations (MICs). These MICs provide estimates of the susceptibility of bacteria to antimicrobial compounds. The MICs should be determined using a standardized procedure based on dilution methods (broth, agar or microdilution) 1,2 or equivalent using standardized inoculum and concentrations of clindamycin. The MIC values should be interpreted according to the criteria provided in Table 1.

    Diffusion Techniques

    Quantitative methods that require the measurement of zone diameters also provide reproducible estimates of the susceptibility of bacteria to antimicrobial compounds. The standardized procedure 1,3 requires the use of standardized inoculum concentrations. This procedure uses paper disks impregnated with 2 mcg of clindamycin to test the susceptibility of microorganisms to clindamycin. Reports from the laboratory providing results of the standard single-disk susceptibility test with a 2 mcg clindamycin disk should be interpreted according to the criteria in Table 1.

    Table 1. Susceptibility Interpretive Criteria for Clindamycin
    NA = not applicable

    Pathogen

    Susceptibility Interpretive Criteria

    Minimal Inhibitory Concentrations
    (MIC in mcg/mL)

    Disk Diffusion (Zone Diameters in mm)

     

    S

    I

    R

    S

    I

    R

    Staphylococcus spp.

    ≤ 0.5

    1 to 2

    ≥ 4

    ≥ 21

    15 to 20

    ≤ 14

    Streptococcus Pneumoniae
    and other Streptococcus spp.

    ≤ 0.25

    0.5

    ≥ 1

    ≥ 19

    16 to 18

    ≤ 15

    Anaerobic Bacteria

    ≤ 2

    4

    ≥ 8

    NA

    NA

    NA

    A report of “Susceptible” indicates that the pathogen is likely to be inhibited if the antimicrobial compound in the blood reaches the concentrations usually achievable. A report of “Intermediate” indicates that the result should be considered equivocal and, if the microorganism is not fully susceptible to alternative, clinically feasible drugs, the test should be repeated. This category implies possible clinical applicability in body sites where the drug is physiologically concentrated or in situations where high dosage of drug can be used. This category also provides a buffer zone that prevents small, uncontrolled technical factors from causing major discrepancies in interpretation.

    A report of “Resistant” indicates that the pathogen is not likely to be inhibited if the antimicrobial compound in the blood reaches the concentrations usually achievable; other therapy should be selected.

    Quality Control

    Standardized susceptibility test procedures require the use of laboratory controls to monitor and ensure the accuracy and precision of the supplies and reagents used in the assay and the techniques of the individuals performing the test. 1,2,3,4 Standard clindamycin powder should provide the MIC ranges in Table 2. For the disk diffusion technique using the 2 mcg clindamycin disk the criteria provided in Table 2 should be achieved.

    Table 2. Acceptable Quality Control Ranges for Clindamycin to be Used in Validation of Susceptibility Test Results
    NA = Not applicable
    ATCC® is a registered trademark of the American Type Culture Collection

    QC Strain

    Acceptable Quality Control Ranges

    Minimum Inhibitory Concentration Range
    (mcg/mL)

    Disk Diffusion Range
    (Zone Diameters in mm)

    When Testing Aerobic Pathogens

    Staphylococcus aureus
    ATCC 29213

    0.06 to 0.25

    NA

    Staphylococcus aureus
    ATCC 25923

    NA

    24 to 30

    Streptococcus pneumonia
    ATCC 49619

    0.03 to 0.12

    19 to 25

    When Testing Anaerobes

    Bacteroides fragilis
    ATCC 25285

    0.5 to 2

    NA

    Bacteroides thetaiotaomicron
    ATCC 29741

    2 to 8

    NA

    Eubacterium lentum
    ATCC 43055

    0.06 to 0.25

    NA

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  • INDICATIONS AND USAGE

    Clindamycin hydrochloride capsules are indicated in the treatment of serious infections caused by susceptible anaerobic bacteria.

    Clindamycin hydrochloride capsules are also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci and staphylococci. Its use should be reserved for penicillin-allergic patients or other patients for whom, in the judgment of the physician, a penicillin is inappropriate. Because of the risk of colitis, as described in the WARNING box, before selecting clindamycin the physician should consider the nature of the infection and the suitability of less toxic alternatives (e.g., erythromycin).

    Anaerobes: Serious respiratory tract infections such as empyema, anaerobic pneumonitis and lung abscess; serious skin and soft tissue infections; septicemia; intra-abdominal infections such as peritonitis and intra-abdominal abscess (typically resulting from anaerobic organisms resident in the normal gastrointestinal tract); infections of the female pelvis and genital tract such as endometritis, nongonococcal tubo-ovarian abscess, pelvic cellulitis and postsurgical vaginal cuff infection.

    Streptococci: Serious respiratory tract infections; serious skin and soft tissue infections.

    Staphylococci: Serious respiratory tract infections; serious skin and soft tissue infections.

    Pneumococci: Serious respiratory tract infections.

    Bacteriologic studies should be performed to determine the causative organisms and their susceptibility to clindamycin.

    To reduce the development of drug-resistant bacteria and maintain the effectiveness of clindamycin hydrochloride capsules and other antibacterial drugs, clindamycin hydrochloride capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

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  • CONTRAINDICATIONS

    Clindamycin hydrochloride capsules are contraindicated in individuals with a history of hypersensitivity to preparations containing clindamycin or lincomycin.

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  • WARNINGS

    See WARNING box.

    Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including clindamycin hydrochloride, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C.difficile.

    C.difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C.difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over 2 months after the administration of antibacterial agents.

    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.

    A careful inquiry should be made concerning previous sensitivities to drugs and other allergens.

    Usage in Meningitis

    Since clindamycin does not diffuse adequately into the cerebrospinal fluid, the drug should not be used in the treatment of meningitis.

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  • PRECAUTIONS

    General

    Review of experience to date suggests that a subgroup of older patients with associated severe illness may tolerate diarrhea less well. When clindamycin is indicated in these patients, they should be carefully monitored for change in bowel frequency.

    Clindamycin hydrochloride should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.

    Clindamycin hydrochloride should be prescribed with caution in atopic individuals.

    Indicated surgical procedures should be performed in conjunction with antibiotic therapy.

    The use of clindamycin hydrochloride occasionally results in overgrowth of nonsusceptible organisms - particularly yeasts. Should superinfections occur, appropriate measures should be taken as indicated by the clinical situation.

    Clindamycin dosage modification may not be necessary in patients with renal disease. In patients with moderate to severe liver disease, prolongation of clindamycin half-life has been found. However, it was postulated from studies that when given every eight hours, accumulation should rarely occur. Therefore, dosage modification in patients with liver disease may not be necessary. However, periodic liver enzyme determinations should be made when treating patients with severe liver disease.

    Prescribing clindamycin hydrochloride capsules in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.

    Information for Patients

    Patients should be counseled that antibacterial drugs including clindamycin hydrochloride capsules should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). When clindamycin hydrochloride capsules are prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of therapy, the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may (1) decrease the effectiveness of the immediate treatment and (2) increase the likelihood that bacteria will develop resistance and will not be treatable by clindamycin hydrochloride capsules or other antibacterial drugs in the future.

    Diarrhea is a common problem caused by antibiotics which usually ends when the antibiotic is discontinued. Sometimes after starting treatment with antibiotics, patients can develop watery and bloody stools (with or without stomach cramps and fever) even as late as 2 or more months after having taken the last dose of the antibiotic. If this occurs, patients should contact their physician as soon as possible.

    Laboratory Tests

    During prolonged therapy, periodic liver and kidney function tests and blood counts should be performed.

    Drug Interactions

    Clindamycin has been shown to have neuromuscular blocking properties that may enhance the action of other neuromuscular blocking agents. Therefore, it should be used with caution in patients receiving such agents.

    Antagonism has been demonstrated between clindamycin and erythromycin in vitro. Because of possible clinical significance, these two drugs should not be administered concurrently.

    Carcinogenesis, Mutagenesis, Impairment of Fertility

    Long-term studies in animals have not been performed with clindamycin to evaluate carcinogenic potential. Genotoxicity tests performed included a rat micronucleus test and an Ames Salmonella reversion test. Both tests were negative.

    Fertility studies in rats treated orally with up to 300 mg/kg/day (approximately 1.6 times the highest recommended adult human dose based on mg/m2) revealed no effects on fertility or mating ability.

    Pregnancy

    Teratogenic Effects

    Pregnancy Category B

    Reproduction studies performed in rats and mice using oral doses of clindamycin up to 600 mg/kg/day (3.2 and 1.6 times the highest recommended adult human dose based on mg/m2, respectively) or subcutaneous doses of clindamycin up to 250 mg/kg/day (1.3 and 0.7 times the highest recommended adult human dose based on mg/m2, respectively) revealed no evidence of teratogenicity.

    There are, however, no adequate and well controlled studies in pregnant women. Because animal reproduction studies are not always predictive of the human response, this drug should be used during pregnancy only if clearly needed.

    Nursing Mothers

    Clindamycin has been reported to appear in breast milk in the range of 0.7 to 3.8 mcg/mL.

    Pediatric Use

    When clindamycin hydrochloride is administered to the pediatric population (birth to 16 years), appropriate monitoring of organ system functions is desirable.

    Geriatric Use

    Clinical studies of clindamycin did not include sufficient numbers of patients age 65 and over to determine whether they respond differently from younger patients. However, other reported clinical experience indicates that antibiotic-associated colitis and diarrhea (due to Clostridium difficile) seen in association with most antibiotics occur more frequently in the elderly (> 60 years) and may be more severe. These patients should be carefully monitored for the development of diarrhea.

    Pharmacokinetic studies with clindamycin have shown no clinically important differences between young and elderly subjects with normal hepatic function and normal (age-adjusted) renal function after oral or intravenous administration.

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  • ADVERSE REACTIONS

    The following reactions have been reported with the use of clindamycin.

    Gastrointestinal: Abdominal pain, pseudomembranous colitis, esophagitis, nausea, vomiting and diarrhea (see WARNING box). The onset of pseudomembranous colitis symptoms may occur during or after antibacterial treatment (see WARNINGS).

    Hypersensitivity Reactions: Generalized mild to moderate morbilliform-like (maculopapular) skin rashes are the most frequently reported adverse reactions. Vesiculobullous rashes, as well as urticaria, have been observed during drug therapy. Rare instances of erythema multiforme, some resembling Stevens-Johnson Syndrome, and a few cases of anaphylactoid reactions have also been reported.

    Skin and Mucous Membranes: Pruritus, vaginitis and rare instances of exfoliative dermatitis have been reported. (See Hypersensitivity Reactions.)

    Liver: Jaundice and abnormalities in liver function tests have been observed during clindamycin therapy.

    Renal: Although no direct relationship of clindamycin to renal damage has been established, renal dysfunction as evidenced by azotemia, oliguria and/or proteinuria has been observed in rare instances.

    Hematopoietic: Transient neutropenia (leukopenia) and eosinophilia have been reported. Reports of agranulocytosis and thrombocytopenia have been made. No direct etiologic relationship to concurrent clindamycin therapy could be made in any of the foregoing.

    Musculoskeletal: Rare instances of polyarthritis have been reported.

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  • OVERDOSAGE

    Significant mortality was observed in mice at an intravenous dose of 855 mg/kg and in rats at an oral or subcutaneous dose of approximately 2618 mg/kg. In the mice, convulsions and depression were observed.

    Hemodialysis and peritoneal dialysis are not effective in removing clindamycin from the serum.

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  • DOSAGE AND ADMINISTRATION

    If significant diarrhea occurs during therapy, this antibiotic should be discontinued (see WARNING box).

    Adults

    Serious infections - 150 mg to 300 mg every 6 hours. More severe infections - 300 mg to 450 mg every 6 hours.

    Pediatric Patients

    Serious infections - 8 to 16 mg/kg/day (4 to 8 mg/lb/day) divided into three or four equal doses. More severe infections - 16 to 20 mg/kg/day (8 to 10 mg/lb/day) divided into three or four equal doses.

    To avoid the possibility of esophageal irritation, clindamycin hydrochloride capsules should be taken with a full glass of water.

    Serious infections due to anaerobic bacteria are usually treated with clindamycin injection. However, in clinically appropriate circumstances, the physician may elect to initiate treatment or continue treatment with clindamycin hydrochloride capsules.

    In cases of β-hemolytic streptococcal infections, treatment should continue for at least 10 days.

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  • HOW SUPPLIED

    Clindamycin Hydrochloride Capsules, USP are available containing clindamycin hydrochloride, USP equivalent to 75 mg, 150 mg or 300 mg of clindamycin.

    The 75 mg capsule is a hard-shell gelatin capsule with a lavender opaque cap and lavender opaque body axially printed with MYLAN over CL 75 in black ink on both the cap and the body. It is filled with a white to off-white powder. They are available as follows:

    NDC 0378-6068-01
    bottles of 100 capsules

    NDC 0378-6068-05
    bottles of 500 capsules

    The 150 mg capsule is a hard-shell gelatin capsule with a lavender opaque cap and green opaque body axially printed with MYLAN over CL 150 in black ink on both the cap and the body. It is filled with a white to off-white powder. They are available as follows:

    NDC 0378-6069-01
    bottles of 100 capsules

    NDC 0378-6069-05

    bottles of 500 capsules

    The 300 mg capsule is a hard-shell gelatin capsule with a green opaque cap and green opaque body axially printed with MYLAN over CL 300 in black ink on both the cap and the body. It is filled with a white to off-white powder. They are available as follows:

    NDC 0378-6070-01
    bottles of 100 capsules

    NDC 0378-6070-05
    bottles of 500 capsules

    Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]

    Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.

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  • ANIMAL TOXICOLOGY

    One year oral toxicity studies in Spartan Sprague-Dawley rats and beagle dogs at dose levels up to 300 mg/kg/day (approximately 1.6 and 5.4 times the highest recommended adult human dose based on mg/m2, respectively) have shown clindamycin to be well tolerated. No appreciable difference in pathological findings has been observed between groups of animals treated with clindamycin and comparable control groups. Rats receiving clindamycin hydrochloride at 600 mg/kg/day (approximately 3.2 times the highest recommended adult human dose based on mg/m2) for 6 months tolerated the drug well; however, dogs dosed at this level (approximately 10.8 times the highest recommended adult human dose based on mg/m2) vomited, would not eat and lost weight.

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  • REFERENCES

    1.
    CLSI. Performance Standards for Antimicrobial Susceptibility Testing: Twentieth Informational Supplement. CLSI document M 100-S20. Wayne, PA: Clinical and Laboratory Standards Institute; 2010.
    2.
    CLSI. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically; Approved Standard – Eighth Edition. CLSI document M07-A8. Wayne, PA: Clinical and Laboratory Standards Institute; 2009.
    3.
    CLSI. Performance Standards for Antimicrobial Disk Susceptibility Tests ; Approved Standard – Tenth Edition. CLSI document M02-A10. Wayne, PA: Clinical and Laboratory Standards Institute; 2009.
    4.
    CLSI. Methods for Antimicrobial Susceptibility Testing of Anaerobic Bacteria; Approved Standard-Seventh Edition. CLSI document M11-A7. Wayne, PA: Clinical and Laboratory Standards Institute; 2007.

    Manufactured for:
    Mylan Pharmaceuticals Inc.
    Morgantown, WV 26505 U.S.A.

    Manufactured in India by:
    Mylan Laboratories Limited
    Hyderabad—500 034, India
    Code No. MH/DRUGS/28/NKD/43

    REVISED APRIL 2013
    75050180
    MX:CLIND:R3

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  • PRINCIPAL DISPLAY PANEL

    PRINCIPAL DISPLAY PANEL - 75 mg

    NDC 0378-6068-01

    Clindamycin
    HCl
    Capsules, USP
    75 mg*

    Rx only     100 Capsules

    *Each capsule contains clindamycin
    hydrochloride, USP equivalent to
    75 mg of clindamycin.

    Usual Dosage: See accompanying
    prescribing information.

    Keep this and all medication out of
    the reach of children.

    Store at 20° to 25°C (68° to 77°F).
    [See USP Controlled Room
    Temperature.]

    Manufactured for:
    Mylan Pharmaceuticals Inc.
    Morgantown, WV 26505 U.S.A.

    Made in India

    Mylan.com

    RMX6068A1

    Dispense in a tight, light-resistant
    container as defined in the USP
    using a child-resistant closure.

    Keep container tightly closed.

    Code No.: MH/DRUGS/28/NKD/43

    Clindamycin HCI Capsules 75 mg Bottle Labels
    Close
  • PRINCIPAL DISPLAY PANEL

    PRINCIPAL DISPLAY PANEL - 150 mg

    NDC 0378-6069-01

    Clindamycin
    HCl
    Capsules, USP
    150 mg*

    Rx only     100 Capsules

    *Each capsule contains clindamycin
    hydrochloride, USP equivalent to
    150 mg of clindamycin.

    Usual Dosage: See accompanying
    prescribing information.

    Keep this and all medication out of
    the reach of children.

    Store at 20° to 25°C (68° to 77°F).
    [See USP Controlled Room
    Temperature.]

    Manufactured for:
    Mylan Pharmaceuticals Inc.
    Morgantown, WV 26505 U.S.A.

    Made in India

    Mylan.com

    RMX6069A1

    Dispense in a tight, light-resistant
    container as defined in the USP
    using a child-resistant closure.

    Keep container tightly closed.

    Code No.: MH/DRUGS/28/NKD/43

    Clindamycin HCI Capsules 150 mg Bottle Labels
    Close
  • PRINCIPAL DISPLAY PANEL

    PRINCIPAL DISPLAY PANEL - 300 mg

    NDC 0378-6070-01

    Clindamycin
    HCl
    Capsules, USP
    300 mg*

    Rx only     100 Capsules

    *Each capsule contains clindamycin
    hydrochloride, USP equivalent to
    300 mg of clindamycin.

    Usual Dosage: See accompanying
    prescribing information.

    Keep this and all medication out of
    the reach of children.

    Store at 20° to 25°C (68° to 77°F).
    [See USP Controlled Room
    Temperature.]

    Manufactured for:
    Mylan Pharmaceuticals Inc.
    Morgantown, WV 26505 U.S.A.

    Made in India

    Mylan.com

    RMX6070A1

    Dispense in a tight, light-resistant
    container as defined in the USP
    using a child-resistant closure.

    Keep container tightly closed.

    Code No.: MH/DRUGS/28/NKD/43

    Clindamycin HCI Capsules 300 mg Bottle Labels
    Close
  • INGREDIENTS AND APPEARANCE
    CLINDAMYCIN HYDROCHLORIDE 
    clindamycin hydrochloride capsule
    Product Information
    Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:0378-6068
    Route of Administration ORAL DEA Schedule     
    Active Ingredient/Active Moiety
    Ingredient Name Basis of Strength Strength
    CLINDAMYCIN HYDROCHLORIDE (CLINDAMYCIN) CLINDAMYCIN 75 mg
    Inactive Ingredients
    Ingredient Name Strength
    STARCH, CORN  
    FD&C BLUE NO. 2  
    GELATIN  
    LACTOSE MONOHYDRATE  
    MAGNESIUM STEARATE  
    PROPYLENE GLYCOL  
    FERRIC OXIDE RED  
    SHELLAC  
    TALC  
    TITANIUM DIOXIDE  
    FERROSOFERRIC OXIDE  
    POTASSIUM HYDROXIDE  
    Product Characteristics
    Color PURPLE (lavender opaque) Score no score
    Shape CAPSULE Size 14mm
    Flavor Imprint Code MYLAN;CL;75
    Contains     
    Packaging
    # Item Code Package Description Marketing Start Date Marketing End Date
    1 NDC:0378-6068-01 100 in 1 BOTTLE, PLASTIC
    2 NDC:0378-6068-05 500 in 1 BOTTLE, PLASTIC
    Marketing Information
    Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
    ANDA ANDA091225 05/07/2013
    CLINDAMYCIN HYDROCHLORIDE 
    clindamycin hydrochloride capsule
    Product Information
    Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:0378-6069
    Route of Administration ORAL DEA Schedule     
    Active Ingredient/Active Moiety
    Ingredient Name Basis of Strength Strength
    CLINDAMYCIN HYDROCHLORIDE (CLINDAMYCIN) CLINDAMYCIN 150 mg
    Inactive Ingredients
    Ingredient Name Strength
    STARCH, CORN  
    FD&C BLUE NO. 2  
    FD&C GREEN NO. 3  
    FD&C RED NO. 40  
    GELATIN  
    LACTOSE MONOHYDRATE  
    MAGNESIUM STEARATE  
    PROPYLENE GLYCOL  
    FERRIC OXIDE RED  
    SHELLAC  
    TALC  
    TITANIUM DIOXIDE  
    FERROSOFERRIC OXIDE  
    POTASSIUM HYDROXIDE  
    Product Characteristics
    Color PURPLE (lavender opaque) , GREEN (green opaque) Score no score
    Shape CAPSULE Size 18mm
    Flavor Imprint Code MYLAN;CL;150
    Contains     
    Packaging
    # Item Code Package Description Marketing Start Date Marketing End Date
    1 NDC:0378-6069-01 100 in 1 BOTTLE, PLASTIC
    2 NDC:0378-6069-05 500 in 1 BOTTLE, PLASTIC
    Marketing Information
    Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
    ANDA ANDA091225 05/07/2013
    CLINDAMYCIN HYDROCHLORIDE 
    clindamycin hydrochloride capsule
    Product Information
    Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:0378-6070
    Route of Administration ORAL DEA Schedule     
    Active Ingredient/Active Moiety
    Ingredient Name Basis of Strength Strength
    CLINDAMYCIN HYDROCHLORIDE (CLINDAMYCIN) CLINDAMYCIN 300 mg
    Inactive Ingredients
    Ingredient Name Strength
    STARCH, CORN  
    FD&C GREEN NO. 3  
    FD&C RED NO. 40  
    GELATIN  
    LACTOSE MONOHYDRATE  
    MAGNESIUM STEARATE  
    PROPYLENE GLYCOL  
    SHELLAC  
    TALC  
    TITANIUM DIOXIDE  
    FERROSOFERRIC OXIDE  
    POTASSIUM HYDROXIDE  
    Product Characteristics
    Color GREEN (green opaque) Score no score
    Shape CAPSULE Size 21mm
    Flavor Imprint Code MYLAN;CL;300
    Contains     
    Packaging
    # Item Code Package Description Marketing Start Date Marketing End Date
    1 NDC:0378-6070-01 100 in 1 BOTTLE, PLASTIC
    2 NDC:0378-6070-05 500 in 1 BOTTLE, PLASTIC
    Marketing Information
    Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
    ANDA ANDA091225 05/07/2013
    Labeler - Mylan Pharmaceuticals Inc. (059295980)
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