lincomycin (Rx)

Brand and Other Names:Lincocin
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Dosing & Uses

AdultPediatric

Dosage Forms & 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

Dosage Forms & 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
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Interactions

Interaction Checker

and lincomycin

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    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

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            Contraindicated (0)

              Serious - Use Alternative (9)

              • atracurium

                lincomycin increases effects of atracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

              • cholera vaccine

                lincomycin, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

              • cisatracurium

                lincomycin increases effects of cisatracurium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

              • onabotulinumtoxinA

                lincomycin increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

              • pancuronium

                lincomycin increases effects of pancuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

              • rapacuronium

                lincomycin increases effects of rapacuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

              • rocuronium

                lincomycin increases effects of rocuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

              • succinylcholine

                lincomycin increases effects of succinylcholine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

              • vecuronium

                lincomycin increases effects of vecuronium by pharmacodynamic synergism. Avoid or Use Alternate Drug. Risk of respiratory depression.

              Monitor Closely (2)

              • rimabotulinumtoxinB

                lincomycin, rimabotulinumtoxinB. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Aminoglycosides may enhance botulinum toxin effects. Closely monitor for increased neuromuscular blockade.

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                lincomycin decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

              Minor (0)

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                Adverse 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

                Postmarketing Reports

                Anal pruritus, pseudomembranous colitis, Clostridium difficile colitis, pancytopenia, aplastic anemia, thrombocytopenic purpura, liver function test abnormal, transaminases increased, renal impairment, oliguria, proteinuria, azotemia, cardio-respiratory arrest

                Skin and subcutaneous tissue disorders: Toxic epidermal necrolysis, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, dermatitis bullous, dermatitis exfoliative, erythema multiforme, rash, urticaria, pruritus may occur

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                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

                Parenteral form contains benzyl alcohol; risk of benzyl alcohol toxicity depends on quantity administered and liver and kidneys’ capacity to detoxify the chemical; AAP states the small amounts doesn't proscribe it in neonates

                Severe hypersensitivity reactions, including anaphylactic reactions and severe cutaneous adverse reactions (SCAR) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis (AGEP), and erythema multiforme (EM) reported; if anaphylactic reaction or severe skin reaction occurs, discontinue drug and initiate appropriate therapy

                Certain infections may require incision and drainage or other indicated surgical procedures in addition to antibacterial therapy

                Drug should not be injected intravenously undiluted as a bolus, but should be infused over at least 60 minutes as directed

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

                Therapy may result in overgrowth of nonsusceptible organisms—particularly yeasts; should superinfections occur, appropriate measures should be taken as indicated by clinical situation; when patients with pre-existing monilial infections require therapy with lincomycin, concomitant antimonilial treatment should be given

                Serum half-life of lincomycin may be prolonged in patients with severe impairment of renal function compared to patients with normal renal function; in patients with abnormal hepatic function, serum half-life may be twofold longer than in patients with normal hepatic function

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                Pregnancy & Lactation

                Pregnancy

                There are no adequate and well-controlled studies in pregnant women; sterile Solution contains benzyl alcohol as a preservative; benzyl alcohol can cross placenta; should be used during pregnancy only if clearly needed; experience with obstetrical patients receiving drug revealed no ill effects related to pregnancy

                Animal data

                • No evidence of teratogenicity when drug administered in diet or via oral gavage to pregnant Sprague Dawley rats during period of major organogenesis at doses up to 5000 mg/kg and 100 mg/kg (approximately 6 times and 0.12 times the maximum recommended human dose [MRHD], respectively, based on body surface area comparison)
                • Reproduction studies performed in rats administered drug for 2 weeks prior to mating, throughout pregnancy and lactation, revealed no adverse effects on survival of offspring from birth to weaning at doses up to 1000 mg/kg (1.2 times the MRHD based on body surface area comparison) up to 2 generations

                Lactation

                Drug has been reported to appear in human milk in concentrations of 0.5 to 2.4 mcg/mL; because of potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing, or to discontinue drug, taking into account importance of drug to mother

                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.

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                Pharmacology

                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)

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                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

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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Lincocin injection
                -
                300 mg/mL vial
                Lincocin injection
                -
                300 mg/mL vial
                lincomycin injection
                -
                300 mg/mL vial
                lincomycin injection
                -
                300 mg/mL vial
                lincomycin injection
                -
                300 mg/mL vial
                lincomycin injection
                -
                300 mg/mL vial

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                lincomycin injection

                LINCOMYCIN - INJECTION

                (LIN-koe-MYE-sin)

                COMMON BRAND NAME(S): Lincocin

                WARNING: This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool. If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.

                USES: This medication is used to treat a wide variety of bacterial infections. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.

                HOW TO USE: This medication is given by injection into a vein or muscle as directed by your doctor, usually 1 to 3 times a day. The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight.If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same time(s) every day.Continue to use this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.

                SIDE EFFECTS: See also Warning section.Nausea, vomiting, diarrhea, or headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: pain/swelling at injection site, signs of liver disease (such as nausea/vomiting that doesn't stop, yellowing eyes/skin, dark urine), easy bruising/bleeding, unusual tiredness, fast/slow/irregular heartbeat, dizziness, fainting.Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: Before using lincomycin, tell your doctor or pharmacist if you are allergic to it; or to clindamycin; or if you have any other allergies. This product may contain inactive ingredients (such as benzyl alcohol), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this drug, tell your doctor your medical history, especially of: kidney disease, liver disease, stomach/bowel disease (such as colitis).Lincomycin may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using lincomycin before having any immunizations/vaccinations.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially diarrhea.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: macrolide antibiotics (such as clarithromycin, erythromycin).

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

                NOTES: Lab and/or medical tests (such as kidney/liver function, blood counts) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details

                MISSED DOSE: It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

                STORAGE: Consult the product instructions and your pharmacist for storage details. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

                Information last revised October 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

                Adding plans allows you to compare formulary status to other drugs in the same class.

                To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                Adding plans allows you to:

                • View the formulary and any restrictions for each plan.
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                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.