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Clindamycin Phosphate side effects: what 5,387 FDA adverse event reports show

Clindamycin Phosphate · 1,212 reaction terms · 140,666 drug–reaction co-reports · data 2026-09-14
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Drug class

Not stated in label

Who reports

5,387 reports · 61% serious · 391 with death outcome · 68% female

openFDA FAERS counts, all years, deduplication not applied

Used for

CLINICAL STUDIES In one 12-week multicenter, randomized, evaluator-blind, vehicle-controlled, parallel comparison clinical trial in which patients used CLINDAGEL (clindamycin phosphate topical gel, 1%) once daily or the vehicle gel once daily, in the treatment of acne vulgaris of mild to moderate severity, CLINDAGEL applied once daily was more effective than the vehicle applied once daily.

FDA label, Indications and Usage

What it is

DESCRIPTION CLINDAGEL (clindamycin phosphate) topical gel, 1%, a topical antibiotic, contains clindamycin phosphate, USP, at a concentration equivalent to 10 mg clindamycin per gram in a gel v.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 1Labeled (related wording) 3Lab value / disease marker 1Not in label — unassessed 35
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,172 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Babesiosis3590.0
63.1–128.2ROR 90.1 · calibrated p 5e-7 ✓
75.6 EB05 56.8 · IC025 +4.7
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Graft infection3368.2
47.6–97.7ROR 68.3 · calibrated p 4e-6 ✓
59.6 EB05 44.4 · IC025 +4.4
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Scrotal abscess3258.4
40.6–83.9ROR 58.4 · calibrated p 1e-5 ✓
51.9 EB05 38.5 · IC025 +4.3
3/3 methods agree
Not in label — unassessedserious n=7not reported in cached trials
Microsporidia infection2956.0
38.3–81.9ROR 56.1 · calibrated p 1e-5 ✓
49.9 EB05 36.4 · IC025 +4.2
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Genital abscess3050.3
34.7–73.0ROR 50.4 · calibrated p 2e-5 ✓
45.4 EB05 33.3 · IC025 +4.1
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Chronic kidney disease-mineral and bone disorder6540.6
31.6–52.1ROR 40.6 · calibrated p 6e-5 ✓
37.8 EB05 30.7 · IC025 +4.5
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Hyperparathyroidism secondary14538.3
32.4–45.3ROR 38.5 · calibrated p 7e-5 ✓
36.0 EB05 31.3 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=10not reported in cached trials
Type iv hypersensitivity reaction15137.0
31.4–43.6ROR 37.2 · calibrated p 9e-5 ✓
34.9 EB05 30.4 · IC025 +4.7
3/3 methods agree
Not in label — unassessedserious n=9not reported in cached trials
Nephrogenic anaemia24935.5
31.3–40.3ROR 35.8 · calibrated p 1e-4 ✓
33.6 EB05 30.2 · IC025 +4.8
3/3 methods agree
Not in label — unassessedserious n=19not reported in cached trials
Aortic calcification2932.6
22.4–47.3ROR 32.6 · calibrated p 3e-4 ✓
30.4 EB05 22.2 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=5not reported in cached trials
Primary sequestrum4532.5
24.1–43.9ROR 32.6 · calibrated p 2e-4 ✓
30.6 EB05 23.8 · IC025 +4.0
3/3 methods agree
Not in label — unassessedserious n=13not reported in cached trials
Toxic shock syndrome3031.4
21.7–45.3ROR 31.4 · calibrated p 3e-4 ✓
29.4 EB05 21.6 · IC025 +3.7
3/3 methods agree
Not in label — unassessedserious n=5not reported in cached trials
Acute generalised exanthematous pustulosis34329.3
26.3–32.6ROR 29.6 · calibrated p 3e-4 ✓
28.0 EB05 25.6 · IC025 +4.6
3/3 methods agree
Not in label — unassessedserious PRR 14.2 · 100% cliniciannot reported in cached trials
Symmetrical drug-related intertriginous and flexural exanthema3327.4
19.3–38.8ROR 27.4 · calibrated p 6e-4 ✓
25.9 EB05 19.3 · IC025 +3.7
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Hidradenitis35226.6
23.9–29.6ROR 26.9 · calibrated p 5e-4 ✓
25.5 EB05 23.4 · IC025 +4.5
3/3 methods agree
Not in label — unassessedserious n=49not reported in cached trials
Intervertebral disc space narrowing3024.4
17.0–35.2ROR 24.5 · calibrated p 0.001 ✓
23.2 EB05 17.0 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=5not reported in cached trials
Osteosclerosis5723.6
18.2–30.8ROR 23.7 · calibrated p 0.001 ✓
22.7 EB05 18.1 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=16not reported in cached trials
Rebound acid hypersecretion11023.5
19.4–28.4ROR 23.5 · calibrated p 0.001 ✓
22.6 EB05 19.2 · IC025 +4.1
3/3 methods agree
Not in label — unassessedserious n=6not reported in cached trials
Vertebral foraminal stenosis2922.9
15.8–33.2ROR 22.9 · calibrated p 0.001 ✓
21.9 EB05 15.9 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=9not reported in cached trials
Red man syndrome3022.0
15.3–31.6ROR 22.0 · calibrated p 0.002 ✓
21.0 EB05 15.4 · IC025 +3.4
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Groin abscess3720.7
14.9–28.7ROR 20.7 · calibrated p 0.002 ✓
19.8 EB05 15.0 · IC025 +3.5
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Pneumocystis jirovecii infection3620.3
14.6–28.3ROR 20.3 · calibrated p 0.002 ✓
19.5 EB05 14.7 · IC025 +3.4
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Cerebral toxoplasmosis2920.2
13.9–29.2ROR 20.2 · calibrated p 0.003 ✓
19.3 EB05 14.0 · IC025 +3.3
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Clostridium test positive6720.0
15.7–25.5ROR 20.0 · calibrated p 0.002 ✓
19.3 EB05 15.7 · IC025 +3.7
3/3 methods agree
Lab value / disease markerserious n=4not reported in cached trials
Abscess jaw3219.8
13.9–28.2ROR 19.8 · calibrated p 0.003 ✓
19.0 EB05 14.0 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=4NCT00729937: 1/249 (0.4%) on Clindamycin; 8/617 (1.3%) control (serious AE)
Loss of employment9219.6
16.0–24.2ROR 19.7 · calibrated p 0.002 ✓
19.0 EB05 15.9 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious n=8not reported in cached trials
Pseudomembranous colitis6518.8
14.7–24.1ROR 18.8 · calibrated p 0.003 ✓
18.2 EB05 14.8 · IC025 +3.6
3/3 methods agree
Labeled adverse reaction
exact term
serious n=10not reported in cached trials
Osteolysis5718.0
13.9–23.5ROR 18.1 · calibrated p 0.004 ✓
17.4 EB05 13.9 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Megacolon4217.4
12.8–23.6ROR 17.4 · calibrated p 0.005 ✓
16.8 EB05 12.9 · IC025 +3.3
3/3 methods agree
Not in label — unassessedserious n=6not reported in cached trials
Exposed bone in jaw5817.2
13.2–22.3ROR 17.2 · calibrated p 0.005 ✓
16.6 EB05 13.3 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious n=15not reported in cached trials
Necrotising fasciitis8916.3
13.3–20.2ROR 16.4 · calibrated p 0.005 ✓
15.9 EB05 13.3 · IC025 +3.5
3/3 methods agree
Not in label — unassessedserious n=11NCT00729937: 1/248 (0.4%) on Clindamycin (serious AE)
End stage renal disease44815.7
14.3–17.3ROR 15.9 · calibrated p 0.006 ✓
15.3 EB05 14.2 · IC025 +3.8
3/3 methods agree
Not in label — unassessedserious PRR 4.8not reported in cached trials
Perirectal abscess2715.6
10.7–22.9ROR 15.6 · calibrated p 0.008 ✓
14.9 EB05 10.5 · IC025 +3.0
3/3 methods agree
Not in label — unassessedserious n=11not reported in cached trials
Rash morbilliform6615.4
12.0–19.6ROR 15.4 · calibrated p 0.007 ✓
14.9 EB05 12.1 · IC025 +3.4
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Methaemoglobinaemia5114.3
10.8–18.9ROR 14.3 · calibrated p 0.010 ✓
13.8 EB05 10.8 · IC025 +3.2
3/3 methods agree
Not in label — unassessed–not reported in cached trials
Clostridial infection7313.8
10.9–17.4ROR 13.8 · calibrated p 0.011 ✓
13.4 EB05 10.9 · IC025 +3.2
3/3 methods agree
Not in label — unassessedserious n=7not reported in cached trials
Left atrial dilatation2713.5
9.2–19.8ROR 13.5 · calibrated p 0.013 ✓
12.8 EB05 8.9 · IC025 +2.8
3/3 methods agree
Not in label — unassessedserious n=8not reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Clindamycin as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (4 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Drug ineffective (drug did not work)2,8791.4
1.3–1.4ROR 1.4 · calibrated p 0.587
1.4 EB05 1.3 · IC025 +0.4Reporting / coding artifactserious PRR 1.8not reported in cached trials
Diarrhoea (diarrhea)2,2262.2
2.1–2.3ROR 2.3 · calibrated p 0.915
2.2 EB05 2.1 · IC025 +1.1
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 2.6NCT00729937: 81/249 (32.5%) on Clindamycin; 96/617 (15.6%) control
Rash2,0223.0
2.8–3.1ROR 3.1 · calibrated p 0.601
2.9 EB05 2.8 · IC025 +1.5
3/3 methods agree
Labeled adverse reaction
exact term
serious PRR 4.1NCT00729937: 4/249 (1.6%) on Clindamycin; 9/617 (1.5%) control
Nausea1,9421.6
1.5–1.6ROR 1.6 · calibrated p 0.700
1.6 EB05 1.5 · IC025 +0.6Not in label — unassessedserious PRR 2.1NCT00729937: 28/249 (11.2%) on Clindamycin; 102/617 (16.5%) control
Pain1,7701.8
1.7–1.9ROR 1.9 · calibrated p 0.868
1.8 EB05 1.7 · IC025 +0.8Labeled adverse reaction
exact term
serious PRR 2.3NCT00729937: 1/630 (0.2%) on Clindamycin (serious AE)
Off label use (used outside approved label)1,6161.2
1.1–1.2ROR 1.2 · calibrated p 0.430
1.2 EB05 1.1 · IC025 +0.2Reporting / coding artifactserious PRR 1.5not reported in cached trials
Fatigue (tiredness)1,5411.3
1.2–1.3ROR 1.3 · calibrated p 0.485
1.3 EB05 1.2 · IC025 +0.2Not in label — unassessedserious PRR 1.9not reported in cached trials
Acute kidney injury (sudden kidney damage)1,4276.0
5.7–6.3ROR 6.2 · calibrated p 0.139
5.9 EB05 5.7 · IC025 +2.5
3/3 methods agree
Not in label — unassessedserious PRR 2.7not reported in cached trials
Dyspnoea (shortness of breath)1,3931.6
1.5–1.6ROR 1.6 · calibrated p 0.694
1.6 EB05 1.5 · IC025 +0.5Not in label — unassessedserious PRR 1.6not reported in cached trials
Chronic kidney disease1,36311.4
10.8–12.0ROR 11.9 · calibrated p 0.018 ✓
11.2 EB05 10.7 · IC025 +3.4
3/3 methods agree
Not in label — unassessedserious PRR 3.5not reported in cached trials
Pyrexia (fever)1,3452.5
2.3–2.6ROR 2.5 · calibrated p 0.804
2.5 EB05 2.3 · IC025 +1.2
3/3 methods agree
Not in label — unassessedserious PRR 2.1NCT00729937: 1/630 (0.2%) on Clindamycin (serious AE)
Headache1,1651.2
1.1–1.2ROR 1.2 · calibrated p 0.428
1.2 EB05 1.1 · IC025 +0.1Not in label — unassessedserious PRR 1.8NCT00729937: 27/249 (10.8%) on Clindamycin; 76/617 (12.3%) control
Vomiting1,1571.6
1.5–1.7ROR 1.6 · calibrated p 0.694
1.6 EB05 1.5 · IC025 +0.5Not in label — unassessedserious PRR 1.6NCT00729937: 14/249 (5.6%) on Clindamycin; 40/617 (6.5%) control
Renal failure (kidney failure)1,1445.4
5.1–5.8ROR 5.6 · calibrated p 0.179
5.4 EB05 5.1 · IC025 +2.3
3/3 methods agree
Not in label — unassessedserious PRR 2.3NCT00729937: 1/248 (0.4%) on Clindamycin (serious AE)

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

✓ A hand-written Bradford Hill causality assessment exists for this drug: Clindamycin ↔ Clostridioides difficile colitis.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Clindamycin?

In FDA FAERS, the most frequently co-reported reaction terms for Clindamycin are drug hypersensitivity, diarrhoea, rash, nausea, pain, fatigue. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Clindamycin have an FDA boxed warning?

No. The FDA label retrieved for Clindamycin has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Clindamycin causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.