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Drug Safety-related Labeling Changes (SrLC)

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CLINDESSE (NDA-050793)

(CLINDAMYCIN PHOSPHATE)

Safety-related Labeling Changes Approved by FDA Center for Drug Evaluation and Research (CDER)

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01/30/2025 (SUPPL-33)

Approved Drug Label (PDF)

8 Use in Specific Populations

8.1 Pregnancy

PLLR conversion:

Risk Summary

Clindesse has not been studied in pregnant women. The systemic exposure (based on AUC and Cmax) of Clindesse administered intravaginally is substantially lower than clindamycin administered intravenously [see Clinical Pharmacology (12.3)]; therefore, maternal use is not likely to result in significant fetal exposure to the drug. Available data from published observational studies and randomized controlled trials over decades of use with other clindamycin products during pregnancy have not identified an increased risk of major birth defects, miscarriage, or other adverse maternal and fetal outcomes.

In animal reproduction studies, no adverse developmental outcomes were observed in pregnant rats and mice administered oral doses of clindamycin at up to 600 mg/kg/day (58 and 29 times, respectively, the recommended human dose based on a body surface area comparison) (see Data).

The background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

Data

Animal Data

Reproduction studies have been performed in rats and mice using oral doses of clindamycin up to 600 mg/kg/day (58 and 29 times, respectively, the recommended human dose based on body surface area comparisons) and have revealed no evidence of harm to the fetus due to clindamycin.

8.2 Lactation

PLLR conversion:

Risk Summary

The systemic exposure (based on AUC and Cmax) of Clindesse is substantially lower than intravenous administration of clindamycin [see Clinical Pharmacology (12.3)]; therefore, adverse effects on the breastfed infant are not expected from transfer of clindamycin into breastmilk. There are no data on the effect of clindamycin on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for Clindesse and any potential adverse effects on the breastfed infant from Clindesse or from the underlying maternal condition.

8.3 Females and Males of Reproductive Potential

PLLR conversion:

Contraception

Clindesse contains mineral oil that may weaken latex or rubber products such as condoms or vaginal contraceptive diaphragms. Therefore, the use of such barrier contraceptives is not recommended concurrently or for 5 days following treatment with Clindesse. During this time period, condoms may not be reliable for preventing pregnancy or for protecting against transmission of HIV and other sexually transmitted diseases [see Warnings and Precautions (5.2)].

17 PCI/PI/MG (Patient Counseling Information/Patient Information/Medication Guide)

PATIENT INFORMATION

Extensive additions and/or revisions, please refer to label for complete information.

11/03/2023 (SUPPL-31)

Approved Drug Label (PDF)

6 Adverse Reactions

6.2 Other Clindamycin Formulations

Additions and/or revisions underlined:

Immune System: Drug reaction with eosinophilia and systemic symptoms (DRESS) cases have been reported.