Chemical formula: C₁₈H₃₄N₂O₆S Molecular mass: 406.54 g/mol PubChem compound: 3000540
Lincomycin interacts in the following cases:
In patients with impaired hepatic function, the serum half-life of lincomycin is increased. Consideration should be given to decreasing the frequency and dose of lincomycin administered in patients with impaired hepatic function.
Since adequate data are not yet available in patients with pre-existing liver disease, its use in such patients is not recommended at this time unless special clinical circumstances so indicate.
Lincomycin 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.
Hypersensitivity reactions (such anaphylactic reaction, angioedema and serum sickness) have been reported, some of these in patients known to be sensitive to penicillin. If an allergic reaction should occur, the drug should be discontinued and the usual agents (adrenalin, corticosteroids, antihistamines) should be available for emergency treatment.
Severe hypersensitivity reactions, including anaphylactic reactions and severe cutaneous adverse reactions (SCAR) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), acute generalised exanthematous pustulosis (AGEP), and erythema multiforme (EM) have been reported in patients receiving lincomycin therapy. If an anaphylactic reaction or severe skin reaction occurs, lincomycin should be discontinued and appropriate therapy should be initiated.
The use of lincomycin can lead to the development of severe colitis. Fatalities have been reported. Therefore lincomycin should be reserved for serious infections where less toxic antimicrobial agents are inappropriate. It should not be used in patients with non-bacterial infections such as most upper respiratory tract infections.
A toxin produced by Clostridium difficile appears to be the primary cause. The severity of the colitis may range from mild to life threatening. It is important to consider this diagnosis in patients who develop diarrhoea or colitis in association with the use of antibiotics, including parenteral lincomycin. Symptoms may occur up to several weeks after cessation of antibiotic therapy.
Mild cases of pseudomembranous colitis usually respond to drug discontinuation alone, however, in moderate to severe cases appropriate therapy with a suitable oral antibacterial agent effective against Clostridium difficile should be considered. Fluids, electrolytes and protein replacement should be provided when indicated.
Drugs which delay peristalsis (e.g. opiates and diphenoxylate with atropine) may prolong and/or worsen the condition and should not be used.
Review of experience to date suggests that a subgroup of older patients with associated severe illness may tolerate diarrhoea less well. When lincomycin is indicated in these patients, they should be carefully monitored for change in bowel frequency.
Clostridium difficile associated diarrhoea (CDAD) has been reported with use of nearly all antibacterial agents, including lincomycin, and may range in severity from mild diarrhoea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of Clostridium difficile.
Clostridium difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of Clostridium 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 diarrhoea following antibiotic use. Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents.
Lincomycin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis.
Category A.
In humans, lincomycin crosses the placenta and results in cord serum levels about 25% of the maternal serum levels. No significant accumulation occurs in the amniotic fluid. There are limited data on the use of lincomycin in pregnant women. The progeny of 302 patients treated with lincomycin at various stages of pregnancy showed no increases in congenital anomalies or delayed development compared to a control group for up to 7 years after birth. Lincomycin should be used during pregnancy only if clearly needed. Lincomycin is not indicated in the newborn. Benzyl alcohol can cross the placenta.
No embryo fetal toxicity was observed in rats dosed with 10% lincomycin in the diet (equivalent to 5000 mg/kg/day) during organogenesis.
Lincomycin has been reported to appear in breast milk in ranges of 0.5 to 2.4 micrograms/mL. It should not, therefore, be used during lactation unless alternative arrangements can be made for feeding the baby.
No data available.
No studies were conducted to determine the effect of lincomycin on ability to drive and use machines.
Adverse reactions are listed according to the following categories: Very common: ≥1/10, common: ≥1/100 to <1/10, uncommon: ≥1/1,000 to <1/100, rare: ≥1/10,000 to <1/1,000, very rare: <1/10,000, not known: cannot be estimated from available data
Uncommon: Vaginal infection.
Not known: Pseudomembranous colitis, Clostridium difficile colitis.
Common: Diarrhoea, vomiting, nausea.
Rare: Stomatitis.
Not known: Enterocolitis, oesophagitisa, glossitis, abdominal discomfort.
Not known: Pancytopenia, agranulocytosis, aplastic anaemia, leukopenia, neutropenia, thrombocytopenic purpura.
Not known: Anaphylactic reaction, angioedema, serum sickness
Uncommon: Rash, urticaria.
Rare: Pruritus.
Not known: Toxic epidermal necrolysis, Stevens-Johnson syndrome, acute-generalised exanthematous pustulosis, erythema multiforme, dermatitis bullous, dermatitis exfoliative, anal pruritus.
Not known: Jaundice, liver function test abnormal, transaminases increased.
Not known: Renal impairment, oliguria, proteinuria, azotaemia.
Not known: Cardio-respiratory arrestc.
Not known: Hypotensiond, thrombophlebitise.
Not known: Vertigo, tinnitus.
Not known: Injection site abscess sterilef, injection site indurationf, injection site painf, injection site irritationf.
a Reported with oral preparations.
b No direct relationship of lincomycin to renal damage has been established.
c Rare instances have been reported after too rapid intravenous administration.
d Following parenteral administration, particularly after too rapid administration.
e Reported with intravenous injection. This reaction can be minimised by avoidance of indwelling intravenous catheters.
f Reported with intramuscular injection. These reactions can be minimised by deep intramuscular injection.
© All content on this website, including data entry, data processing, decision support tools, "RxReasoner" logo and graphics, is the intellectual property of RxReasoner and is protected by copyright laws. Unauthorized reproduction or distribution of any part of this content without explicit written permission from RxReasoner is strictly prohibited. Any third-party content used on this site is acknowledged and utilized under fair use principles.
