Lincomycin (Lincocin) is an antibiotic of the class lincosamide. It is used in the treatment of serious susceptible infections resistant to penicillins. It is used in the treatment of serious upper respiratory tract, skin infections, and infections of the bones.
Lincomycin is an antibiotic that is used to treat severe bacterial infections in people who cannot use penicillin antibiotics.
Lincomycin is used only for a severe infection. lincomycin will not treat a viral infection such as the common cold or flu.
Lincomycin may also be used for purposes not listed in this medication guide.
Warnings
Antibiotic medicine can cause overgrowth of normally harmless bacteria in the intestines. This can lead to an infection that causes mild to severe diarrhea, even months after your last antibiotic dose. Call your doctor at the first sign of diarrhea during and shortly after your treatment with lincomycin.
If you have diarrhea that is watery or bloody, stop using lincomycin and call your doctor right away. Do not use anti-diarrhea medicine unless your doctor tells you to. Stopping the diarrhea can make an intestinal infection worse.
Before taking this medicine
You should not be treated with lincomycin if you are allergic to lincomycin or clindamycin.
Before you receive lincomycin, tell your doctor if you have a history of intestinal disorder such as ulcerative colitis.
Tell your doctor if you have ever had:
asthma;
an intestinal disorder such as colitis;
severe allergies; or
liver or kidney disease.
It is not known whether lincomycin will harm an unborn baby. Tell your doctor if you are pregnant.
It may not be safe to breast-feed while using this medicine. Ask your doctor about any risk.
Lincomycin Uses:
Serious Bacterial infections:
It is indicated for the treatment of serious infections caused by susceptible strains of streptococci, staphylococci, and pneumococci.
It should be used only in those patients in whom penicillins can not be given either due to resistance or hypersensitivity reactions.
Lincomycin Dose in the treatment of serious bacterial infection:
Note: The dosing frequency may be adjusted/ increased in severe infections.
IM: 600 mg once or twice daily
IV: 600 mg to 1 g twice or thrice daily (maximum dose: 8 g daily)
Ophthalmic: Subconjunctival injection: 75 mg as a single dose (ocular fluid levels with sufficient minimum inhibitory concentrations [MICs] last for at least five hours)
Lincomycin Dose in the treatment of Bacterial infection (serious):
Note: The dosing frequency may be adjusted/ increased in severe infecfions.
Infants >1 month, Children, and Adolescents:
IM: 10 mg/kg once or twice a day.
IV: 10 to 20 mg/kg/day in divided doses twice or thrice daily.
The maximum daily dose is 8 gms.
Lincomycin Pregnancy Category: C
Lincomycin crosses over the placental barrier at term, and can be detected both in cord blood or the amniotic liquid.
You may also find benzyl alcohol in the injection, which could cross the placenta.
Use during breastfeeding:
It is excreted from breast milk.
According to the manufacturer, concentrations range from 0.5 to 2 mcg/mL.
The manufacturer suggests that you weigh the risks and benefits of administering drugs to the infant with the potential for serious adverse reactions in the mother.
Lincomycin Dose in Kidney Disease:
Mild to moderate impairment:
There are no dosage adjustments provided in the manufacturer’s labeling.
Severe impairment:
Use with caution in severe renal impairment. The dose may be reduced by 70% to 75%.
End-stage renal disease (ESRD) on hemodialysis:
No dosage adjustments have been recommended by the manufacturer.
The drug is not removed by hemodialysis and should be used with caution.
Peritoneal dialysis:
No dosage adjustments have been recommended by the manufacturer.
The drug is not removed by peritoneal dialysis and should be used with caution.
Dose in Liver disease:
No dosage adjustments have been recommended by the manufacturer.
It should be used with caution.
Side effects of Lincomycin:
Gastrointestinal:
Colitis
Severe colitis
Contraindications to Lincomycin:
Hypersensitivity to lincomycin or clindamycin or any other component of the formulation
Canadian labeling: Additional contraindications not in US labeling
Newborns
Patients with pre-existing candida infections
Warnings and precautions
Colitis: [US Boxed Warning]
Clostridium difficile associated diarrhea (CDAD), can occur either during or after treatment.
CDAD can be life-threatening and severe.
For serious infections, which require more toxic treatments, the treatment should not be performed.
It should be avoided for mild upper respiratory tract infections or other mild infections.
CDAD can persist up to 2 months after an antibiotic course has ended.
Hypersensitivity reactions
There have been reports of hypersensitivity reactions to it, including shock and anaphylaxis as well as severe skin-related adverse effects such as Stevens-Johnson Syndrome [SJS], toxic epidermal necrolysis (TEN), acute generalized exanthematous pustulosis[AGEP] and erythema multiflora.
If there are any allergic reactions, the treatment should be stopped immediately.
Superinfection
Extended use of the drug can lead to secondary opportunistic infections, such as fungal infections or resistant bacteria.Antifungal therapy must be administered to patients with candida infections.
Allergies
Patients with severe allergies should be cautious.
Asthma
Patients with a history or asthma should be cautious.
Gastrointestinal Disease:
Patients with history of ulcerative colitis and other gastrointestinal disorders should be cautious.
Hepatic impairment
Patients with liver disease should be cautious as the half-life may be extended up to 2 times.
Renal impairment
Patients with kidney disease should be cautious.The half-life of this drug could be extended.
Patients with severe renal impairment may need dosage adjustment.
Lincomycin: Drug Interaction
Note: Drug Interaction Categories:
Risk Factor C: Monitor When Using Combination
Risk Factor D: Consider Treatment Modification
Risk Factor X: Avoid Concomitant Use
Risk Factor C (Monitor therapy)
BCG Vaccine (Immunization)
Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization).
Doxofylline
Lincomycin may increase the serum concentration of Doxofylline.
Kaolin
May decrease the absorption of Lincosamide Antibiotics.
Lactobacillus and Estriol
Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol.
Neuromuscular-Blocking Agents
Lincosamide Antibiotics may enhance the neuromuscularblocking effect of Neuromuscular-Blocking Agents.
Risk Factor D (Consider therapy modification)
Sodium Picosulfate
Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic. Risk
Typhoid Vaccine
Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Vaccination with live attenuated typhoid vaccine (Ty21a) should be avoided in patients being treated with systemic antibacterial agents. Use of this vaccine should be postponed until at least 3 days after cessation of antibacterial agents. Risk
Risk Factor X (Avoid combination)
BCG (Intravesical)
Antibiotics may diminish the therapeutic effect of BCG (Intravesical).
Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics.
Erythromycin (Systemic)
May diminish the therapeutic effect of Lincomycin.
Lincosamide Antibiotics may enhance the neuromuscular-blocking effect of Mecamylamine.
Monitoring parameters:
Monitor for diarrhea or a change in bowel frequency or consistency;
Baseline renal function (serum creatinine) and liver function tests (LFTs);
During prolonged treatment, periodically monitor:
renal function and LFTs,
complete blood cell count (CBC) with differential;
serum lincomycin during high-dose therapy in patients with renal and/or hepatic impairment.
How to administer Lincomycin (Lincocin)?
Intravenous Injection:
Administer as a slow intravenous infusion over at least one hour per gram. Avoid injecting undiluted drug or bolus administration. Bolus administration or an Intravenous push may result in hypotension and cardiopulmonary arrest.
Intramuscular:
Inject as a deep IM injection into a large muscle mass.
Ophthalmic, subconjunctival:
Administer beneath the conjunctiva.
Mechanism of action of Lincomycin (Lincocin):
Lincosamide antibiotic was isolated from Streptomyces Lincolnensis.Lincomycin binds to the 50S subunit in bacterial ribosomes. This alters the process for peptide chain initiation and inhibits bacterial protein production.
Antibiotics that act by binding to the 50S ribosomes (such as erythromycin and lincomycin) should not be concomitantly used.
Metabolism:
It is metabolized in the liver.
Half-life elimination, serum:
About 5 hours that is prolonged with renal or hepatic impairment
Time to peak, serum:
IM: 1 hour
Excretion:
Urine (2% to 30%);
bile
International Brand Names of Lincomycin:
Lincocin
Albiotic
Biolincom
Cillimicina
Cillimycin
Clordelin
Formicina
Frademicina
Libiocid
Licoxin
Limidrax
Linatron
Linbacyc
Linco ANB
Lincobiotic
Lincocin
Lincocina
Lincocine
Lincodar
Lincofan
Lincomed
Lincono
Lincophar
Lincoplus
Lincosa
Lincosan
Lincoway
Linkam
Lintropsin
Medoglycin
Mycoxin
Neloren
Nolipo
Princol
Tamcocin
Zencocin
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