This combination product contains 2 medications: clindamycin and tretinoin. Clindamycin belongs to the family of medications known as antibiotics. It works by killing bacteria that cause acne. Tretinoin belongs to the family of medications known as retinoids. It works to treat acne by exfoliating the skin's outer layer, which helps to reduce the formation of blackheads, whiteheads, and other acne lesions.

This combination product is used by adults and adolescents 12 years of age and older, to treat the papules, blackheads, and whiteheads that are characteristics of acne. It works by killing bacteria that cause acne and by peeling off skin cells. It may take several weeks to months for your acne to improve.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Clindamycin - tretinoin topical should be applied once daily (preferably at bedtime) to lightly cover the areas being treated. Your doctor may suggest that you apply this medication every other day for the first few weeks of treatment. Wash your hands thoroughly before and after applying the medication.

To apply this medication, thoroughly clean your face with a mild soap and water and pat dry with a soft towel. Apply a pea-sized amount of gel on your fingertip and dot it on your chin, cheeks, forehead, and nose. Gently rub it in. Use only enough medication to cover the affected areas lightly. Avoid contact with the eyes, corners of the nose and mouth, or any open sores. When you are finished, wash your hands with soap and water.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Each gram of aqueous based gel contains 10 mg of clindamycin as clindamycin phosphate and 0.25 mg of tretinoin. Nonmedicinal ingredients: butylated hydroxytoluene NF, carbomer 981 NF, citric acid USP, edetate disodium USP, glycerin USP, methylparaben NF, polysorbate 80 NF, propylparaben NF, purified water USP, and tromethamine USP.

Do not use this medication if you:

• are allergic to clindamycin, lincomycin, tretinoin, or any ingredients of this medication
• have a history of colitis associated with antibiotic use
• have a history of Crohn's disease, ulcerative colitis, or inflammation of the small intestine

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• headache
• sinus infections
• skin irritation due to dryness, redness, peeling, burning, or stinging
• sunburn
• temporary change in skin colour

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• red, swollen, blistered, or crusted skin
• severe abdominal cramps, pain, or bloating
• severe watery diarrhea that may be bloody

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of an allergic reaction (e.g., rash, hives, swelling of the lips or face, difficulty breathing)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Application: Avoid contact with the eyes, eyelids, corners of the nose and mouth, easily irritated areas, or other areas where treatment is not intended. If contact does occur, wash with plenty of lukewarm water. Do not apply clindamycin - tretinoin to severely inflamed skin or to open lesions. Do not use more of this medication than recommended by your doctor. Doing so will not speed up treatment and will irritate your skin.

Colitis: When applied to the skin, clindamycin is absorbed into the bloodstream and can cause colitis (inflammation of the colon). Contact your doctor immediately if you experience abdominal pain, cramps or bloating, severe watery diarrhea that may be bloody, or nausea and vomiting.

Other acne medications: Other acne medications and skin preparations should not be used at the same time as clindamycin - tretinoin, as it may cause increased skin irritation. If severe irritation occurs, stop using this medication and contact your doctor.

Overgrowth of organisms (super-infection): Prolonged or repeated use of this medication may allow certain types of bacteria, that are not killed by the antibiotic, to overgrow, causing unwanted infections. Bacteria that used to be susceptible to clindamycin may also overgrow, causing acne to return and not respond to this medication. Contact your doctor if you notice your acne worsening or you develop red or irritated patches after you have been using this medication for a while.

Skin irritation: Some people may experience temporary skin irritation, especially in early weeks of treatment. If excessive reactions occur and the skin becomes extremely red, swollen, and crusted, the medication should be stopped and you should contact your doctor.

Sunlight exposure: Exposure to sunlight, including ultraviolet sunlamps, may cause more irritation. Avoid or minimize this type of exposure while using tretinoin. If you cannot avoid exposure to sunlight, use sunscreen products (minimum SPF 30) and wear protective clothing over treated areas. If you get a sunburn, stop using this medication until skin redness and peeling resolves.

Pregnancy: This medication is not recommended for use during pregnancy. Women who may become pregnant should use an effective method of birth control while they are using this medication. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if clindamycin - tretinoin passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 12 years of age.

There may be an interaction between clindamycin - tretinoin and any of the following:

• erythromycin
• methoxsalen
• other topical medications to treat acne
• porfimer
• vitamin A

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.