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Cabtreo
clindamycin/ adapalene/ benzoyl peroxide topical
Adult Dosing .
Dosage forms: GEL: 1%/0.15%/3.1%
Special Note
- [strength clarification]
- Info: contains 1.2% clindamycin phosphate equivalent to 1% clindamycin
acne vulgaris
- [apply qd]
Peds Dosing .
- Dosage forms: GEL: 1%/0.15%/3.1%
Special Note
- [strength clarification]
- Info: contains 1.2% clindamycin phosphate equivalent to 1% clindamycin
acne vulgaris
- [12 yo and older]
- Dose: apply qd
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- hypersensitivity to lincosamides
- breast admin. (breastfeeding pts)
- ulcerative colitis hx
- regional enteritis hx
- colitis hx, abx-associated
- avoid: sun exposure
- avoid: UV light exposure, artificial
- caution: atopy
Drug Interactions .
Overview
adapalene topical
retinoid topical
- photosensitivity
- skin irritant/drying agent
benzoyl peroxide topical
keratolytic topical
- photosensitivity
- skin irritant/drying agent
clindamycin topical
lincosamide topical
- alters GI flora
- neuromuscular blocking effects
Avoid/Use Alternative
- aminolevulinic acid topical
- fecal microbiota, live
- hydroquinone topical
- methotrexate
- porfimer
- tazarotene topical
Monitor/Modify Tx
- atracurium
- cisatracurium
- pancuronium
- rocuronium
- succinylcholine
- vecuronium
- warfarin
Caution Advised
- acitretin
- adapalene topical
- benzoyl peroxide topical
- isotretinoin
- lactulose
- methoxsalen
- salicylic acid topical
- sodium picosulfate
- sulfur topical
- tretinoin topical
- trifarotene topical
- verteporfin
Adverse Reactions .
Serious Reactions
- hypersensitivity rxn
- anaphylaxis
- angioedema
- C. difficile-assoc. diarrhea
- tumorigenicity (animal studies)
Common Reactions
- application site pain
- erythema
- xeroderma
- skin irritation
- scaling
- photosensitivity
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Pregnancy/Lactation .
Pregnancy
Clinical Summary
clindamycin topical: may use during pregnancy; no human data available, though risk of fetal harm not expected based on minimal systemic absorption; possible risk of teratogenicity based on conflicting human data w/ systemic clindamycin
adapalene topical: may use during pregnancy; risk of fetal harm not expected based on limited human data and insignificant systemic absorption; no known risk of teratogenicity, though risk of rib variation and delayed ossification based on animal data w/ adapalene topical at 15x and 30x MRHD
benzoyl peroxide topical: may use during pregnancy; inadequate human data available, though risk of fetal harm not expected based on minimal systemic absorption
Lactation
Clinical Summary
clindamycin topical: avoid use on breast while breastfeeding, otherwise may use on other areas; limited human data available, though possible risk of infant diarrhea if used on breast based on potential infant oral ingestion; no human data available, though risk of adverse effects on milk production not expected based on minimal maternal systemic absorption
adapalene topical: avoid use on breast while breastfeeding, otherwise may use on other areas; no human data available, though possible risk of infant harm if used on breast based on potential infant oral ingestion; no human data available, though risk of adverse effects on milk production not expected based on insignificant maternal systemic absorption
benzoyl peroxide topical: may use while breastfeeding; no human data available, though risk of infant harm and adverse effects on milk production not expected based on minimal maternal systemic absorption
Pharmacology .
Metabolism: for clindamycin: liver; CYP450: 3A4 (primary), 3A5 substrate; Info: active metabolites; minimal systemic absorption; for adapalene: unknown; CYP450: unknown; Info: minimal systemic absorption; for benzoyl peroxide: skin; CYP450: unknown; Info: <2% systemic absorption
Excretion: for clindamycin: urine, feces; Half-life: unknown (topical form), 2-3h (PO or INJ form); for adapalene: bile; Half-life: 17.2h; for benzoyl peroxide: urine; Half-life: unknown
Subclass: Acne, Topical Agents
Mechanism of Action
clindamycin binds to 50S ribosomal subunit, inhibiting protein synthesis (lincosamide); adapalene's exact mechanism of action unknown; binds to nuclear retinoic acid receptors, modulating differentiation, keratinization, and inflammation (retinoid); benzoyl peroxide's exact mechanism of action unknown; exerts keratolytic effects and antibacterial activity against Cutibacterium acnes
Formulary .
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