Pitressin
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Questions & Answers
Side Effects & Adverse Reactions
Orally and parenterally administered clindamycin has been associated with severe colitis which may result in patient death. Use of the topical formulation of clindamycin results in absorption of the antibiotic from the skin surface. Diarrhea, bloody diarrhea, and colitis (including pseudomembranous colitis) have been reported with the use of topical and systemic clindamycin.
Studies indicate a toxin(s) produced by clostridia is one primary cause of antibiotic-associated colitis. The colitis is usually characterized by severe persistent diarrhea and severe abdominal cramps and may be associated with the passage of blood and mucus. Endoscopic examination may reveal pseudomembranous colitis. Stool culture for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically.
When significant diarrhea occurs, the drug should be discontinued. Large bowel endoscopy should be considered to establish a definitive diagnosis in cases of severe diarrhea.
Antiperistaltic agents such as opiates and diphenoxylate with atropine may prolong and/or worsen the condition. Vancomycin has been found to be effective in the treatment of antibiotic-associated pseudomembranous colitis produced by Clostridium difficile. The usual adult dosage is 500 milligrams to 2 grams of vancomycin orally per day in three to four divided doses administered for 7 to 10 days. Cholestyramine or colestipol resins bind vancomycin in vitro. If both a resin and vancomycin are to be administered concurrently, it may be advisable to separate the time of administration of each drug.
Diarrhea, colitis, and pseudomembranous colitis have been observed to begin up to several weeks following cessation of oral and parenteral therapy with clindamycin.
Legal Issues
There is currently no legal information available for this drug.
FDA Safety Alerts
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Manufacturer Warnings
There is currently no manufacturer warning information available for this drug.
FDA Labeling Changes
There are currently no FDA labeling changes available for this drug.
Uses
Clindamycin Phosphate Topical Solution is indicated in the treatment of acne vulgaris. In view of the potential for diarrhea, bloody diarrhea and pseudomembranous colitis, the physician should consider whether other agents are more appropriate. (See CONTRAINDICATIONS, WARNINGS and ADVERSE REACTIONS.)
History
There is currently no drug history available for this drug.
Other Information
Clindamycin Phosphate Topical Solution contains clindamycin phosphate, USP, at a concentration equivalent to 10 mg clindamycin per milliliter. Each Clindamycin Phosphate Topical Solution pledget applicator contains approximately 1 mL of topical solution.
Clindamycin phosphate is a water soluble ester of the semi-synthetic antibiotic produced by a 7(S)-chloro-substitution of the 7(R)-hydroxyl group of the parent antibiotic lincomycin.
The solution contains isopropyl alcohol 50% v/v, propylene glycol, sodium hydroxide (to adjust the pH to between 4.0 – 7.0) and purified water.
The structural formula is represented below:
The chemical name for clindamycin phosphate is Methyl 7-chloro-6,7,8-trideoxy-6-(1-methyl-trans-4-propyl-L-2-pyrrolidinecarboxamido)-1-thio-L-threo-α-D-galacto-octopyranoside 2-(dihydrogen phosphate).
Sources
Pitressin Manufacturers
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Jhp Pharmaceuticals Llc
![Pitressin (Vasopressin) Injection [Jhp Pharmaceuticals Llc]](/wp-content/themes/bootstrap/assets/img/loading2.gif)
Pitressin | Versapharm Incorporated
Apply a thin film of Clindamycin Phosphate Topical Solution twice daily to affected area. More than one pledget may be used. Each pledget should be used only once and then be discarded.
Pledget: Remove pledget from jar just before use. Do not use if the seal under the cap is broken. Discard after single use.
Keep all liquid dosage forms in containers tightly closed.
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Cardinal Health
Pitressin | Cardinal Health
Pitressin may be administered subcutaneously or intramuscularly.
Ten units of Pitressin (0.5 mL) will usually elicit full physiologic response in adult patients; 5 units will be adequate in many cases. Pitressin should be given intramuscularly at 3- or 4-hour intervals as needed. The dosage should be proportionately reduced for pediatric patients. (For an additional discussion of dosage, consult the sections below.)
When determining the dose of Pitressin for a given case, the following should be kept in mind.
It is particularly desirable to give a dose not much larger than is just sufficient to elicit the desired physiologic response. Excessive doses may cause undesirable side effects—blanching of the skin, abdominal cramps, nausea—which, though not serious, may be alarming to the patient. Spontaneous recovery from such side effects occurs in a few minutes. It has been found that one or two glasses of water given at the time Pitressin is administered reduce such symptoms.
Abdominal DistentionIn the average postoperative adult patient, give 5 units (0.25 mL) initially; increase to 10 units (0.5 mL) at subsequent injections if necessary. It is recommended that Pitressin be given intramuscularly and that injections be repeated at 3- or 4-hour intervals as required. Dosage to be reduced proportionately for pediatric patients.
Pitressin used in this manner will frequently prevent or relieve postoperative distention. These recommendations apply also to distention complicating pneumonia or other acute toxemias.
Abdominal RoentgenographyFor the average case, two injections of 10 units each (0.5 mL) are suggested. These should be given two hours and one-half hour, respectively, before films are exposed. Many roentgenologists advise giving an enema prior to the first dose of Pitressin.
Diabetes InsipidusPitressin may be given by injection or administered intranasally on cotton pledgets, by nasal spray, or by dropper. The dose by injection is 5 to 10 units (0.25 to 0.5 mL) repeated two or three times daily as needed. When Pitressin is administered intranasally by spray or on pledgets, the dosage and interval between treatments must be determined for each patient.
![Pitressin (Vasopressin) Injection [Cardinal Health]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=5d6cdb9f-f9cd-488e-8c88-bec8606aa4cf&name=759fe013-c185-4373-ab70-cee4e7cd49c1-01.jpg)
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