LINCOMYCIN HCL
Clinical safety rating: caution
Comprehensive clinical and safety monograph for LINCOMYCIN HCL (LINCOMYCIN HCL).
Lincomycin inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, inhibiting peptide bond formation and translocation.
| Metabolism | Primarily hepatic via unknown enzymes; small amount excreted unchanged in urine and bile. |
| Excretion | Renal (approximately 40% unchanged in urine) and biliary/fecal (approximately 50% as active drug and metabolites). |
| Half-life | 4-5 hours (prolonged in renal impairment, up to 10 hours in anuria; no significant change in hepatic disease). |
| Protein binding | 70-85% bound, primarily to albumin. |
| Volume of Distribution | 0.7-1.3 L/kg (widely distributed, including bone, but low CNS penetration). |
| Bioavailability | Oral: 20-30% (subject to high first-pass metabolism); Intramuscular: 100% (absolute bioavailability). |
| Onset of Action | Oral: 2-4 hours; Intramuscular: 30-60 minutes; Intravenous: immediate. |
| Duration of Action | Oral: 6-8 hours; Intramuscular: 8-12 hours; Intravenous: 6-8 hours (bacteriostatic effect persists longer). |
600 mg IM every 12-24 hours or 600 mg IV every 8-12 hours, up to 8 g/day for severe infections.
| Dosage form | Injectable |
| Renal impairment | For GFR 10-50 mL/min: administer 25-50% of usual dose every 12 hours or full dose every 12-24 hours. For GFR <10 mL/min: administer 25% of usual dose every 24 hours or full dose every 24-48 hours. |
| Liver impairment | In severe hepatic impairment (Child-Pugh C): reduce dose by 50-75% and monitor serum levels. Avoid use in acute hepatic failure. |
| Pediatric use | Neonates: 10 mg/kg IM/IV every 12 hours. Infants and children: 10-20 mg/kg/day IM/IV divided every 12-24 hours; for severe infections, up to 40 mg/kg/day divided every 6-12 hours. |
| Geriatric use | No specific dose adjustment; use with caution due to age-related renal decline. Monitor renal function and consider lower end of dosing range. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for LINCOMYCIN HCL (LINCOMYCIN HCL).
| Breastfeeding | Excreted in human milk in low concentrations. M/P ratio not established. Use with caution, monitor infant for gastrointestinal disturbances and potential alteration of gut flora. American Academy of Pediatrics considers compatible with breastfeeding. |
| Teratogenic Risk | Pregnancy Category C. Animal studies have shown adverse effects on fetal development, but no adequate human studies. Risk cannot be ruled out; use only if clearly needed. First trimester: potential for teratogenicity, avoid unless essential. Second and third trimesters: limited data, use only if benefit outweighs risk. |
■ FDA Black Box Warning
Clostridioides difficile-associated diarrhea (CDAD) can occur, ranging from mild diarrhea to fatal colitis; use with caution in patients with history of gastrointestinal disease.
| Serious Effects |
["Hypersensitivity to lincomycin or clindamycin","History of antibiotic-associated colitis","Minor bacterial infections (not indicated)"]
| Precautions | ["Risk of severe pseudomembranous colitis","Neuromuscular blockade may occur with high doses; use caution in patients with neuromuscular disorders","Monitor renal and hepatic function in prolonged therapy"] |
Loading safety data…
| Fetal Monitoring | Monitor maternal liver function, renal function, and complete blood counts periodically. Observe for signs of pseudomembranous colitis. Monitor fetal growth and well-being via ultrasound if used long-term. |
| Fertility Effects | No specific human studies on fertility. In animal studies, no adverse effects on fertility observed at therapeutic doses. |