Clindamycin Vaginal and Doxacurium: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Clindamycin Vaginal
Doxacurium
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Enhanced and prolonged neuromuscular blockade
Interaction Deep Dive
Coadministration of clindamycin and nondepolarizing muscle relaxants may produce excessive neuromuscular blockade, especially with higher doses of clindamycin1234. The mechanism of the effect of clindamycin may be related to both pre- and postsynaptic activity, as well as direct action on muscle contractility.
Why it happens (mechanism)
Additive effects
Literature reports
1 report — tap to read
a) A 58-year-old woman with severe rheumatoid arthritis had wrist arthrodesis under general anesthesia. She was given a small defasciculating dose of tubocurarine 3 mg and fentanyl 1.5 mcg/kg intravenously (IV). Anesthesia was induced with thiopentone 4 mg/kg and succinylcholine 1.5 mg/kg, and maintained with nitrous oxide in oxygen and isoflurane. Full return of neuromuscular activity was observed after succinylcholine injection. At that point, clindamycin phosphate 2400 mg IV was given; this was a mistaken overdose as 600 mg had been ordered. After surgery, the patient made no attempts at spontaneous ventilation and was unresponsive to painful stimulation. She was treated with calcium chloride, edrophonium, atropine, and neostigmine with little effect. Nine hours postsurgery the patient coughed and train-of-four (TOF) had returned to 1.0. Two hours later, she was extubated and spontaneous respiration ensued. The authors suggested that clindamycin caused muscle relaxation predominately by direct action on contractility, although some pre-synaptic effects were also thought to occur 1.
Common questions
Can I take Clindamycin Vaginal and Doxacurium together?
Enhanced and prolonged neuromuscular blockade Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clindamycin Vaginal and Doxacurium interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Clindamycin Vaginal or Doxacurium need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (4)
- Al Ahdal O & Bevan DR: Clindamycin-induced neuromuscular blockade. Can J Anaesth 1995; 42:614-617. PubMed
- Ostergaard D, Engbaek J, & Viby-Mogensen J: Adverse reactions and interactions of the neuromuscular blocking drugs. Med Toxicol Adverse Drug Exp 1989; 4:351-368. DOI
- Rubbo JT, Gergis SD, & Sokoll MD: Comparative neuromuscular effects of lincomycin and clindamycin. Anesth Analg 1977; 56:329-332. PubMed
- Fogdall RP & Miller RD: Prolongation of a pancuronium-induced neuromuscular blockade by clindamycin. Anesthesiology 1974; 41:407-408. DOI
Keep reading about Clindamycin Vaginal
Keep reading about Doxacurium
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