Hulgram Injection (Clindamycin Phosphate)

Adult administration

For adults, as clindamycin phosphate for severe infections, administer 600 to 1200 mg (potency) divided into 2 to 4 intravenous or intramuscular injections per day. For severe, severe infections, administer 1200 to 2700 mg (potency) divided into 2 to 4 injections per day. In emergencies, the daily dose may be increased to 4.8 g (potency) for intravenous administration. The injection is not directly injected into the vein as the injection solution; it should be administered over a period of at least 10 to 60 minutes as indicated in the table below.

Child administration

For children (over 1 month), for severe infections, administer 15 to 25 mg/kg (potency) divided into 3 to 4 intravenous or intramuscular injections per day. For severe, severe infections, administer 25 to 40 mg/kg divided into 3 to 4 injections per day.

This medication is used for severe infections and can sometimes cause serious colitis, so caution is required. Symptoms of colitis can include severe diarrhea, abdominal pain, and fever; if these occur, administration should be stopped immediately. It should especially be used with caution in the elderly or frail patients. This drug does not penetrate well into cerebral spinal fluid and is not suitable for treating meningitis. Care should be taken during handling the injection to prevent glass fragment contamination, and it should not be administered to premature infants due to the presence of benzyl alcohol. It should not be used in patients with a history of hypersensitivity reactions, newborns, or premature infants. Patients with impaired liver or kidney function, atopic constitution, asthma, or severe myasthenia gravis should consult their doctor before use. Intramuscular injection may cause pain or numbness at the injection site, and adverse reactions such as thrombophlebitis have also been reported. Gastrointestinal disturbances may include diarrhea, abdominal pain, nausea, and vomiting. If severe allergic reactions occur, administration should be stopped immediately and emergency measures should be taken. Liver dysfunction or kidney dysfunction may occur, so regular testing is necessary with prolonged use. This drug may interact with other medications, so caution should be exercised especially when used in conjunction with muscle relaxants, anticoagulants, CYP3A4 inhibitors and inducers. It is safest not to administer to pregnant or breastfeeding women, as this drug can be transmitted through breast milk and may affect the newborn. Safety has not been established in children under 12 years of age, newborns, or premature infants, and it should be used cautiously in these populations. There is no specific antidote for overdose, and appropriate emergency measures should be initiated depending on symptoms. After administration, the use should be limited to the minimum required duration to prevent the development of resistant bacteria, and rapid intravenous injection should be avoided as it may induce cardiac arrest. If severe diarrhea, abdominal pain, or other symptoms occur during use, immediate consultation with medical personnel is required.

Serious side effects

• Hives, severe swelling (edema), chest tightness, difficulty breathing, cold sweat, pallor, generalized flushing, cyanosis, chest discomfort, hypotension (severe allergic reaction)
• High fever along with severe rashes, blisters, skin sloughing, pain in the mouth/eye mucosa, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, acute generalized exanthematous pustulosis (AGEP), drug hypersensitivity syndrome (DRESS, DIHS) (severe skin abnormalities)

Mild side effects

• Pain
• numbness
• thrombophlebitis at the injection site
• diarrhea
• loose stools
• loss of appetite
• nausea
• vomiting
• abdominal pain
• esophagitis

This medication should be stored in a sealed container to prevent air or moisture ingress, ideally at room temperature between 1 and 30 degrees Celsius. Storing it this way helps maintain the drug's effectiveness for a longer period.

Appearance

A colorless and transparent injection in a brown ampoule

Package unit

Domestic use - 50 ampoules/box [2mL/ampoule], Export use - 10 ampoules/box [2mL/ampoule]