Overview

Antibiotics, such as rifampicin and clindamycin, are used to prevent and treat infections in people with hidradenitis suppurativa (HS). They can also reduce inflammation (swelling).

Rifampicin and clindamycin can be used together, or with other antibiotics.

• Do not take rifampicin on its own. Always take it with clindamycin or another antibiotic that you’re prescribed.

Prescribing rifampicin and clindamycin

Rifampicin and clindamycin are licenced in the UK to treat infections. But they are an unlicensed medicine for infections in people with hidradenitis suppurativa.

You doctor will only prescribe rifampicin and clindamycin if they think it will benefit your condition. They can tell you more about why they’re prescribing it. 

Taking rifampicin and clindamycin

You'll usually take rifampicin and clindamycin 2 times each day for 3 months. It’s important to read the information leaflet that comes with the medicine before you start taking them.

You should:

• take your medicines exactly as prescribed by your doctor
• take rifampicin on an empty stomach (30 to 60 minutes before food, or 2 hours after food)
• drink a full glass of water when taking clindamycin
• take your medicine at the same time each day to avoid missing doses

Do not stop taking these medicines without speaking to your doctor first. You should finish the full course of antibiotics.

If you forget to take it

If you forget to take rifampicin or clindamycin, try to take it as soon as you remember. If your next dose is due soon, skip the missed dose and return to your normal dosing schedule.

Side effects

All of the possible side effects are listed in the information leaflet that comes with your medicine.

Clindamycin

The most common side effects of clindamycin are:

• stomach ache or cramps
• an unpleasant taste in the mouth
• skin dryness or irritation

Rifampicin

The most common side effects of rifampicin are:

• a red colour in your pee (urine), sweat, phlegm, and tears
• headaches
• redness in your skin, which can be harder to see on black or brown skin
• a mild rash

If you have any other side effects, or you have any concerns about your side effects, speak to your doctor, nurse, or pharmacist.

Risks of rifampicin and clindamycin

There is a risk that rifampicin and clindamycin will interact with other medicines you take. Tell your doctor about any other medicines you take, including any you buy from a shop or pharmacy, and any herbal or homeopathic remedies. You can also discuss your medicines with your pharmacist.

If you’re taking a contraceptive pill

Rifampicin reduces the effectiveness of some types of hormonal contraception. If you're using hormonal contraception, including the contraceptive pill, discuss this with your doctor.

Your doctor can offer a different contraceptive method that will not be affected by your treatment. This will continue throughout treatment and for 4 weeks after finishing treatment.

If you’re pregnant or breastfeeding

If you're pregnant, think you might be pregnant, or are planning to become pregnant, speak to your doctor before taking rifampicin or clindamycin.

If you're breastfeeding, small amounts of rifampicin and clindamycin could pass into your breast milk. Speak to your doctor before breastfeeding.

Monitoring your health

You'll have regular blood tests to check that the medicines are not causing any serious side effects.

We'll measure your kidney function, liver function, and full blood count every 6 to 12 weeks.

If you have diabetes, you might need to monitor your blood glucose levels more often as your diabetes might be harder to control. Your doctor can advise you about this.

Repeat prescriptions

Your dermatologist will give you a prescription at your dermatology outpatient appointment. If you're stable and are not having any problems with your medicines, your GP might be able to prescribe them for you. You’ll need to check with your GP if this is possible. Either way, you'll continue to have regular follow-ups at the hospital.