Onexton (Clindamycin and Benzoyl Peroxide) – Topical

What Is Onexton?

Onexton is an acne skin product composed of clindamycin 1.2% and benzoyl peroxide 3.75% used to treat acne vulgaris in people 12 years and older.

Clindamycin is an antibiotic. It works by stopping bacteria from growing or multiplying. Benzoyl peroxide peels the skin to get rid of dead skin, bacteria, and oil underneath. However, the exact way benzoyl peroxide works to treat acne is unknown.

Onexton gel is applied topically (directly to your skin). It's only available as a prescription, so you can't purchase it over the counter (OTC). You'll need to get a prescription from a healthcare provider.

Drug Facts

Generic Name: Clindamycin and benzoyl peroxide

Brand Name(s): Onexton

Drug Availability: Prescription

Administration Route: Topical

Therapeutic Classification: Lincosamide antibacterial

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Clindamycin phosphate and benzoyl peroxide

Dosage Form(s): Gel

What Is Onexton Used For?

Onexton is used to treat acne or pimples in people 12 years or older. You can only use it externally, applied to the skin. Do not let it get into your eyes or mouth. It is not for vaginal use.

How to Take Onexton

Wash your hands before you apply this medication. Gently wash your face with a mild cleanser and water. Pat your face and allow it to dry well before you apply Onexton.

Apply a pea-sized amount to the affected area once daily, either in the morning or night. Dot a pea-sized amount on six areas of your face. You can apply it on your chin, nose, right cheek, left cheek, right side of the forehead, and left side of the forehead. Gently rub in the medicine, then wash your hands after.

Apply Onexton on your skin only. Do not take it by mouth. Avoid applying it to your nose, eyes, lips, or mouth. Do not apply Onexton on scrapes, cuts, scratches, or damaged or broken skin. Doing so may cause a burning feeling.

Use Onexton for up to 12 weeks as directed by your healthcare provider.

Storage

Store clindamycin and benzoyl peroxide at room temperature or in the refrigerator (77 degrees F or below). Do not freeze it.

When storing the medication, keep the container upright with the cap on. Store it in a dry place; do not keep it in your bathroom. Keep it out of the reach of children and pets.

Toss any remaining medicine after 10 weeks from the day you pick it up from the pharmacy. Ask your pharmacist about the best way to discard unused and expired medications. There may be a drug take-back program in your local area.

How Long Does Onexton Take to Work?

The effect of clindamycin and benzoyl peroxide varies from person to person. It can take up to 12 weeks to see the full benefits.

What Are the Side Effects of Onexton?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The most common side effects of Onexton affect your skin and include:

These are not all the side effects that can occur. Call your healthcare provider if you have any questions or concerns.

Severe Side Effects

Contact your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or you think you're having a medical emergency. Serious side effects can include allergic reactions, which may cause the following symptoms:

  • Skin rash, itchiness, redness, blistering, or hives
  • Wheezing
  • Unusual hoarseness
  • Tightness in the throat or chest
  • Swollen skin with or without fever
  • Trouble breathing, swallowing, or talking
  • Swelling of the tongue, mouth, lips, face, or throat

Report Side Effects

Onexton may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Onexton Should I Use?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For topical dosage form (gel):
    • For acne:
      • Adults and children 12 years of age and older—
        • Benzaclin®: Apply a thin layer to the affected area(s) of the skin two times a day (morning and evening).
        • Duac®: Apply a thin layer to the affected area(s) of the face once a day, in the evening, or as directed by your doctor.
        • Onexton™: Apply a thin layer to the affected area(s) of the face once a day.
      • Children younger than 12 years of age—Use and dose must be determined by your doctor.

Modifications

There is not enough data on the use of Onexton in pregnant people to determine if there is a risk to the fetus. If you are pregnant, discuss whether to use this medication or alternative acne treatments with your healthcare provider.

Short-term use of clindamycin is considered safe during pregnancy; however, there are no studies looking at its long-term use. No human studies have evaluated benzoyl peroxide's use during pregnancy.

Also, talk to your healthcare provider if you are breastfeeding or plan to breastfeed while taking Onexton. It is not known if this medication affects human breast milk; although clindamycin has been reported in breast milk after oral administration. Still, there is not enough data to determine the effects of topical administration on breast milk.

Missed Dose

Apply the missed dose immediately when you remember. If it is too close to your next dose, skip the missed dose. Start back at your regularly scheduled time. Do not apply two doses or use extra gel.

Overdose: What Happens If I Take Too Much Onexton?

Overdose through applying Onexton on the skin is unlikely. However, contact dermatitis (an itchy, red, inflamed rash that occurs when you touch certain substances) and local irritation is possible.

What Happens If I Overdose on Onexton?

If you think you or someone else may have ingested Onexton, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after ingesting Onexton, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is important that your doctor check your progress at regular visits to see if the medicine is working properly and to decide if you should continue to use it.

This medicine may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

This medicine may make your skin more sensitive to sunlight. Use a sunscreen when you are outdoors. Avoid sunlamps and tanning beds. You may need to wear protective clothing, such as a hat.

If you develop severe swelling, trouble breathing, or any allergic reaction to this medicine, check with your doctor right away.

Do not use any other medicines on the treated skin areas without asking your doctor. Avoid using any skin care products that can dry or irritate your skin. These include skin peeling agents.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Onexton?

Do not take Onexton if you are allergic or very sensitive to clindamycin, benzoyl peroxide, or lincomycin.

Additionally, you should not take Onexton if you have a history of:

It is not known if clindamycin or benzoyl peroxide can be present in breast milk. Talk to your healthcare provider if you plan to breastfeed. Avoid direct contact with an infant after treating your skin with Onexton.

What Other Medications Interact With Onexton?

If you are taking Onexton, avoid using both oral and topical forms of erythromycin and any erythromycin-containing combination medication. Erythromycin may lower the effect of clindamycin.

What Medications Are Similar?

Other medications used to treat acne include:

Claravis and Minocin are oral prescription drugs and have more side effects than topical acne medications like Onexton. For instance, Claravis can cause serious harm if used during pregnancy.

Finacea and Retin-A are also prescription drugs. Like Onexton, they're both available for topical use and have similar side effects, such as skin irritation and stinging.

If you are looking for OTC options, you can use Differin or salicylic acid. You can find them at your local pharmacy. Talk to your healthcare provider before you start, adjust, or stop any OTC treatment.

This is a list of drugs also prescribed for acne. It is not a list of drugs recommended to use with Onexton. Talk to a healthcare provider or pharmacist if you have any questions about your treatment.

Frequently Asked Questions

  • What is Onexton used for?

    Onexton is a topical prescription antibacterial medication used to treat acne in people 12 years and older.

  • How long is Onexton good for?

    Onexton is good for 10 weeks from the day you pick it up from the pharmacy. After 10 weeks, toss any unused medication you have left.

  • What are some common side effects of Onexton?

    The most common side effects of Onexton include skin-related irritation, dryness, itching, stinging, redness, and peeling.

  • What temperature can I store Onexton?

    Store Onexton at room temperature or in the refrigerator (77 F or below). Do not freeze it.

How Can I Stay Healthy While Taking Onexton?

Here are a few tips for staying healthy while taking Onexton.

  • Your skin may burn quickly while on Onexton. Therefore, avoid being exposed to sunlight for an extended period. Wear sunscreen and hats to protect yourself from the sun. 
  • Onexton gel may bleach your clothes or your hair. Be careful when applying. Remember to wash your hands after using.
  • Your healthcare provider may allow you to use Onexton while breastfeeding. If so, avoid direct infant contact with treated skin. 
  • Give your medicine a chance to work. It can take up to 12 weeks for you to see the full results of this drug.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Onexton label.

  2. Warner GT, Plosker GL. Clindamycin/benzoyl peroxide gel: a review of its use in the management of acne. Am J Clin Dermatol. 2002;3(5):349-360. doi:10.2165/00128071-200203050-00007

  3. Chien AL, Qi J, Rainer B, Sachs DL, Helfrich YR. Treatment of acne in pregnancy. J Am Board Fam Med. 2016;29(2):254-262. doi:10.3122/jabfm.2016.02.150165

  4. DailyMed. Claravis- isotretinoin capsule, liquid filled.

  5. DailyMed. Retin-A-tretinoin cream. Retin-A- tretinoin gel.

  6. Food and Drug Administration. Finacea label.

By Queen Buyalos, PharmD
Queen Buyalos is a pharmacist and freelance medical writer. She takes pride in advocating for cancer prevention, overall health, and mental health education. Queen enjoys counseling and educating patients about drug therapy and translating complex ideas into simple language.