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What is Onexton?

Onexton (clindamycin phosphate and benzoyl peroxide) is a prescription medication used to treat acne vulgaris in individuals aged 12 and older. 

This FDA-approved treatment effectively combats acne by targeting and treating various types of breakouts, including whiteheads, blackheads, and pimples.

It contains two active ingredients:

  • Clindamycin phosphate, an antibiotic that stops the growth of acne-causing bacteria,
  • Benzoyl peroxide, which reduces oil production and keeps pores clear

Onexton is applied topically and helps decrease the number of acne pimples. The safety and effectiveness of using Onexton for more than 12 weeks, or in children under 12, have not been established. 

It should not be used by individuals who have had allergic reactions to its ingredients or have specific medical conditions such as Crohn’s disease, ulcerative colitis, or a history of colitis or severe diarrhea with past antibiotic use.

Dosage Information and Usage

Dosage Form and Strengths of Onexton

Onexton comes in the form of a 50g gel, with a strength of 1.2% clindamycin phosphate and 3.75% benzoyl peroxide. The gel is white to off-white in color, opaque, and has a smooth texture.

How to Use Onexton?

Using Onexton is simple, but it’s important to follow the instructions carefully. 

Here is the step-by-step process:

  1. Wash your face gently with mild soap and warm water, then pat your skin dry. 
  2. Once your face is clean, use the pump to dispense one pea-sized amount of Onexton gel onto your fingertip. 
  3. Apply this pea-size amount to six areas of your face: your chin, left cheek, right cheek, nose, left forehead, and right forehead. 
  4. After that, spread the gel evenly over your entire face, gently rubbing it in. If your doctor advises you to apply Onexton to other areas with acne, make sure to ask how much to use. 
  5. Remember to wash your hands with soap and water after applying the gel. 

Important note: Only use Onexton on the skin, therefore, avoid getting it in your mouth, eyes, or vagina. Always follow your doctor’s instructions and consult them if you have any questions.

Storage Information

To store Onexton properly, keep it at room temperature, at or below 77°F (25°C). Do not freeze it, as this can reduce its effectiveness. Discard any Onexton past its expiration date. 

Store the pump upright to prevent leaks or damage, and always close the container tightly to maintain the gel’s quality. Following these steps will help ensure Onexton remains effective and safe to use.

Side Effects

Onexton, like any medication, may cause side effects in some individuals. It’s important to be aware of these potential side effects and to discuss any concerns with your healthcare provider.

Common Side Effects

  • Burning sensation
  • Skin redness or swelling
  • Itching
  • Rash

Serious but Rare Side Effects

  • Inflammation of the colon (colitis): Stop using Onexton Gel and contact your doctor immediately if you experience the following:
  • severe stomach cramps
  • watery diarrhea, or 
  • bloody diarrhea during treatment or within several weeks after treatment
  • Allergic reactions: Seek medical help right away if you have symptoms such as:
  • severe itching, 
  • swelling of your face, eyes, lips, tongue, or throat, or
  •  trouble breathing while using Onexton

Warnings and Precautions

When using Onexton, certain precautions should be taken to ensure safe and effective treatment. It’s important to be aware of these warnings to minimize any potential risks associated with the prescription.

Here are some key points to consider:

  • Colitis: Onexton contains clindamycin, which can be absorbed into the bloodstream. In rare cases, this can lead to diarrhea, bloody diarrhea, or colitis (inflammation of the colon). If you experience significant diarrhea while using Onexton, discontinue use and consult your doctor immediately.
  • Ultraviolet Light and Environmental Exposure: After applying Onexton Gel, it’s important to minimize exposure to sunlight, including tanning beds or sun lamps. This is because Onexton can make your skin more sensitive to sunlight, increasing the risk of sunburn or other skin reactions.
  • Other Topical Medications: If you’re using other topical acne treatments alongside Onexton, use them with caution. Using multiple acne treatments at once may increase the risk of skin irritation or dermatitis. If you experience irritation or dermatitis, reduce the frequency of application or temporarily stop using the treatment until the irritation subsides. Onexton should not be used with products that contain erythromycin.

These precautions are important to ensure the safe and effective use of Onexton Gel. If you have any concerns or questions about these warnings, consult your healthcare provider for further guidance.

Drug Interactions

When using Onexton, it’s essential to be aware of potential interactions with other medications, as these interactions can affect the effectiveness or safety of treatment:

  • Erythromycin: Avoid using Onexton with products containing erythromycin, whether topical or oral, because it includes clindamycin. Studies suggest erythromycin and clindamycin may counteract each other, though the clinical importance of this interaction is not fully clear.
  • Neuromuscular Blocking Agents: Clindamycin, an ingredient in Onexton, can affect the action of other drugs that block neuromuscular transmission, causing prolonged muscle paralysis. Healthcare providers should closely monitor patients for signs of prolonged muscle paralysis, as this can affect their ability to breathe and move after surgery or anesthesia.

Alternative Treatment

If Onexton is not available, other options for treating acne include:

  • Minocycline
  • Accutane (Isotretinoin)
  • Clindamycin topical
  • Aldactone (Spironolactone)
  • Tretinoin topical
  • Doxycycline


Onexton is typically used for up to 12 weeks, as shown in clinical studies. Follow your dermatologist’s instructions on how long to use it. Acne treatment takes time, make sure to keep using Onexton as directed.

You should not use Onexton if you are allergic to clindamycin, benzoyl peroxide, lincomycin, or any other ingredients in Onexton. Additionally, avoid using Onexton if you have Crohn’s disease or ulcerative colitis, or if you have had inflammation of the colon (colitis) or severe diarrhea from past antibiotic use. If you’re unsure about these conditions, talk to your doctor.

Before using Onexton, ask or tell your doctor about the following:

  • If you plan to have surgery with general anesthesia.
  • If you are pregnant or plan to become pregnant. It is not known if Onexton will harm your unborn baby.
  • If you are breastfeeding or plan to breastfeed. It is not known if Onexton passes into your breast milk. Clindamycin, an ingredient in Onexton, has been found in breast milk when taken orally or by injection. You and your doctor should decide if you will use Onexton while breastfeeding.
  • All the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and skin products you use. Using other topical acne products with Onexton may increase skin irritation.
  • If you take a medicine that contains erythromycin. Onexton should not be used with products that contain erythromycin.

It’s common for Onexton to cause a burning sensation when you first start using it. If the burning is severe or doesn’t go away, talk to your doctor.

Yes, Onexton can cause your acne to get worse during the first few weeks of treatment. However, this is normal, and your skin should start to improve after this initial period. If you have concerns, talk to your doctor.

Yes, Onexton can be used as a spot treatment as it is an FDA-approved prescription medication for acne, including whiteheads, blackheads, and pimples.

Yes, Onexton is generally safe. However, it’s important to note that its safety and effectiveness for use beyond 12 weeks haven’t been established. Always follow your doctor’s instructions carefully and consult them if you have any concerns about its long-term use.

Yes, it’s safe and effective to use Onexton and Tretinoin together. Research shows that combining clindamycin phosphate and tretinoin gel treats acne, including inflammatory acne, better than using either alone. This combination is well-tolerated, and individuals are more likely to continue using both medications together. However, consult your healthcare provider before starting any new treatment to ensure it’s right for you.

Generally, using Onexton during pregnancy isn’t harmful if necessary for your skin condition. However, discuss the risks and benefits with your doctor first. It’s uncertain if this medication passes into breast milk, avoid using it on areas that may contact your baby if you’re breastfeeding.

It’s safe to use Onexton once a day to start, as using it more frequently may irritate your skin. Always ask your doctor for advice on the best application frequency for your specific skin condition and needs.

Yes, you can use Onexton at night. Applying it before bedtime allows the medication to work overnight, helping to treat acne while you sleep. 

You can purchase Onexton at pharmacies with a valid prescription from your healthcare provider. Additionally, some online pharmacies may offer Onexton for sale, but ensure they are reputable and licensed to sell prescription medications.

Onexton may start reducing acne after about 6 weeks of regular use, but full benefits might take up to 12 weeks.