Penicillin G benzathine and penicillin G procaine (Intramuscular route)

Pronunciation:

pen-i-SIL-in G BEN-za-theen, pen-i-SIL-in G PROE-kane

Brand Names:

  • Bicillin C-R
  • Bicillin CR 900/300

Dosage Forms:

  • Suspension

Warnings:

Intramuscular route(Suspension)

Not for intravenous use. Do not inject intravenously or admix with other intravenous solutions. There have been reports of inadvertent intravenous administration of penicillin G benzathine which has been associated with cardiorespiratory arrest and death .

Classifications:

Therapeutic—

Antibiotic

Pharmacologic—

Penicillin, Natural

Uses of This Medicine:

Penicillin G benzathine and penicillin G procaine combination injection is used to treat moderate to severe bacterial infections (eg, infections of the upper respiratory tract, scarlet fever, erysipelas, skin and soft tissue infections, severe pneumonia and otitis media). This medicine is an antibiotic. It works by killing bacteria or preventing their growth.

This medicine is to be given only by or under the direct supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of penicillin G benzathine and penicillin G procaine combination injection in children. Safety and efficacy have been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of penicillin G benzathine and penicillin G procaine combination injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Chlortetracycline
  • Cholera Vaccine, Live
  • Demeclocycline
  • Doxycycline
  • Lymecycline
  • Meclocycline
  • Methacycline
  • Minocycline
  • Oxytetracycline
  • Rolitetracycline
  • Sarecycline
  • Tetracycline

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy (eg, cephalosporin antibiotic), history of or
  • Asthma, history of—Use with caution. May increase risk for more side effects.
  • Glucose-6-phosphate dehydrogenase deficiency (G6PD) or
  • Heart problems or
  • Lung or breathing problems—Use with caution. May increase risk of having methemoglobinemia.
  • Kidney disease—Use with caution. The effects may be increased because of the slower removal of the medicine from the body.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine in a medical facility. It is given as a shot into one of your muscles.

Precautions While Using This Medicine:

It is very important that your doctor check your or your child's progress closely while receiving the medicine to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine may cause a serious allergic reaction, called anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

This medicine may cause a rare, but serious blood problem called methemoglobinemia. The risk may be increased in children younger than 6 months of age, elderly patients, or patients with certain inborn defects. It is more likely to occur in patients receiving too much of the medicine, but can also occur with small amounts. Check with your doctor right away if you or your child has the following symptoms after receiving this medicine: pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness.

Call your doctor if your symptoms do not improve or get worse.

This medicine may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop receiving this medicine. 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.

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.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known
Agitation
anxiety
back pain, sudden and severe
back, leg, or stomach pains
black, tarry stools
bleeding gums
blindness
bloating
bloody or cloudy urine
bluish color of the fingernails, lips, skin, palms, or nail beds
blurred vision
burning, tingling, numbness, or pain in the hands, arms, feet, or legs
chest pain or discomfort
chills
confusion
continuing ringing or buzzing or other unexplained noise in the ears
cough
dark urine
decreased frequency or amount of urine
diarrhea, watery and severe, which may also be bloody
difficult or painful urination
difficulty breathing
difficulty swallowing
dizziness or lightheadedness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
euphoria
fainting
fast, pounding, or irregular heartbeat or pulse
feeling of discomfort
fever
general body swelling
headache
hearing loss
hives, itching, skin rash
increased blood pressure
increased thirst
joint swelling loss of appetite
lower back or side pain
muscle cramps, pain, stiffness, or spasms
muscle weakness, sudden and progressing
nausea
nosebleeds
pale skin
pinpoint red spots on the skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
seeing or hearing things that are not there
seizures
sensation of pins and needles
skin blisters
sore throat
sores, ulcers, or white spots on the lips or in the mouth
stabbing pain
stomach cramps or tenderness
sudden decrease in the amount of urine
swelling of the face, fingers, or lower legs
swollen, painful, or tender lymph glands in the neck, armpit, or groin
tightness in the chest
tremors
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight loss
vomiting
weight gain
yellowing of the eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
Bad unusual or unpleasant (after)taste
bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
change in taste
decreased interest in sexual intercourse
inability to have or keep an erection
increased sweating
loss in sexual ability, desire, drive, or performance
painful or prolonged erection of the penis
sleepiness or unusual drowsiness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 12/6/2019

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.

All rights reserved.


The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites.
All rights reserved.

A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.