Pronunciation:

pen-i-SIL-in G BEN-za-theen

Brand Names:

• Bicillin L-A

Dosage Forms:

• Suspension

Warnings:

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 injection is used to treat bacterial infections (eg, mild to moderate infections of the upper respiratory tract, syphilis, yaws, bejel, pinta). It is also used to prevent rheumatic fever, chorea, rheumatic heart disease, or acute glomerulonephritis. 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 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 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.

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
• Eravacycline
• Lymecycline
• Meclocycline
• Methacycline
• Minocycline
• Oxytetracycline
• Rolitetracycline
• Sarecycline
• Tetracycline
• Tigecycline

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.

• 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, usually in the upper buttock or hip area.

Missed dose—

This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.

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 or your child has 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 serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), or acute generalized exanthematous pustulosis (AGEP). Check with your doctor right away if you or your child has black, tarry stools, blistering, peeling, loosening of the skin, chest pain, chills, cough, diarrhea, fever, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in them mouth or on the lips, swollen glands, trouble breathing, unusual bleeding or bruising, 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

fever

general body swelling

general feeling of illness or discomfort

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

painful or difficult urination

pale skin

pinpoint red spots on the skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

rigidity

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

sweating

swelling of the face, fingers, or lower legs

swollen, painful, or tender lymph glands in the neck, armpit, or groin

swollen glands

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

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.