Classes
DEA Class; Rx
Common Brand Names; Bicillin LA, Permapen
- Penicillins, Natural
Description
Repository form of penicillin for intramuscular use only; tissue depot allows slow drug absorption over several days; provides lower and prolonged serum concentrations compared to aqueous penicillin G; used in mild to moderate infections due to susceptible organisms, prophylaxis and treatment of rheumatic fever, syphilis.
Indications
Indicated for Group A Streptococcal Respiratory Infections
Contraindications
Hypersensitivity; serious and occasionally fatal reactions have been reported
Adverse Effects
Skin rashes including maculopapular eruptions and exfoliative dermatitis
Urticaria
Serum-sicknesslike reactions (eg, chills, fever, edema, arthralgia, prostration)
Jarisch-Herxheimer reaction reported when treating syphilis
Pseudomembranous colitis
Warnings
For deep IM administration only; do not administer IV, SC, or IT
Do not inject near nerve or artery
Severe cutaneous adverse reactions (SCAR), such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP) reported in patients taking beta-lactam antibiotics; discontinue therapy when SCAR suspected; consider an alternative treatment
Pseudomembranous colitis reported with antibacterial agents, including penicillin G
Administer by deep intramuscular injection only in the upper, outer quadrant of buttock (dorsogluteal) or ventrogluteal site; quadriceps femoris fibrosis and atrophy reported following repeated intramuscular injections of penicillin preparations into anterolateral thigh and is not recommended
Pregnancy and Lactation
Pregnancy Category: B
Lactation: Excreted into breast milk, caution advised
Maximum Dosage
2.4 million units/day IM.
2.4 million units/day IM.
50,000 units/kg/day IM (Max: 2.4 million units/day).
50,000 units/kg/day IM (Max: 2.4 million units/day).
50,000 units/kg/day IM (Max: 600,0000 units/day).
50,000 units/kg/day IM.
How supplied
Penicillin G benzathine
injectable suspension
- 600,000 units/1mL
- 1.2 million units/2mL
- 2.4 million units/4mL