Benzyl Penicillin + Procaine Penicillin

Benzyl Penicillin + Procaine Penicillin is a combination penicillin antibiotic used for various bacterial infections. Procaine penicillin is a long-acting form of benzyl penicillin that is slowly released after intramuscular injection.

Benzyl penicillin has bactericidal action against gram-positive bacteria, gram-negative cocci, spirochetes, and actinomycetes. It inhibits the final cross-linking stage of peptidoglycan production by binding and inactivating transpeptidases on the inner surface of the bacterial cell membrane, thus inhibiting bacterial cell wall synthesis.

Common side effects include hypersensitivity reactions (rash, urticaria, fever), pseudomembranous colitis, and anaphylaxis.

• Meningitis
• Peritonitis
• Anthrax
• Non-gonococcal urethritis
• Diphtheria
• Syphilis
• Staphylococcus, Streptococcus, Pneumococcus infections
• Gonorrhea
• Subacute bacterial endocarditis
• Upper respiratory tract infections
• Skin and soft tissue infections
• Erysipelas
• Otitis media
• Empyema
• Bacteremia
• Pericarditis
• Arthritis

Benzylpenicillin has a bactericidal action against gram-positive bacteria, gram-negative cocci, some other gram-negative bacteria, spirochetes and actinomycetes. It inhibits the final cross-linking stage of peptidoglycan production through binding and inactivation of transpeptidases on the inner surface of the bacterial cell membrane, thus inhibiting bacterial cell wall synthesis. Procaine penicillin is slowly hydrolyzed to benzylpenicillin after IM injection, providing a prolonged antibacterial effect.

Benzyl Penicillin exerts bactericidal action by inhibiting bacterial cell wall peptidoglycan synthesis. Procaine Penicillin is slowly released as active benzylpenicillin after IM injection, providing prolonged antibacterial activity.

Adults:

• Streptococcal Infections (Group A, >60 lbs): 2,400,000 units in a single session (multiple IM sites)
• Pneumococcal Infections (except meningitis): 1,200,000 units, repeated every 2-3 days until temperature is normal for 48 hours

Pediatric:

• Streptococcal Infections (>60 lbs): 2,400,000 units
• Streptococcal Infections (30-60 lbs): 900,000-1,200,000 units
• Streptococcal Infections (<30 lbs): 600,000 units
• Pneumococcal Infections: 600,000 units, repeated every 2-3 days

Renal Dose: CrCl 10-50 mL/min: Decrease dose by 25%; CrCl <10 mL/min: Decrease dose by 50-70%; Hemodialysis: Administer after dialysis.

For intramuscular (IM) or intravenous (IV) administration only. Do not inject near arteries or nerves (may cause permanent neurological damage). Neonates, infants: prefer mid-lateral thigh. Older children and adults: deep IM injection in the upper outer quadrant of the buttock. Administer at a slow, steady rate.

If you miss a dose, please consult your doctor.

• Hypersensitivity reactions: Skin eruptions (maculopapular to exfoliative dermatitis), urticaria, laryngeal edema, fever, eosinophilia
• Serum sickness-like reactions (chills, fever, edema, arthralgia, prostration)
• Anaphylaxis (including shock and death)
• Pseudomembranous colitis

• Caution in patients with previous hypersensitivity to penicillin or procaine
• Caution in patients with significant allergies and/or asthma
• Avoid intravenous or intra-arterial administration
• Avoid injection near major peripheral nerves or blood vessels (may cause neurovascular damage)
• Caution during lactation

• Previous hypersensitivity reaction to any penicillin or procaine

• Probenecid: Increases and prolongs serum penicillin levels
• Tetracycline: May antagonize the bactericidal effect of penicillin

[SAFE] Consuming alcohol with Benzyl Penicillin + Procaine Penicillin does not cause any harmful side effects.

[SAFE IF PRESCRIBED] Benzyl Penicillin + Procaine Penicillin is generally considered safe to use during pregnancy (Pregnancy Category B). Animal studies have shown low or no adverse effects to the developing baby.

[CAUTION] Benzyl Penicillin + Procaine Penicillin is excreted into breast milk. Caution is advised in nursing mothers.

Pediatric dosing is weight-based (see dosage chart above).

Elderly patients may have decreased renal function, so dose adjustment may be needed.

[CAUTION] Dose adjustment needed in renal impairment: CrCl 10-50 mL/min: Decrease dose by 25%; CrCl <10 mL/min: Decrease dose by 50-70%; Hemodialysis: Administer after dialysis.

[CAUTION] Caution in liver disease.

Overdose may cause neurotoxicity (seizures), especially in renal impairment. Consult a doctor if symptoms occur.

Store below 25°C, away from light and moisture. Keep out of reach of children.

Benzyl Penicillin + Procaine Penicillin