Benzathine Benzylpenicillin

Generic Name: Benzathine Penicillin G

It’s an antibiotic useful for the treatment of a number of bacterial infections. Specifically it is to treat strep throat, diphtheria, syphilis, and yaws. It is also used to prevent rheumatic fever. It is given by injection into a muscle.

Benzathine benzylpenicillin was patented in 1950. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. The wholesale cost in the developing world is about 0.27 to 1.71 USD for a course of treatment. In the United States the medication costs 50 to 100 USD for a dose as of 2015. In the United Kingdom it costs the NHS about 0.95 to 1.89 pounds a dose as of 2015.

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It is in the penicillin class of medications. It is slowly absorbed into the circulation, after intramuscular injection, and hydrolysed to benzylpenicillin in vivo. It is the drug-of-choice when prolonged low concentrations of benzylpenicillin are required and appropriate, allowing prolonged antibiotic action over 2–4 weeks after a single IM dose.

Benzylpenicillin (Penicillin G) is narrow spectrum antibiotic used to treat infections caused by susceptible bacteria. It is a natural penicillin antibiotic that is administered intravenously or intramuscularly due to poor oral absorption. Penicillin G may also be used in some cases as prophylaxis against susceptible organisms.

Natural penicillins are considered the drugs of choice for several infections caused by susceptible gram positive aerobic organisms, such as Streptococcus pneumoniae, groups A, B, C and G streptococci, nonenterococcal group D streptococci, viridans group streptococci, and non-penicillinase producing staphylococcus. Aminoglycosides may be added for synergy against group B streptococcus (S. agalactiae), S. viridans, and Enterococcus faecalis. The natural penicillins may also be used as first or second line agents against susceptible gram positive aerobic bacilli such as Bacillus anthracisCorynebacterium diphtheriae, and Erysipelothrix rhusiopathiae. Natural penicillins have limited activity against gram negative organisms; however, they may be used in some cases to treat infections caused by Neisseria meningitidis and Pasteurella. They are not generally used to treat anaerobic infections. Resistance patterns, susceptibility and treatment guidelines vary across regions.

Pain at the injection site, nausea, or vomiting may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: joint/muscle pain, vision changes, signs of a new infection (such as sore throat that doesn't go away, fever, chills), easy bruising/bleeding, unusual tiredness, mental/mood changes (such as confusion, hallucinations, depression, agitation).

This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.

Do not use anti-diarrhea products or narcotic pain medications if you have any of these symptoms because these products may make them worse.

Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

When used to treat syphilis and certain other infections, this medication may cause a reaction that occurs several hours after starting treatment and can last up to 24 hours. Tell your doctor right away if you have any of these symptoms: headache, fever/chills, sweating, joint/muscle pain, fast heartbeat, dizziness, worsening of skin sores or other disease symptoms.

Get medical help right away if you have any very serious side effects, including: pain/redness/swelling/numbness/weakness of arms/legs, change in skin color near the injection site or on arms/legs, severe pain/peeling skin at the injection site, muscle cramps/weakness around the injection site, inability to move (paralysis), chest pain, swollen lymph nodes, severe stomach/abdominal pain, nausea/vomiting that doesn't stop, yellowing eyes/skin, irregular heartbeat, seizures, pink/bloody/dark urine, signs of kidney problems (such as a change in the amount of urine).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Benzathine penicillin and procaine penicillin is injected into a muscle. A healthcare provider will give you this injection. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Benzathine penicillin and procaine penicillin must be injected slowly into a muscle of the buttock or upper thigh.

Do not inject the medication into a vein or life-threatening side effects could result.

Benzathine penicillin and procaine penicillin is sometimes given only once or only for a few days until your symptoms clear up. Be sure to have all injections your doctor has prescribed. Your symptoms may get better before the infection is completely cleared.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Benzathine penicillin and procaine penicillin will not treat a viral infection such as the common cold or flu.

Use a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

After you have finished your treatment with benzathine penicillin and procaine penicillin, your doctor may want to do tests to make sure your infection has completely cleared up.

Store this medication in the refrigerator. Do not freeze. Do not use the mixed medication if it has changed colors or has any particles in it.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop taking this medication and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Tell your doctor about all other medications you use, especially:

  • probenecid (Benemid);
  • a blood thinner such as warfarin (Coumadin);
  • methotrexate (Rheumatrex, Trexall); or
  • a tetracycline antibiotic, such as doxycycline (Adoxa, Doryx, Oracea, Vibramycin), minocycline (Dynacin, Minocin, Solodyn, Vectrin), or tetracycline (Brodspec, Panmycin, Sumycin, Tetracap).

This list is not complete and other drugs may interact with benzathine penicillin and procaine penicillin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Do not inject this medication into a vein or life-threatening side effects may result.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Benzathine penicillin and procaine penicillin will not treat a viral infection such as the common cold or flu.

After you have finished your treatment with benzathine penicillin and procaine penicillin, your doctor may want to do tests to make sure your infection has completely cleared up.

You should not use this medication if you are allergic to penicillin. Tell your doctor if you have ever had an allergic reaction to a cephalosporin antibiotic such as Ceclor, Ceftin, Duricef, Keflex, Lorabid, Omnicef, Spectracef, and others.

If you have any of these other conditions, you may need a dose adjustment or special tests:

  • asthma or a history of allergies;
  • liver disease;
  • kidney disease; or
  • heart disease.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Benzathine penicillin and procaine penicillin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or to other antibiotics (such as other penicillins, cephalosporins); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease.

This medication may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk in small amounts. Consult your doctor before breast-feeding.

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