Procaine penicillin

Uses

What is procaine penicillin used for?

Procaine penicillin is used to treat many different types of infections caused by bacteria, including syphilis (a sexually transmitted disease).

How should I take procaine penicillin?

Procaine penicillin is given as an injection into a muscle. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine 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.

Procaine penicillin must be injected slowly into a muscle of the buttock or upper thigh.

How do I store procaine penicillin?

Dry powder

Procaine penicillin is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store procaine penicillin in the bathroom or the freezer. There may be different brands of procaine penicillin that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush procaine penicillin down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Solution

Procaine penicillin is best stored in the refrigerator. To prevent drug damage, do not freeze. There may be different brands of procaine penicillin that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush procaine penicillin down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using procaine penicillin?

Procaine penicillin can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while using procaine penicillin. Hormonal forms of contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using procaine penicillin during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking procaine penicillin. Procaine penicillin is pregnancy risk category B, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

• A=No risk
• B=No risk in some studies
• C=There may be some risk
• D=Positive evidence of risk
• X=Contraindicated
• N=Unknown

Side effects

What side effects can occur from procaine penicillin?

Get emergency medical help if you have any of these signs of an allergic reaction:

• Hives
• Difficulty breathing
• Swelling of your face, lips, tongue, or throat

Call your doctor at once if you have a serious side effect such as:

• Diarrhea
• Peeling skin , severe pain, or changes in skin color
• Dizziness, joint or muscle pain
• Fast or pounding heartbeats
• Numbness, tingling, pain, swelling, or redness in your arms or legs
• Confusion, agitation, depression, unusual thoughts or behavior
• Chest pain, problems with vision or speech
• Fever, chills, dizziness, muscle pain, rapid breathing or heart rate
• Uncontrolled muscle movements, problems with balance or walking
• Pale skin, easy bruising or bleeding, unusual weakness
• Sore throat, flu symptoms
• Urinating less than usual or not at all
• Rash or itching with swollen glands, joint pain, or general ill feeling
• Slow heart rate, weak pulse, fainting, slow breathing

Less serious side effects may include:

• Pain where the injection was given
• Vaginal itching or discharge
• White patches in your mouth or throat
• Nausea, vomiting
• Blurred vision, ringing in your ears
• Headache, dizziness
• Mild skin rash

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with procaine penicillin?

Procaine penicillin may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

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

• Probenecid (Benemid)
• A blood thinner such as warfarin (Coumadin)
• A diuretic (water pill) such as furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor HCT, Vasoretic, Zestoretic), and others
• Methotrexate (Rheumatrex, Trexall)
• A tetracycline antibiotic, such as demeclocycline (Declomycin, Ledermycin), doxycycline (Adoxa, Doryx, Vibramycin, Periostat), minocycline (Minocin), or tetracycline (Ala-Tet, Sumycin, Tetracap)
• NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), naproxen (Aleve, Naprosyn), meloxicam (Mobic), piroxicam (Feldene), and others
• A cephalosporin antibiotic such as Ceclor, Ceftin, Duricef, Keflex, Lorabid, Omnicef, Spectracef, and others

Does food or alcohol interact with procaine penicillin?

Procaine penicillin may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with procaine penicillin?

Procaine penicillin may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Tell your doctor if you have:

• Asthma
• A history of allergies
• Kidney disease

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using procaine penicillin.

What is the dose of procaine penicillin for an adult?

Skin or soft tissue infection:

Moderately severe to severe infections due to susceptible group A streptococci:

The recommended dose is 600,000 to 1,000,000 units/day IM for at least 10 days.

Upper respiratory tract infection:

Moderately severe to severe infections due to susceptible group A streptococci:

The recommended dose is 600,000 to 1,000,000 units/day IM for at least 10 days.

Tonsillitis/pharyngitis:

Moderately severe to severe infections due to susceptible group A streptococci:

The recommended dose is 600,000 to 1,000,000 units/day IM for at least 10 days.

Streptococcal infection:

Erysipelas, scarlet fever: moderately severe to severe infections due to susceptible group A streptococci:

The recommended dose is 600,000 to 1,000,000 units/day IM for at least 10 days.

Pneumonia:

Moderately severe (uncomplicated) infections due to susceptible pneumococci:

The recommended dose is 600,000 to 1,000,000 units/day IM.

Bacterial infection:

Moderately severe to severe infections due to susceptible staphylococci and uncomplicated infections due to Erysipelothrix rhusiopathiae: The recommended dose is 600,000 to 1,000,000 units/day IM.

Bejel, pinta, and yaws: The usual treatment is the same as for syphilis in the corresponding stage of disease.

Anthrax prophylaxis:

The recommended dose is 1.2 million units IM every 12 hours.

Duration: Anthrax prophylaxis should continue for 60 days. Safety of procaine penicillin has not been established for more than 2 weeks of use. Consider an alternate treatment beyond 2 weeks.

Cutaneous Bacillus anthracis:

The recommended dose is 600,000 to 1,000,000 units/day IM.

Although 5 to 10 days of treatment may be adequate for mild, uncomplicated cutaneous anthrax (naturally occurring or endemic exposures), the Centers for Disease Control and Prevention (CDC) recommend continuing therapy for 60 days if cutaneous anthrax occurs as a result of exposure to aerosolized Bacillus anthracis spores.

Neurosyphilis:

The recommended dose is 600,000 units/day IM for 10 to 15 days.

Total dose: 6 to 9 million units.

If compliance can be ensured, the CDC recommends: Procaine penicillin 2.4 million units IM once a day plus probenecid 500 mg orally 4 times a day for 10 to 14 days; may follow with penicillin G benzathine 2.4 million units IM once a week for up to 3 weeks.

IV penicillin G is the recommended regimen for the treatment of neurosyphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Tertiary Syphilis:

The recommended dose is 600,000 units/day IM for 10 to 15 days.

Total dose: 6 to 9 million units.

All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Syphilis – Latent:

Latent with a negative spinal fluid: 600,000 units/day IM for 8 days.

Total dose: 4,800,000 units.

Latent with positive or no spinal fluid examination: 600,000 units/day IM for 10 to 15 days.

Total dose: 6 to 9 million units.

The CDC recommends penicillin G benzathine as the drug of choice for the treatment of latent syphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Syphilis – Early:

Primary and secondary: 600,000 units/day IM for 8 days.

Total dose: 4,800,000 units.

The CDC recommends penicillin G benzathine as the drug of choice for the treatment of primary or secondary syphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Diphtheria:

Adjunctive therapy with antitoxin: 300,000 to 600,000 units/day IM for 14 days; the CDC recommends 300,000 units/day IM for patients weighing 10 kg or less and 600,000 units/day IM for patients weighing more than 10 kg.

Patients usually are not contagious 48 hours after starting therapy. Two consecutive negative cultures after treatment is completed should be obtained to confirm eradication of the organism.

Carrier state: 300,000 units/day IM.

Follow-up cultures at least 2 weeks after treatment is completed are recommended. If positive, erythromycin and additional follow-up cultures are recommended.

Fusospirochetosis:

The recommended dose is 600,000 to 1,000,000 units/day IM.

Rat-bite fever:

The recommended dose is 600,000 to 1,000,000 units/day IM.

Endocarditis:

Only in extremely sensitive infections: 600,000 to 1,000,000 units/day IM

What is the dose of procaine penicillin for a child?

Bacterial infection:

The American Academy of Pediatrics (AAP) recommends 50,000 units/kg IM once a day for neonates and 25,000 to 50,000 units/kg/day IM in 1 or 2 divided doses (maximum adult dose 4.8 million units/day) for children older than 1 month of age.

Moderately severe to severe infections due to susceptible staphylococci in patients weighing less than 27 kg: 300,000 units/day IM.

Streptococcal infection:

Moderately severe to severe infections due to susceptible group A streptococci in patients weighing less than 27 kg: 300,000 units/day IM.

Pneumonia:

Moderately severe (uncomplicated) infections due to susceptible pneumococci in patients weighing less than 27 kg: 300,000 units/day IM.

Anthrax prophylaxis:

The recommended dose is 25,000 units/kg IM every 12 hours. Duration: Anthrax prophylaxis should continue for 60 days. Safety of procaine penicillin has not been established for more than 2 weeks of use. Consider an alternate treatment beyond 2 weeks.

Congenital Syphilis:

Less than 32 kg: 50,000 units/day IM for 10 days. The CDC and AAP recommend readministration of the entire course of therapy if more than 1 day is missed.

Neurosyphilis:

Greater than 12 years: 600,000 units/day IM for 10 to 15 days.

Total dose: 6 to 9 million units.

If compliance can be ensured, the CDC recommends: Procaine penicillin 2.4 million units IM once a day plus probenecid 500 mg orally 4 times a day for 10 to 14 days; may follow with penicillin G benzathine 2.4 million units IM once a week for up to 3 weeks.

IV penicillin G is the recommended regimen for the treatment of neurosyphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Tertiary syphilis:

Greater than 12 years: 600,000 units/day IM for 10 to 15 days.

Total dose: 6 to 9 million units.

All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Syphilis – Latent:

Greater than 12 years: Latent with a negative spinal fluid: 600,000 units/day IM for 8 days.

Total dose: 4,800,000 units.

Latent with positive or no spinal fluid examination: 600,000 units/day IM for 10 to 15 days.

Total dose: 6 to 9 million units.

The CDC recommends penicillin G benzathine as the drug of choice for the treatment of latent syphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Syphilis – Early:

Greater than 12 years:

Primary and secondary: 600,000 units/day IM for 8 days.

Total dose: 4,800,000 units.

The CDC recommends penicillin G benzathine as the drug of choice for the treatment of primary or secondary syphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Diphtheria:

Adjunctive therapy with antitoxin: The CDC recommends 300,000 units/day IM for patients weighing 10 kg or less and 600,000 units/day IM for patients weighing more than 10 kg. The AAP recommends 25,000 to 50,000 units/kg/day in 2 divided for 14 days with a maximum dose of 1.2 million units per day.

Patients usually are not contagious 48 hours after starting therapy. Two consecutive negative cultures after treatment is completed should be obtained to confirm eradication of the organism.

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is procaine penicillin available?

Procaine penicillin is available in the following dosage forms and strengths:

• Injection
• Powder 0,8g, 1,2 g
• Solution

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

Overdose symptoms may include mood changes, agitation, confusion, and seizure (convulsions).

What should I do if I miss a dose?

If you miss a dose of procaine penicillin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.