d. Adverse Reactions.
(1) Hypersensitivity reactions to penicillin are common and include: skin
rashes, urticaria, and serum sickness-like reactions. Severe and often fatal anaphylaxis
have been reported.
(2) The Jarisch-Herxheimer reaction (increase in syphilis symptoms) has
been reported with the treatment for syphilis.
(1) Procaine penicillin for aqueous injection in dry powder form, 300,000
units and 1,500,000 units.
Sterile procaine penicillin G suspension with cartridge- needle units:
(a) 600,000 units, 1-ml size.
(b) 1,200,000 units, 2-ml size.
2,400,000 units 4-ml size.
5-16. BENZATHINE PENICILLIN G
Benzathine penicillin G (Bicillin) is always given IM. It is absorbed into the
bloodstream much more slowly than are the other penicillins and is, therefore, longer
acting. Depending upon the size of the dose, a single intramuscular injection produces
an effective blood level for 1 to 4 weeks. The drug may be used when prolonged action
at low blood levels is desirable. For example, it is the preferred drug for preventing
recurrence of rheumatic fever in those who have had previous attacks. The usual dose
is 1,200,000 units, once a month. The usual dose range is 600,000 to 3,000,000 units,
from three times a week to once a month. Preparations containing benzathine penicillin
G are given below.
a. Sterile Benzathine Penicillin G Suspension. This preparation is supplied in
cartridge-needle units with one plastic cartridge syringe. The available sizes are 1 ml
(600,000 units) and 2 ml (1,200,000 units).
b. Sterile Benzathine Penicillin G and Procaine Penicillin G Suspension.
This preparation is also supplied in cartridge-needle units with one plastic cartridge
syringe. The 1-ml size contains 300,000 units of each penicillin, and the 2-ml size
contains 600,000 units of each penicillin.