Procaine penicillin

Applies to procaine penicillin: intramuscular suspension

Get emergency medical help if you have any of these signs of an allergic reaction while taking procaine penicillin: 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 that is watery or bloody;

• peeling skin , severe pain, or changes in skin color where the medicine was injected;

• 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;

• feeling like you might pass out;

• 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; or

• slow heart rate, weak pulse, fainting, slow breathing.

Less serious side effects of procaine penicillin 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; or

• mild skin rash,

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Applies to procaine penicillin: intramuscular suspension

Hypersensitivity

Hypersensitivity side effects associated with penicillin have included skin rashes (ranging from maculopapular eruptions to exfoliative dermatitis), urticaria, and serum sickness-like reactions (including chills, fever, edema, arthralgia, and prostration). Anaphylaxis (severe and often fatal) and Jarisch-Herxheimer reaction (as with other treatments for syphilis) have been reported. Procaine toxicity manifestations and hypersensitivity reactions have been reported.[Ref]

Gastrointestinal

Gastrointestinal side effects associated with penicillin G have included pseudomembranous colitis.[Ref]

The onset of pseudomembranous colitis symptoms may occur during or after treatment.[Ref]

Psychiatric

Psychiatric side effects have included a syndrome manifested by a variety of central nervous system symptoms such as severe agitation with confusion, visual and auditory hallucinations, and a fear of impending death (Hoigne's syndrome) following procaine penicillin use. Other symptoms associated with this syndrome have included psychosis, seizures, dizziness, tinnitus, cyanosis, palpitations, tachycardia, and abnormal taste perception.[Ref]

Renal

Renal side effects associated with parenteral penicillin G have included nephropathy.[Ref]

Hematologic

Hematologic side effects associated with parenteral penicillin G have included hemolytic anemia, leukopenia, and thrombocytopenia.[Ref]

Nervous system

Nervous system side effects associated with parenteral penicillin G have included neuropathy.[Ref]

Some side effects of procaine penicillin may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Moderately severe to severe infections due to susceptible group A streptococci: 600,000 to 1,000,000 units/day IM for at least 10 days

Moderately severe to severe infections due to susceptible staphylococci and uncomplicated infections due to Erysipelothrix rhusiopathiae: 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.

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.

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.

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

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.

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.

Data not available