Procaine benzylpenicillin
| Combination of | |
|---|---|
| Benzylpenicillin | antibiotic |
| Procaine | anaesthetic |
| Clinical data | |
| Trade names | Bicillin C-R,[1] other |
| Other names | penicillin G procaine, procaine penicillin G, procaine penicillin |
| AHFS/Drugs.com | FDA Professional Drug Information |
| Routes of administration | IM |
| ATC code | |
| Legal status | |
| Legal status |
|
| Identifiers | |
| CAS Number | |
| UNII | |
| ChEMBL | |
| E number | E707 (antibiotics) |
| CompTox Dashboard (EPA) | |
| ECHA InfoCard | 100.000.187 |
  (what is this?) (verify) | |
Procaine benzylpenicillin also known as penicillin G procaine, is an antibiotic useful for the treatment of a number of bacterial infections.[2] Specifically it is used for syphilis, anthrax, mouth infections, pneumonia, diphtheria, cellulitis, and animal bites.[2] It is given by injection into a muscle.[2]
Side effects include pain at the site of injection, blood clotting problems, seizures, and allergic reactions including anaphylaxis.[2] When used to treat syphilis a reaction known as Jarisch-Herxheimer may occur.[2] It is not recommended in those with a history of penicillin allergy or procaine allergy.[1][2] Use during pregnancy and breastfeeding is relatively safe.[1][2] Procaine benzylpenicillin is in the penicillin and beta lactam family of medications.[2] It works via benzylpenicillin and results in bacterial death.[2][3] Procaine makes the combination long acting.[4]
Procaine benzylpenicillin was introduced for medical use in 1948.[3] It is on the World Health Organization's List of Essential Medicines.[5]
Medical uses
[edit]Specific indications for procaine penicillin include:[6]
- Syphilis
- In the United States, Bicillin C-R (an injectable suspension which 1.2 million units of benzathine penicillin and 1.2 million units of procaine penicillin per 4 ml) is not recommended for treating syphilis, since it contains only half the recommended dose of benzathine penicillin. Medication errors have been made due to the confusion between Bicillin L-A & Bicillin C-R.[7] As a result, changes in product packaging have been made; specifically, the statement "Not for the Treatment of Syphilis" has been added in red text to both the Bicillin CR and Billin CR 900/300 syringe labels.[8]
- Respiratory tract infections where compliance with oral treatment is unlikely
- Alongside Pen V and Erythromycin, Bicillin C-R is used to treat strep throat, given as one IM injection
- Cellulitis, erysipelas
- Procaine penicillin is also used as an adjunct in the treatment of anthrax.
Adverse effects
[edit]At high doses procaine penicillin can cause seizures and CNS abnormalities due to procaine present in it.[citation needed]
Mechanism
[edit]It is a form of penicillin which is a combination of benzylpenicillin and the local anaesthetic agent procaine.[9] Following deep intramuscular injection, it is slowly absorbed into the circulation and hydrolysed to benzylpenicillin — thus it is used where prolonged low concentrations of benzylpenicillin are required.
Compendial status
[edit]See also
[edit]References
[edit]- ^ a b c d Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 95. ISBN 9781284057560.
- ^ a b c d e f g h i World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. pp. 113, 607, 618. hdl:10665/44053. ISBN 9789241547659.
- ^ a b "Penicillin G Procaine - FDA prescribing information, side effects and uses". www.drugs.com. Archived from the original on 20 December 2016. Retrieved 10 December 2016.
- ^ Ebadi, Manuchair (2007). Desk Reference of Clinical Pharmacology, Second Edition. CRC Press. p. 555. ISBN 9781420047448. Archived from the original on 2016-12-20.
- ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ^ Rossi S, ed. (2006). Australian Medicines Handbook. Adelaide: Australian Medicines Handbook. ISBN 0-9757919-2-3.
- ^ Centers for Disease Control and Prevention (CDC) (2005). "Inadvertent use of Bicillin C-R to treat syphilis infection—Los Angeles, California, 1999–2004". MMWR Morb. Mortal. Wkly. Rep. 54 (9): 217–9. PMC 6820132. PMID 15758893.
- ^ United States Food & Drug Administration. "FDA Strengthens Labels of Two Specific Types of Antibiotics to Ensure Proper Use." Archived 2009-01-14 at the Wayback Machine Published December 1, 2004. Last accessed June 18, 2007.
- ^ Residues of Some Veterinary Drugs in Animals and Foods: Monographs Prepared by the Fiftieth Meeting of the Joint FAO/WHO Expert Committee on Food Additives : Rome, 17-26 February 1998. Food & Agriculture Org. 1999. p. 96. ISBN 9789251042809.
- ^ British Pharmacopoeia Commission Secretariat. "Index (BP 2009)" (PDF). Archived from the original (PDF) on 11 April 2009. Retrieved 26 March 2010.
External links
[edit]- "Penicillin G Procaine". Drug Information Portal. U.S. National Library of Medicine.
