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Procaine benzylpenicillin

procaine benzylpenicillin, procaine benzylpenicillin or procaine penicillin g for cattle
Procaine benzylpenicillin also known as penicillin G procaine, is an antibiotic useful for the treatment of a number of bacterial infections Specifically it is used for syphilis, anthrax, mouth infections, pneumonia, diphtheria, cellulitis, and animal bites It is given by injection into a muscle

Side effects include pain at the site of injection, blood clotting problems, seizures, and allergic reactions including anaphylaxis When used to treat syphilis a reaction known as Jarisch-Herxheimer may occur It is not recommended in those with a history of penicillin allergy or procaine allergy Use during pregnancy and breastfeeding is relatively safe Procaine benzylpenicillin is in the penicillin and beta lactam family of medications It works via benzylpenicillin and results in bacterial death Procaine makes the combination long acting

Procaine benzylpenicillin was introduced for medical use in 1948 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 009 to 018 USD per day In the United States a course of treatment costs 100 to 200 USD


  • 1 Medical uses
  • 2 Adverse effects
  • 3 Mechanism
  • 4 Compendial status
  • 5 References

Medical uses

Specific indications for procaine penicillin include:

  • Syphilis
    • In the United States, Bicillin C-R a injectable suspension which 12 million units of benzathine penicillin and 12 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 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
  • 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

Further information:Penicillin drug reaction

At high doses procaine penicillin can cause seizures and CNS abnormalities due to procaine present in it


It is a form of penicillin which is a combination of benzylpenicillin and the local anaesthetic agent procaine 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

  • British Pharmacopoeia


  1. ^ a b c d e Hamilton, Richart 2015 Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition Jones & Bartlett Learning p 95 ISBN 9781284057560 
  2. ^ a b c d e f g h i WHO Model Formulary 2008 PDF World Health Organization 2009 pp 113, 607, 618 ISBN 9789241547659 Archived PDF from the original on 13 December 2016 Retrieved 8 December 2016 
  3. ^ a b "Penicillin G Procaine - FDA prescribing information, side effects and uses" wwwdrugscom Archived from the original on 20 December 2016 Retrieved 10 December 2016 
  4. ^ Ebadi, Manuchair 2007 Desk Reference of Clinical Pharmacology, Second Edition CRC Press p 555 ISBN 9781420047448 Archived from the original on 2016-12-20 
  5. ^ "WHO Model List of Essential Medicines 19th List" PDF World Health Organization April 2015 Archived PDF from the original on 13 December 2016 Retrieved 8 December 2016 
  6. ^ "Penicillin, Procaine Benzyl" International Drug Price Indicator Guide Retrieved 8 December 2016 
  7. ^ Rossi S, editor, ed 2006 Australian Medicines Handbook Adelaide:Australian Medicines Handbook ISBN 0-9757919-2-3 CS1 maint:Extra text:editors list link
  8. ^ 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 PMID 15758893 
  9. ^ 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
  10. ^ 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 Archived from the original on 20 December 2016 
  11. ^ British Pharmacopoeia Commission Secretariat "Index BP 2009" PDF Archived from the original PDF on 11 April 2009 Retrieved 26 March 2010 
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Procaine benzylpenicillin

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