Benzathine benzylpenicillin injectable

Therapeutic action

Long-acting penicillin antibacterial.

Indications

• Early and late latent syphilis.
• Congenital syphilis without clinical signs in the neonate and adequate treatment in the mother.
• Endemic treponematoses such as yaws, bejel, and pinta.
• Streptococcal tonsillitis, prophylaxis of diphtheria, and primary and secondary prophylaxis of rheumatic fever.

Forms and strengths, route of administration

• Powder for injection in 1.2 MIU vial and 2.4 MIU vial, for IM injection only.
• Never for IV injection or infusion.

Dose

Duration

• Early syphilis, congenital syphilis, tonsillitis, yaws, bejel, pinta, prophylaxis of diphtheria, primary prophylaxis of rheumatic fever: single dose.
• Late latent syphilis: one injection weekly for 3 weeks.
• Secondary prophylaxis of rheumatic fever: one injection every 4 weeks for several years.

Contra-indications, adverse effects, precautions

• Once reconstituted, suspension must be used immediately.
• Do not administer to penicillin-allergic patients.
• Administer with caution to patients allergic to cephalosporins and to patients with renal impairment.
• May cause gastrointestinal disturbances, pain at injection site, allergic reactions, Jarisch-Herxheimer reaction, convulsions in renal impairment or high doses, and symptoms of shock in case of accidental IV injection.
• Ensure that the IM injection does not enter a blood vessel.
• Do not combine with methotrexate.
• Pregnancy and breast-feeding: no contra-indication.
• Do not confuse long-acting benzathine benzylpenicillin for IM use with rapidly acting benzylpenicillin administered by IV route.
• Do not mix with other drugs in the same syringe.