Procaine benzylpenicillin

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Procaine benzylpenicillin
Combination of
Benzylpenicillin antibiotic
Procaine anaesthetic
Clinical data
AHFS/Drugs.com monograph
Legal status
Identifiers
CAS Number 54-35-3 YesY
ATC code J01CE09 (WHO) QJ51CE09 (WHO)
ChEMBL CHEMBL1628385 N
 NYesY (what is this?)  (verify)

Procaine benzylpenicillin (rINN), also known as procaine penicillin, is an antibiotic useful for the treatment of a number of bacterial infections.

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.

This combination is aimed at reducing the pain and discomfort associated with a large intramuscular injection of penicillin. It is widely used in veterinary settings.

It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.[1]

Uses

Specific indications for procaine penicillin include:[2]

  • Syphilis
    • In the United States, Bicillin C-R (a 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.[3] 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.[4]
  • 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

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

Compendial status

References

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  4. United States Food & Drug Administration. "FDA Strengthens Labels of Two Specific Types of Antibiotics to Ensure Proper Use." Published December 1, 2004. Last accessed June 18, 2007.
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