BENZATHINE BENZYLPENICILLIN injectable

Therapeutic action

• Long-acting penicillin antibacterial

Indications

• Early syphilis (primary, secondary, or early latent infection of less than 12 months duration)
• Late latent syphilis (infection of more than 12 months duration or of unknown duration)
• Congenital syphilis (absence of clinical signs in the neonate and adequate treatment in the mother)
• Endemic treponematoses (yaws, bejel, pinta)
• Streptococcal tonsillitis 
• Prophylaxis of diphtheria in the event of direct contact
• Primary and secondary prophylaxis of rheumatic fever

Forms and strengths, route of administration

• Powder for injection in vials of:
  • 1.2 MIU (900 mg), to be dissolved in 4 ml of water for injection, for IM injection
  • 2.4 MIU (1.8 g), to be dissolved in 8 ml of water for injection, for IM injection
• NEVER FOR IV INJECTION NOR INFUSION

Dosage

Syphilis

• Child: 50 000 IU (37.5 mg)/kg per injection (max. 2.4 MIU or 1.8 g per injection)
• Adult: 2.4 MIU (1.8 g) per injection

Yaws, bejel, pinta

• Child under 10 years: 1.2 MIU (900 mg) per injection
• Child 10 years and over and adult: 2.4 MIU (1.8 g) per injection

Streptococcal tonsillitis, prophylaxis of diphtheria, prophylaxis of rheumatic fever

• Child under 30 kg: 600 000 IU (450 mg) per injection
• Child 30 kg and over and adult: 1.2 MIU (900 mg) per injection

Duration

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

Contra-indications, adverse effects, precautions

• Do not administer to penicillin-allergic patients.
• Administer with caution to patients allergic to cephalosporins (cross-sensitivity may occur) and renal impairment (reduce dosage).
• May cause:
  • gastroinstestinal disturbances, pain at injection site, allergic reactions sometimes severe;
  • Jarisch-Herxheimer reaction (fever, chills, myalgia, tachycardia) in patients with syphilis;
  • convulsions in the event of high dosages or renal impairment;
  • symptoms of shock with neuropsychiatric disorders 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

Remarks

• For a 2.4 MIU (1.8 g) dose, administer 1.2 MIU (900 mg) in each buttock.
• Do not confuse long-acting benzathine benzylpenicillin, for IM injection, with rapidly acting benzylpenicillin (or penicillin G), administered by Iv route.
• Do not mix with other drugs in the same syringe.

Storage