Meds and you

30 September 2013

Procaine benzylpenicillin

Penicillins are antibiotics that are derived from a mold. It is used to treat infections caused by harmful bacteria.


(Also known as procaine penicillin, procaine penicillin G)

Procaine benzylpenicillin is the active ingredient of Bio-Cillin (Nappi Code: 748196-005), Procillin (Nappi Code: 75710-018 & 757179-002). Procaine benzylpenicillin is also one of multiple active ingredients found in Ultracillin (Nappi Code: 773581-006 & 773484-019).

General information
Penicillins are antibiotics that are derived from a mold. It is used to treat infections caused by harmful bacteria.

In South Africa procaine benzylpenicillin is registered for the treatment of a wide range of bacterial infections caused by susceptible organisms, including tonsillitis, pneumonia, meningitis, syphilis, neurosyphilis and soft tissue infections.

Should you develop a skin rash whilst being treated with this medication, you should notify your doctor to rule out the possibility of allergy.

A penicillin allergy may lead to fever, swelling of the mouth and tongue, itching and associated breathing difficulties.

Inadvertent intravascular injection may be life-threatening. Symptoms include psychosis, confusion, seizures, alteration in blood pressure, and heart- or respiratory failure. This should not be confused with a penicillin allergy.

Procaine benzylpenicillin is only effective against bacterial infections and is useless for treating viral infections such as cold or flu.

Antibiotic resistance occurs when a bacterium develops the ability to defend itself against the effect of an antibiotic. It occurs frequently with benzylpenicillin. The most common causes for this is patients not completing prescribed antibiotic courses, allowing the bacteria to recover from treatment, and the use of antibiotics for non-bacterial infections such as cold and flu.

How does procaine benzylpenicillin work?
Procaine functions by changing the structure of the bacterial cell wall, allowing fluid to penetrate into the cell. As a result the bacterial cell literally ruptures.

Fast facts

Drug schedule: schedule 4
Available as: procaine benzylpenicillin is available as injection.
What does it do? Procaine benzylpenicillin has an antibiotic action.
Overdose risk: low
Dependence risk: low
Is Procaine benzylpenicillin available as a generic? yes
Is procaine benzylpenicillin available on prescription only? no

User information

Stopping this medicine: only stop treatment when instructed to do so by your doctor.
Prolonged use: use only as directed by your prescriber.

Special precautions
Consult your doctor before using this drug if:

  • you have a known allergy to penicillin or cephalosporin antibiotics

  • you have kidney or liver disease

Pregnancy: avoid. It is unknown how this medication may affect your baby. Consult your doctor before using this drug, or if you are planning to fall pregnant.
Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: this medication is safe use.
Infants and children: this medication is safe for use in children at the recommended dose.
The elderly: no special precautions need to be taken.
Driving and hazardous work: no special precautions need to be taken.
Alcohol: no special precautions need to be taken.

Possible side effects

Side Effect
Consult your doctor

Only if severe
In all cases
skin rash


itchy skin


difficulty swallowing






fungal infections


black/hairy tongue




loss of consciousness








allopurinol increased risk of skin rash
chloroquine reduce the efficacy of antibiotic
oral contraceptives possible reduced contraceptive efficacy another form of contraceptive is advised
probenecid increased risk of antibiotic toxicity
tetracycline possible reduced antibiotic efficacy
warfarin ncreased risk of warfarin toxicity

Disease interactions
Consult your doctor before using this drug if you have a known allergy to penicillin or cephalosporin antibiotics, or if you have kidney or liver disease.

Overdose action
A small overdose is no cause for concern. In case of intentional large overdose seek emergency medical attention.

Recommended dosage
Adults: Generally, for most indications: 600 000 - 1.2 million units daily

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.

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