Bicillin L-a Generic Name & Formulations
Penicillin G benzathine 600,000 units/mL; susp for deep IM inj; contains parabens.
Disposable syringe 600,000 or 1.2 million units/syr (1mL, 2mL)—10 (w. 1 or 1.5 inch needles); Disposable syringe 2.4million units/syr (4mL)—10 (w. 1.5 inch needles)
Bicillin L-a Indications
Susceptible infections, including mild to moderate upper respiratory strep infections, syphilis. Follow-up prophylaxis of rheumatic heart disease, acute glomerulonephritis.
Bicillin L-a Dosage and Administration
Give by deep IM inj into upper outer quadrant of buttock; rotate inj sites. Upper respiratory Group A strep: 1.2 million units once. Syphilis (primary, secondary, latent): 2.4 million units once; (tertiary and neurosyphilis): 2.4 million units every 7 days for 3 doses. Rheumatic heart disease, acute glomerulonephritis: 1.2 million units once per month, or 600,000 units every 2 weeks.
Give by deep IM inj into upper outer quadrant of buttock or midlateral thigh; rotate inj sites. Upper respiratory Group A strep (<60 lbs): 300,000 to 600,000 units once; (>60 lbs): 900,000 units once. Congenital syphilis (<2yrs): 50,000 units/kg once; (≥2yrs): individualize.
Bicillin L-a Contraindications
Avoid intraarterial, intravascular, or intraneural injection.
Bicillin L-a Boxed Warnings
Not for IV use. Do not admix with other IV solutions. Reports of inadvertent IV administration has been associated with cardiorespiratory arrest and death.
Bicillin L-a Warnings/Precautions
Not for IV use. Cephalosporin, imipenem, or other allergy: not recommended. Discontinue if severe cutaneous adverse reaction (eg, SJS, TEN, DRESS, AGEP) is suspected; consider alternative therapy. Asthma. Monitor renal and hematopoietic function in prolonged use. Elderly. Pregnancy. Nursing mothers.
Bicillin L-a Pharmacokinetics
Bicillin L-a Interactions
Potentiated by probenecid. May cause false (+) glucose test with Clinitest.
Bicillin L-a Adverse Reactions
Rash, serum sickness, anaphylaxis, blood dyscrasias, neuropathy, nephropathy, inj site reactions; severe cutaneous adverse reactions.
Bicillin L-a Clinical Trials
Bicillin L-a Note
Bicillin L-a Patient Counseling