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procaine penicillin

Generic Name: procaine penicillin (PRO kane PEN i SIL in)
Brand Name: Wycillin

What is procaine penicillin ?

Procaine penicillin is an antibiotic that fights bacteria in your body.

Procaine penicillin is used to treat many different types of infections caused by bacteria, including syphilis (a sexually transmitted disease).

Do not use this medication for any other infection that has not been checked by your doctor.

Procaine penicillin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about procaine penicillin ?

You should not use this medication if you are allergic to penicillin. Tell your doctor if you have ever had an allergic reaction to a cephalosporin antibiotic such as Ceftin, Cefzil, Omnicef, Keflex, and others.

Before using procaine penicillin, tell your doctor if you have asthma or a history of allergies, or kidney disease.

Do not inject this medication into a vein or life-threatening side effects may result.

Slideshow: The Shocking Truth About Antibiotic Resistance

Use this medication for the full prescribed length of time. Call your doctor if your infection does not improve, or if it gets worse while using procaine penicillin.

Tell your doctor about all other medications you use, especially gout medication, a blood thinner, a diuretic, a tetracycline antibiotic, or a non-steroidal anti-inflammatory drug (NSAID).

Procaine penicillin can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while using procaine penicillin. Hormonal forms of contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment.

After you have finished your treatment with procaine penicillin, your doctor may want to do tests to make sure your infection has completely cleared up.

What should I discuss with my health care provider before using procaine penicillin ?

You should not use this medication if you are allergic to penicillin. Tell your doctor if you have ever had an allergic reaction to a cephalosporin antibiotic such as Ceclor, Ceftin, Duricef, Keflex, Lorabid, Omnicef, Spectracef, and others.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use procaine penicillin:

  • asthma or a history of allergies; or

  • kidney disease.

FDA pregnancy category B. Procaine penicillin is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Procaine penicillin can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while using procaine penicillin. Hormonal forms of contraception (such as birth control pills, injections, implants, skin patches, and vaginal rings) may not be effective enough to prevent pregnancy during your treatment.

Procaine penicillin can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use procaine penicillin?

Procaine penicillin is given as an injection into a muscle. Your doctor, nurse, or other healthcare provider will give you this injection. You may be shown how to inject your medicine at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Procaine penicillin must be injected slowly into a muscle of the buttock or upper thigh.

Do not inject the medication into a vein or life-threatening side effects could result.

Your procaine penicillin injections should be given at evenly spaced intervals.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Procaine penicillin will not treat a viral infection such as the common cold or flu.

Call your doctor if your infection does not improve, or if it gets worse while using procaine penicillin.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

This medication can cause you to have unusual results with certain lab tests, including tests to check for glucose (sugar) in the urine. Tell any doctor who treats you that you are using procaine penicillin.

After you have finished your treatment with procaine penicillin, your doctor may want to do tests to make sure your infection has completely cleared up.

Store this medication in the refrigerator. Do not freeze. Do not use the mixed medication if it has changed colors or has any particles in it.

What happens if I miss a dose?

Use the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include mood changes, agitation, confusion, and seizure (convulsions).

What should I avoid while using procaine penicillin?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, stop using this medication and call your doctor. Do not use any medicine to stop the diarrhea unless your doctor has told you to.

Do not receive a "live" vaccine such as typhoid vaccine, cholera vaccine, or BCG (Bacillus Calmette and Guérin) vaccine.

Procaine penicillin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • diarrhea that is watery or bloody;

  • peeling skin , severe pain, or changes in skin color where the medicine was injected;

  • dizziness, joint or muscle pain;

  • fast or pounding heartbeats;

  • numbness, tingling, pain, swelling, or redness in your arms or legs;

  • confusion, agitation, depression, unusual thoughts or behavior;

  • chest pain, problems with vision or speech;

  • feeling like you might pass out;

  • fever, chills, dizziness, muscle pain, rapid breathing or heart rate;

  • uncontrolled muscle movements, problems with balance or walking;

  • pale skin, easy bruising or bleeding, unusual weakness;

  • sore throat, flu symptoms;

  • urinating less than usual or not at all;

  • rash or itching with swollen glands, joint pain, or general ill feeling; or

  • slow heart rate, weak pulse, fainting, slow breathing.

Less serious side effects may include:

  • pain where the injection was given;

  • vaginal itching or discharge;

  • white patches in your mouth or throat;

  • nausea, vomiting;

  • blurred vision, ringing in your ears;

  • headache, dizziness; or

  • mild skin rash,

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Procaine penicillin dosing information

Usual Adult Dose for Skin or Soft Tissue Infection:

Moderately severe to severe infections due to susceptible group A streptococci: 600,000 to 1,000,000 units/day IM for at least 10 days

Usual Adult Dose for Upper Respiratory Tract Infection:

Moderately severe to severe infections due to susceptible group A streptococci: 600,000 to 1,000,000 units/day IM for at least 10 days

Usual Adult Dose for Tonsillitis/Pharyngitis:

Moderately severe to severe infections due to susceptible group A streptococci: 600,000 to 1,000,000 units/day IM for at least 10 days

Usual Adult Dose for Streptococcal Infection:

Erysipelas, scarlet fever:
Moderately severe to severe infections due to susceptible group A streptococci: 600,000 to 1,000,000 units/day IM for at least 10 days

Usual Adult Dose for Pneumonia:

Moderately severe (uncomplicated) infections due to susceptible pneumococci: 600,000 to 1,000,000 units/day IM

Usual Adult Dose for Bacterial Infection:

Moderately severe to severe infections due to susceptible staphylococci and uncomplicated infections due to Erysipelothrix rhusiopathiae: 600,000 to 1,000,000 units/day IM

Bejel, pinta, and yaws: The usual treatment is the same as for syphilis in the corresponding stage of disease.

Usual Adult Dose for Anthrax Prophylaxis:

1.2 million units IM every 12 hours

Duration: Anthrax prophylaxis should continue for 60 days. Safety of procaine penicillin has not been established for more than 2 weeks of use. Consider an alternate treatment beyond 2 weeks.

Usual Adult Dose for Cutaneous Bacillus anthracis:

600,000 to 1,000,000 units/day IM

Although 5 to 10 days of treatment may be adequate for mild, uncomplicated cutaneous anthrax (naturally occurring or endemic exposures), the Centers for Disease Control and Prevention (CDC) recommend continuing therapy for 60 days if cutaneous anthrax occurs as a result of exposure to aerosolized Bacillus anthracis spores.

Usual Adult Dose for Neurosyphilis:

600,000 units/day IM for 10 to 15 days
Total dose: 6 to 9 million units

If compliance can be ensured, the CDC recommends: Procaine penicillin 2.4 million units IM once a day plus probenecid 500 mg orally 4 times a day for 10 to 14 days; may follow with penicillin G benzathine 2.4 million units IM once a week for up to 3 weeks

IV penicillin G is the recommended regimen for the treatment of neurosyphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Adult Dose for Tertiary Syphilis:

600,000 units/day IM for 10 to 15 days
Total dose: 6 to 9 million units

All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Adult Dose for Syphilis -- Latent:

Latent with a negative spinal fluid: 600,000 units/day IM for 8 days
Total dose: 4,800,000 units

Latent with positive or no spinal fluid examination: 600,000 units/day IM for 10 to 15 days
Total dose: 6 to 9 million units

The CDC recommends penicillin G benzathine as the drug of choice for the treatment of latent syphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Adult Dose for Syphilis -- Early:

Primary and secondary: 600,000 units/day IM for 8 days
Total dose: 4,800,000 units

The CDC recommends penicillin G benzathine as the drug of choice for the treatment of primary or secondary syphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Adult Dose for Diphtheria:

Adjunctive therapy with antitoxin: 300,000 to 600,000 units/day IM for 14 days; the CDC recommends 300,000 units/day IM for patients weighing 10 kg or less and 600,000 units/day IM for patients weighing more than 10 kg

Patients usually are not contagious 48 hours after starting therapy. Two consecutive negative cultures after treatment is completed should be obtained to confirm eradication of the organism.

Carrier state: 300,000 units/day IM

Follow-up cultures at least 2 weeks after treatment is completed are recommended. If positive, erythromycin and additional follow-up cultures are recommended.

Usual Adult Dose for Fusospirochetosis:

600,000 to 1,000,000 units/day IM

Usual Adult Dose for Rat-bite Fever:

600,000 to 1,000,000 units/day IM

Usual Adult Dose for Endocarditis:

Only in extremely sensitive infections: 600,000 to 1,000,000 units/day IM

Usual Pediatric Dose for Bacterial Infection:

The American Academy of Pediatrics (AAP) recommends 50,000 units/kg IM once a day for neonates and 25,000 to 50,000 units/kg/day IM in 1 or 2 divided doses (maximum adult dose 4.8 million units/day) for children older than 1 month of age.

Moderately severe to severe infections due to susceptible staphylococci in patients weighing less than 27 kg: 300,000 units/day IM

Usual Pediatric Dose for Streptococcal Infection:

Moderately severe to severe infections due to susceptible group A streptococci in patients weighing less than 27 kg: 300,000 units/day IM

Usual Pediatric Dose for Pneumonia:

Moderately severe (uncomplicated) infections due to susceptible pneumococci in patients weighing less than 27 kg: 300,000 units/day IM

Usual Pediatric Dose for Anthrax Prophylaxis:

25,000 units/kg IM every 12 hours

Duration: Anthrax prophylaxis should continue for 60 days. Safety of procaine penicillin has not been established for more than 2 weeks of use. Consider an alternate treatment beyond 2 weeks.

Usual Pediatric Dose for Congenital Syphilis:

Less than 32 kg: 50,000 units/day IM for 10 days

The CDC and AAP recommend readministration of the entire course of therapy if more than 1 day is missed.

Usual Pediatric Dose for Neurosyphilis:

Greater than 12 years: 600,000 units/day IM for 10 to 15 days
Total dose: 6 to 9 million units

If compliance can be ensured, the CDC recommends: Procaine penicillin 2.4 million units IM once a day plus probenecid 500 mg orally 4 times a day for 10 to 14 days; may follow with penicillin G benzathine 2.4 million units IM once a week for up to 3 weeks

IV penicillin G is the recommended regimen for the treatment of neurosyphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Pediatric Dose for Tertiary Syphilis:

Greater than 12 years: 600,000 units/day IM for 10 to 15 days
Total dose: 6 to 9 million units

All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Pediatric Dose for Syphilis -- Latent:

Greater than 12 years:
Latent with a negative spinal fluid: 600,000 units/day IM for 8 days
Total dose: 4,800,000 units

Latent with positive or no spinal fluid examination: 600,000 units/day IM for 10 to 15 days
Total dose: 6 to 9 million units

The CDC recommends penicillin G benzathine as the drug of choice for the treatment of latent syphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Pediatric Dose for Syphilis -- Early:

Greater than 12 years:
Primary and secondary: 600,000 units/day IM for 8 days
Total dose: 4,800,000 units

The CDC recommends penicillin G benzathine as the drug of choice for the treatment of primary or secondary syphilis. All patients should undergo clinical and serological testing every 6 months for 2 to 3 years.

Usual Pediatric Dose for Diphtheria:

Adjunctive therapy with antitoxin: The CDC recommends 300,000 units/day IM for patients weighing 10 kg or less and 600,000 units/day IM for patients weighing more than 10 kg. The AAP recommends 25,000 to 50,000 units/kg/day in 2 divided for 14 days with a maximum dose of 1.2 million units per day.

Patients usually are not contagious 48 hours after starting therapy. Two consecutive negative cultures after treatment is completed should be obtained to confirm eradication of the organism.

What other drugs will affect procaine penicillin?

Tell your doctor about all other medications you use, especially:

  • probenecid (Benemid);

  • a blood thinner such as warfarin (Coumadin);

  • a diuretic (water pill) such as furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDiuril, Hyzaar, Lopressor HCT, Vasoretic, Zestoretic), and others;

  • methotrexate (Rheumatrex, Trexall);

  • a tetracycline antibiotic, such as demeclocycline (Declomycin, Ledermycin), doxycycline (Adoxa, Doryx, Vibramycin, Periostat), minocycline (Minocin), or tetracycline (Ala-Tet, Sumycin, Tetracap); or

  • NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Motrin, Advil), diclofenac (Cataflam, Voltaren), etodolac (Lodine), indomethacin (Indocin), naproxen (Aleve, Naprosyn), meloxicam (Mobic), piroxicam (Feldene), and others.

This list is not complete and there may be other drugs that can interact with procaine penicillin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about procaine penicillin.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.03. Revision Date: 2012-06-12, 4:24:08 PM.

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