Pfizerpen Side Effects

Generic Name: penicillin g potassium

Please note - some side effects for Pfizerpen may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

Side Effects of Pfizerpen - for the Consumer

Pfizerpen

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Pfizerpen:

Black or hairy tongue; exaggerated reflexes; mild diarrhea; nausea or vomiting; pain, swelling, or redness at the injection site; twitching.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; blood in stools or urine; changes in heartbeat; chest pain; chills; coma; convulsions; excessive sweating; extreme tiredness; fainting; fast heartbeat; fever; flushing with lightheadedness or fainting; hallucinations; itching; muscle pain; pale skin; pounding in the chest; rapid breathing; seizures; severe diarrhea; stomach pain/cramps; vaginal irritation or itching; vein swelling; worsening of skin lesions.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

Pfizerpen Side Effects - for the Professional

Pfizerpen

Penicillin is a substance of low toxicity but does have a significant index of sensitization. The following hypersensitivity reactions have been reported: skin rashes ranging from maculopapular eruptions to exfoliative dermatitis; urticaria; and reactions resembling serum sickness, including chills, fever, edema, arthralgia and prostration. Severe and occasionally fatal anaphylaxis has occurred.

Hemolytic anemia, leucopenia, thrombocytopenia, nephropathy, and neuropathy are rarely observed adverse reactions and are usually associated with high intravenous dosage. Patients given continuous intravenous therapy with penicillin G potassium in high dosage (10 million to 100 million units daily) may suffer severe or even fatal potassium poisoning, particularly if renal insufficiency is present. Hyperreflexia, convulsions, and coma may be indicative of this syndrome.

Cardiac arrhythmias and cardiac arrest may also occur. (High dosage of penicillin G sodium may result in congestive heart failure due to high sodium intake.)

The Jarisch-Herxheimer reaction has been reported in patients treated for syphilis.

Side Effects by Body System - for Healthcare Professionals

Hypersensitivity

Hypersensitivity reactions with penicillin are more common and more serious with intravenous therapy, but have also been reported with oral therapy. An initial sensitizing exposure is required to stimulate the production of antigen-specific IgE before clinical manifestations of hypersensitivity are seen on the second exposure. There are numerous "hidden" environmental or occupational exposures to penicillin including in utero exposure, breast milk exposure, and occupational exposure.

Hypersensitivity side effects have included rash, maculopapular rash, exfoliative dermatitis, pruritus, urticaria, laryngeal edema, fever, eosinophilia, hypersensitivity myocarditis, serum sickness-like reactions (chills, fever, edema, arthralgia, and prostration), severe or fatal anaphylaxis, shock, and death. Parenteral administration has been associated with allergic vasculitis, asthenia and pain. Hypersensitivity reactions including allergic vasculitis, pruritus, fatigue, asthenia, and pain have been temporally associated with parenteral penicillin G benzathine use. The Jarisch-Herxheimer reaction has been reported during syphilis treatment.

Nervous system

Neurologic side effects have included severe reactions with high dose penicillin therapy or in patients with renal dysfunction. These reactions include myoclonus, seizures, auditory and visual hallucinations, and decreased mentation. Neurologic reactions occur frequently in patients with renal dysfunction. Parenteral administration has also been associated with neurovascular reactions (including warmth, vasospasm, pallor, mottling, gangrene, numbness of the extremities, cyanosis of the extremities, and neurovascular damage), nervousness, neuropathy, headache, tremors, dizziness, somnolence, transverse myelitis, severe agitation, and coma. Aseptic meningitis has been reported.

Severe neurologic reactions are most often seen with penicillin doses of 18 to 80 million units daily. These reactions frequently abate after discontinuation of penicillin. In several cases, penicillin was restarted at a lower dose with no further sequelae. In one review, the authors found that cerebral spinal fluid (CSF) penicillin levels were higher in patients with seizures than in those without. CSF penicillin levels ranged from 12 to 61 units/mL in the seizure group with the highest CSF concentrations, compared to 7.8 units/mL in the group without seizures.

Gastrointestinal

Gastrointestinal side effects have included nausea, vomiting, and diarrhea. These side effects are more common with oral therapy. Pseudomembranous colitis may occur during or after therapy. Pancreatitis, intestinal necrosis, and blood in the stool have also been reported.

Psychiatric

Psychiatric side effects temporally associated with parenteral penicillin G benzathine have included nervousness, confusion, anxiety, and euphoria.

Hematologic

Hematologic side effects have included hemolytic anemia, anemia, leukopenia, thrombocytopenia, and lymphadenopathy.

Renal

Renal side effects associated with parenteral administration have included increased BUN and creatinine, renal failure, and nephropathy.

Cardiovascular

Cardiovascular side effects associated with parenteral administration have included cardiac arrest, hypotension, tachycardia, palpitations, pulmonary hypertension, pulmonary embolism, vasodilatation, vasovagal reaction, cerebrovascular accident, and syncope.

Local

Local side effects have included injection site reactions, including pain, inflammation, lump, abscess, necrosis, edema, hemorrhage, cellulitis, hypersensitivity, atrophy, ecchymosis, and skin ulcer. Neurovascular reactions including warmth, vasospasm, pallor, mottling, gangrene, numbness or cyanosis of the extremities, and neurovascular damage have also been reported.

Hepatic

Hepatic side effects have included increased SGOT, reversible hepatotoxicity, jaundice, and prolonged cholestasis.

A 28-year-old female developed jaundice, fever, epidermolysis, abnormal liver function tests, and cholestasis several days after receiving a single dose of penicillin intramuscularly. Her liver dysfunction continued for up to 18 months. She had taken acetaminophen concurrently but denied alcohol use.

Musculoskeletal

Musculoskeletal side effects associated with parenteral administration have included joint disorder, periostitis, exacerbation of arthritis, myoglobinuria, and rhabdomyolysis. Fibrosis of the quadriceps femoris and atrophy have been reported following repeated intramuscular injections into the thigh.

Respiratory

Respiratory side effects have included hypoxia, apnea, and dyspnea.

Ocular

Ocular side effects associated with parenteral administration have included blurred vision and blindness.

Genitourinary

Genitourinary side effects associated with parenteral administration have included neurogenic bladder, hematuria, proteinuria, impotence, and priapism.

Other

Other side effects have included fatigue, asthenia, pain, abnormal taste perception, tinnitus, and aggravation of existing disorders.

Metabolic

Metabolic side effects associated with intravenous penicillin G have included hypernatremia and hyperkalemia, especially in the presence of renal insufficiency. Severe or fatal hyperkalemia has occurred in patients receiving high doses (10 to 100 million units/day).

Dermatologic

Dermatologic side effects have included rash, peeling, mucosal ulceration, and urticaria. Diaphoresis has been associated with parenteral administration.

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