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Bicillin C-R (Intramuscular)

Generic Name: penicillin g benzathine and penicillin g procaine (Intramuscular route)

pen-i-SIL-in G BEN-za-theen, pen-i-SIL-in G PROE-kane

Intramuscular route(Suspension)

Not for intravenous use. Do not inject intravenously or admix with other intravenous solutions. There have been reports of inadvertent intravenous administration of penicillin G benzathine which has been associated with cardiorespiratory arrest and death .

Commonly used brand name(s)

In the U.S.

  • Bicillin C-R
  • Bicillin CR 900/300

Available Dosage Forms:

  • Suspension

Therapeutic Class: Antibiotic

Pharmacologic Class: Penicillin, Natural

Uses for Bicillin C-R

Penicillin G benzathine and penicillin G procaine combination injection is used to treat moderate to severe bacterial infections (eg, infections of the upper respiratory tract, scarlet fever, erysipelas, skin and soft tissue infections, severe pneumonia and otitis media). This medicine is an antibiotic. It works by killing bacteria or preventing their growth.

This medicine is to be given only by or under the direct supervision of your doctor.

Before using Bicillin C-R

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of penicillin G benzathine and penicillin G procaine combination injection in children. Safety and efficacy have been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of penicillin G benzathine and penicillin G procaine combination injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Chlortetracycline
  • Cholera Vaccine, Live
  • Demeclocycline
  • Doxycycline
  • Lymecycline
  • Meclocycline
  • Methacycline
  • Minocycline
  • Oxytetracycline
  • Rolitetracycline
  • Sarecycline
  • Tetracycline

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy (eg, cephalosporin antibiotic), history of or
  • Asthma, history of—Use with caution. May increase risk for more side effects.
  • Glucose-6-phosphate dehydrogenase deficiency (G6PD) or
  • Heart problems or
  • Lung or breathing problems—Use with caution. May increase risk of having methemoglobinemia.
  • Kidney disease—Use with caution. The effects may be increased because of the slower removal of the medicine from the body.

Proper use of Bicillin C-R

This section provides information on the proper use of a number of products that contain penicillin g benzathine and penicillin g procaine. It may not be specific to Bicillin C-R. Please read with care.

A nurse or other trained health professional will give you this medicine in a medical facility. It is given as a shot into one of your muscles.

Precautions while using Bicillin C-R

It is very important that your doctor check your or your child's progress closely while receiving the medicine to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine may cause a serious allergic reaction, called anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

This medicine may cause a rare, but serious blood problem called methemoglobinemia. The risk may be increased in children younger than 6 months of age, elderly patients, or patients with certain inborn defects. It is more likely to occur in patients receiving too much of the medicine, but can also occur with small amounts. Check with your doctor right away if you or your child has the following symptoms after receiving this medicine: pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness.

Call your doctor if your symptoms do not improve or get worse.

This medicine may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop receiving this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues, or gets worse, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Bicillin C-R side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

  • Agitation
  • anxiety
  • back pain, sudden and severe
  • back, leg, or stomach pains
  • black, tarry stools
  • bleeding gums
  • blindness
  • bloating
  • bloody or cloudy urine
  • bluish color of the fingernails, lips, skin, palms, or nail beds
  • blurred vision
  • burning, tingling, numbness, or pain in the hands, arms, feet, or legs
  • chest pain or discomfort
  • chills
  • confusion
  • continuing ringing or buzzing or other unexplained noise in the ears
  • cough
  • dark urine
  • decreased frequency or amount of urine
  • diarrhea, watery and severe, which may also be bloody
  • difficult or painful urination
  • difficulty breathing
  • difficulty swallowing
  • dizziness or lightheadedness
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • euphoria
  • fainting
  • fast, pounding, or irregular heartbeat or pulse
  • feeling of discomfort
  • fever
  • general body swelling
  • headache
  • hearing loss
  • hives, itching, skin rash
  • increased blood pressure
  • increased thirst
  • joint swelling loss of appetite
  • lower back or side pain
  • muscle cramps, pain, stiffness, or spasms
  • muscle weakness, sudden and progressing
  • nausea
  • nosebleeds
  • pale skin
  • pinpoint red spots on the skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • seeing or hearing things that are not there
  • seizures
  • sensation of pins and needles
  • skin blisters
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stabbing pain
  • stomach cramps or tenderness
  • sudden decrease in the amount of urine
  • swelling of the face, fingers, or lower legs
  • swollen, painful, or tender lymph glands in the neck, armpit, or groin
  • tightness in the chest
  • tremors
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight loss
  • vomiting
  • weight gain
  • yellowing of the eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  • Bad unusual or unpleasant (after)taste
  • bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
  • change in taste
  • decreased interest in sexual intercourse
  • inability to have or keep an erection
  • increased sweating
  • loss in sexual ability, desire, drive, or performance
  • painful or prolonged erection of the penis
  • sleepiness or unusual drowsiness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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