Penicillin G Benzathine / Procaine Penicillin Side Effects
Medically reviewed by Drugs.com. Last updated on Apr 12, 2024.
Applies to penicillin g benzathine / procaine penicillin: intramuscular suspension.
Important warnings
This medicine can cause some serious health issues
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.
Precautions
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 and urine 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 or your child has 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 serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), or acute generalized exanthematous pustulosis (AGEP). Check with your doctor right away if you or your child has black, tarry stools, blistering, peeling, loosening of the skin, chest pain, chills, cough, diarrhea, fever, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in them mouth or on the lips, swollen glands, trouble breathing, unusual bleeding or bruising, or unusual tiredness or weakness.
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 pale, gray, or blue-colored skin, lips, or nails, confusion, headache, lightheadedness, fast heartbeat, or unusual tiredness or weakness after receiving this medicine.
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.
Serious side effects
Along with its needed effects, penicillin g benzathine/procaine penicillin 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 while taking penicillin g benzathine / procaine penicillin:
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
- painful or difficult urination
- 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
- swollen glands
- 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
Other side effects
Some side effects of penicillin g benzathine / procaine penicillin 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
For healthcare professionals
Applies to penicillin g benzathine / procaine penicillin: intramuscular suspension.
Psychiatric adverse events
- Frequency not reported: Hoigne's syndrome (including severe agitation with confusion, visual and auditory hallucinations, fear of impending death, psychosis)
Parenteral Penicillin G Benzathine:
- Frequency not reported: Nervousness, confusion, anxiety, euphoria[Ref]
Hoigne's syndrome, characterized by various central nervous system symptoms (e.g., severe agitation with confusion, visual and auditory hallucinations, fear of impending death), has been reported after use of procaine penicillin, and less commonly, after use of this drug. Other symptoms associated with this syndrome have included psychosis, seizures, dizziness, tinnitus, cyanosis, palpitations, tachycardia, and abnormal taste perception.[Ref]
Nervous system
- Frequency not reported: Symptoms associated with Hoigne's syndrome (including seizures, dizziness, tinnitus, abnormal taste perception)
Parenteral Penicillin G:
- Frequency not reported: Neuropathy
Parenteral Penicillin G Benzathine:
- Frequency not reported: Headache, tremors, dizziness, somnolence, transverse myelitis, seizures, coma, vasovagal reaction, cerebrovascular accident, syncope[Ref]
Cardiovascular
- Frequency not reported: Symptoms associated with Hoigne's syndrome (including cyanosis, palpitations, tachycardia)
Parenteral Penicillin G Benzathine:
- Frequency not reported: Cardiac arrest, hypotension, tachycardia, palpitations, vasodilation[Ref]
Hypersensitivity
Parenteral Penicillin G:
- Frequency not reported: Hypersensitivity reactions (including skin eruptions [maculopapular to exfoliative dermatitis], urticaria, laryngeal edema, fever, eosinophilia, other serum sickness-like reactions [including chills, fever, edema, arthralgia, prostration], anaphylaxis [including shock, death])
Parenteral Penicillin G Benzathine:
- Frequency not reported: Hypersensitivity reactions (including allergic vasculitis, pruritus, fatigue, asthenia, pain)[Ref]
Gastrointestinal
Parenteral Penicillin G:
- Frequency not reported: Clostridium difficile-associated diarrhea, pseudomembranous colitis
Parenteral Penicillin G Benzathine:
- Frequency not reported: Nausea, vomiting, blood in stool, intestinal necrosis[Ref]
Onset of pseudomembranous colitis symptoms have been reported during or after antibacterial therapy.[Ref]
Renal
Parenteral Penicillin G:
- Frequency not reported: Nephropathy
Parenteral Penicillin G Benzathine:
- Frequency not reported: Elevated BUN, elevated creatinine, renal failure[Ref]
Hematologic
Parenteral Penicillin G:
- Frequency not reported: Hemolytic anemia, leukopenia, thrombocytopenia
Parenteral Penicillin G Benzathine:
- Frequency not reported: Lymphadenopathy[Ref]
Local
Parenteral Penicillin G Benzathine:
- Frequency not reported: Injection site reactions (including pain, inflammation, lump, abscess, necrosis, edema, hemorrhage, cellulitis, hypersensitivity, atrophy, ecchymosis, skin ulcer), neurovascular reactions (including warmth, vasospasm, pallor, mottling, gangrene, numbness of the extremities, cyanosis of the extremities, neurovascular damage)[Ref]
Respiratory
Parenteral Penicillin G Benzathine:
- Frequency not reported: Hypoxia, apnea, dyspnea, pulmonary hypertension, pulmonary embolism[Ref]
Hepatic
Parenteral Penicillin G Benzathine:
- Frequency not reported: Elevated AST[Ref]
Musculoskeletal
Parenteral Penicillin G Benzathine:
- Frequency not reported: Joint disorder, periostitis, myoglobinuria, rhabdomyolysis, exacerbation of arthritis[Ref]
Ocular
Parenteral Penicillin G Benzathine:
- Frequency not reported: Blurred vision, blindness[Ref]
Genitourinary
Parenteral Penicillin G Benzathine:
- Frequency not reported: Neurogenic bladder, hematuria, proteinuria, impotence, priapism[Ref]
Other
Parenteral Penicillin G Benzathine:
- Frequency not reported: Aggravation of existing disorder[Ref]
Dermatologic
Parenteral Penicillin G Benzathine:
- Frequency not reported: Diaphoresis[Ref]
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References
1. (2009) "Product Information. Bicillin C-R 900/300 (benzathine penicillin-procaine penicillin)." Wyeth Laboratories
2. (2017) "Product Information. Bicillin C-R (benzathine penicillin-procaine penicillin)." A-S Medication Solutions
More about penicillin g benzathine / procaine penicillin
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Other brands
Bicillin C-R, Bicillin C-R 900/300
Professional resources
Other brands
Bicillin C-R, Bicillin C-R 900/300
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Further information
Penicillin g benzathine/procaine penicillin side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.