Drug Index

Procaine Penicillin

Mechanism :

It is a combination of procaine and penicillin, which has a longer duration of action than benzyl penicillin. It interferes with cell wall synthesis in susceptible bacteria. It is used in treatment of gram-positive infections. It is the drug of choice in Diphtheria, whooping cough, pneumonia, syphilis, gonorrhoea, scarlet fever, tetanus, gas gangrene, pneumococcal infections and rat bite fever. It causes anaphylactic reactions leading to shock and death and hence hypersensitivity testing always needs to be done before giving full dose.

Indication :

  • Group A Streptococcal infections
  • Congenital syphilis
  • Fusobacterium
  • Anthrax
  • Diphtheria
  • Syphilis, pinta and bejel
  • Rat bite fever

Contraindications :

Hypersensitivity to drug/class/component & ester anesthetics.

IV administration, Anaphylactic reactions to beta-lactams, Endocarditis prophylaxis use.

Dosing :

<2 kg:
50,000 units/kg IM OD.
2-27 kg:
300,000 units IM OD for 10-14 days or 25,000-50,000 units/kg/day IM divided every 12-24 hours.
>27 kg:
600,000 to 1.2 million units IM once daily.
Duration: Give for 10 days for Group A streptococcal infections, congenital syphilis, Fusobacterium infections, diphtheria, rat bite fever. Give for 60 days for inhalational anthrax. May switch to oral penicillin where feasible.

Adverse Effect :

Anaphylaxis. Procaine in the mixture causes allergic reactions, myocardial depression and systemic vasodilation. Other side effects that may be seen are interstitial nephritis and hemolytic anemia.

Interaction :

OATP1B1 substrate: Alters GI flora, antiplatelet effects, bactericidal activity requires, bacterial growth, lowers seizure threshold.
BCG live intravesical.
Avoid/Use Alternative:
Typhoid vaccine, live.

Hepatic Dose :

No dosage adjustments are recommended.
01/28/2024 15:47:33 Procaine Penicillin
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