on. Specific dosage adjustment recommendations are not available for penicillin G procaine.
Intermittent hemodialysis
Penicillin G is removed during hemodialysis.
ADMINISTRATION
Injectable Administration
For intramuscular administration only. NEVER administer intravenously.
Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.
Intramuscular Administration
No dilution or reconstitution necessary.
Shake well before use.
In adults: injection into the midlateral thigh or upper outer quadrant of the gluteus maximus is preferred.
In children and infants: injection into the midlateral muscles of the thigh is preferred. In infants and small children, the periphery of the upper outer quadrant of the gluteus maximus should be used only if necessary (e.g., in burn patients) in order to avoid injury to the sciatic nerve.
Aspirate prior to injection to avoid injection into a blood vessel.
STORAGE
Generic:
- Protect from freezing
- Refrigerate (between 36 and 46 degrees F)
Wycillin:
- Protect from freezing
- Refrigerate (between 36 and 46 degrees F)
CONTRAINDICATIONS / PRECAUTIONS
Viral infection
Penicillin G does not treat viral infection (e.g., common cold). Prescribing in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Patients should complete the full course of treatment, even if they feel better earlier.
Asthma, carbapenem hypersensitivity, cephalosporin hypersensitivity, penicillin hypersensitivity
Penicillin is contraindicated for use in patients with penicillin hypersensitivity. Penicillin should be used cautiously in patients with cephalosporin hypersensitivity or carbapenem hypersensitivity. Due its structural similarity to the cephalosporins and imipenem, these patients are more susceptible to cross-hypersensitivity reactions. Penicillin can cause a variety of hypersensitivity reactions ranging from mild rash to fatal anaphylaxis. Patients with allergies or allergic conditions including asthma may have a greater risk for hypersensitivity reactions to penicillins. Penicillin hypersensitivity has been reported by up to 10% of the population. Of the 10% with penicillin hypersensitivity, more than 80% do not have penicillin-specific IgE antibodies. It is suggested that patients experiencing penicillin hypersensitivity should not be re-challenged. However, one study eva luated the rate of penicillin resensitization in patients with a history of IgE-mediated penicillin allergy. Patients (n=53 adults) who had a negative penicillin skin test received 3 successive 10 day courses of penicillin V potassium (250 mg PO three times daily). Prior to each course, a penicillin skin test was done; skin tests were performed a minimum of 4 weeks after completing a course of penicillin. Forty-six patients completed the study and none developed a positive skin test to penicillin. Penicillin G procaine is contraindicated in any patient with a history of a procaine hypersensitivity reaction. Patients with a history of sensitivity can be given a test dose of procaine intradermally (0.1 ml of a 1—2% procaine solution); development of erythema, wheal, flare, or eruption indicates procaine sensitivity and penicillin G procaine preparations should not |
