Applies to penicillin g benzathine / procaine penicillin: intramuscular suspension.
Warning
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.
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
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]
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]
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
Onset of pseudomembranous colitis symptoms have been reported during or after antibacterial therapy.[Ref]
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]
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]
