Bicillin C-R 1,200,000 unit/2 mL intramuscular syringe

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Medication name

Generic name:
Penicillin g benzathine/penicillin g procaine - injection

Pronunciation
(pen-ih-SILL-in G BEN-zuh-theen/pen-ih-SILL-in G PRO-cane)

Brand name(s)
Bicillin C-R

Warning

This medication must not be injected into a vein or mixed with solutions that will be injected into a vein.

Uses

This medication is used to treat a wide variety of bacterial infections. This medication is known as a long-acting natural penicillin antibiotic. It works by stopping the growth of bacteria.

This medication should not be used to treat sexually transmitted diseases (such as syphilis, gonorrhea).

How to use

See also Warning section.

This medication is given by injection into a large muscle as directed by your doctor.

The dosage is based on your medical condition and response to treatment. Children's dosage is also based on weight.

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

For the best effect, follow your doctor's directions for when to receive this antibiotic, and make sure to not miss any doses.

Continue to receive this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

Tell your doctor if your condition lasts or gets worse.

Side effects

Pain at the injection site, nausea, or vomiting may occur. If these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

  • severe pain/peeling skin at injection site
  • joint/muscle pain
  • headache
  • vision changes
  • fast/slow/pounding heartbeat
  • numbness/tingling of arms/legs
  • pain/redness/swelling of arms/legs
  • change in skin color near injection site or on arms/legs
  • uncontrolled movements
  • inability to move
  • signs of kidney problems (such as change in the amount of urine)
  • new signs of infection (such as sore throat that doesn't go away, fever)
  • easy bruising/bleeding
  • dark/cloudy urine
  • seizures
  • mental/mood changes (such as depression, agitation)

Get medical help right away if you have any very serious side effects, including:

  • chest pain
  • trouble speaking
  • fainting

This medication has rarely caused a very serious (possibly fatal) blood disorder (methemoglobinemia). This effect is more likely if you have breathing problems, certain diseases of the blood, or if you smoke (see also Precautions section). The symptoms of this disorder may occur within minutes to a couple of hours after using this medication. Stop using this medication and get medical help right away if you develop any symptoms of methemoglobinemia, including:

  • headache
  • confusion
  • dizziness
  • shortness of breath
  • tiredness
  • pale/bluish/gray skin
  • fast heartbeat

This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop:

  • diarrhea that doesn't stop
  • abdominal or stomach pain/cramping
  • blood/mucus in your stool

If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.

Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

  • rash
  • itching/swelling (especially of the face/tongue/throat)
  • severe dizziness
  • trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before using this medication, tell your doctor or pharmacist if you are allergic to it; or to penicillin or cephalosporin antibiotics; or to procaine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

  • kidney disease
  • breathing problems (such as asthma, bronchitis, emphysema, smoking history)
  • heart disease
  • certain blood disorders (G6PD deficiency, pyruvate kinase deficiency, hemoglobin-M disease, NADH-methemoglobin reductase deficiency)

Penicillin may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using penicillin before having any immunizations/vaccinations.

Older adults may be at greater risk for side effects while using this drug.

Newborns/infants may be at greater risk for side effects while using this drug.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

This drug passes into breast milk. Consult your doctor before breastfeeding.

Drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

A product that may interact with this drug is:

  • methotrexate

This medication may interfere with certain lab tests (such as certain urine glucose tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: seizures, confusion, mental/mood changes (such as agitation).

Notes

Do not share this medication with others.

Lab and/or medical tests (such as kidney function, complete blood count) may be done while you are using this medication. Keep all medical and lab appointments. Consult your doctor for more details.

Missed dose

It is important to get each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.

Storage

Store in the refrigerator between 36-46 degrees F (2-8 degrees C). Do not freeze. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Important note

HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

Information last revised August 2024.

Selected from NATIONAL DRUG DATA FILE (NDDF) data included with permission and copyrighted by First Databank, Inc., 2019. This copyrighted material has been downloaded from a licensed data provider.

The above information is intended to supplement, not substitute for, the expertise and judgment of your health care professional. You should consult your health care professional before taking any drug, changing your diet, or commencing or discontinuing any course of treatment.