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penicillin G aqueous (Rx)Brand and Other Names:Pfizerpen, penicillin G potassium, more...penicillin G sodium, Crystapen

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

premixed injectable solution

  • 1 million units/50mL
  • 2 million units/50mL
  • 3 million units/50mL

potassium, powder for injectable solution

  • 5 million units/vial
  • 20 million units/vial

sodium, powder for injectable solution

  • 5 million units/vial
more...

Meningococcal Meningitis/Septicemia

20-30 million units/day IV continuous infusion x14 days or afebrile x7days, OR

200,000-300,000 units/kg/day IV divided q2-4hr x24 doses

Actinomycosis

Cervicofacial cases: 1-6 million units/day IV

Thoracic and abdominal disease: 10-20 million units/day IV divided q4-6hr x 6 weeks, may follow with penicillin V

Botulism

Adjunctive to antitoxin: 20 million units/day IV divided q4-6hr

Vincent’s Infection (fusospirochetosis)

5-10 million units/day IV divided q4-6hr

Rat-Bite Fever

Indicated for Streptobacillus moniliformis and Spirillum minus (rat-bite fever)

12-20 million units/day IV divided q4-6hr x3-4 weeks

Listeria Infections

Meningitis: 15-20 million units/day IV divided q4-6hr x2 weeks

Endocarditis: 15-20 million units/day IV divided q4-6hr x4 weeks

Pasteurella Infections

Bacteremia or meningitis: 4-6 million units/day IV divided q4-6hr x2 weeks

Erysipeloid

Endocarditis: 12-20 million units/day IV divided q4-6hr x4-6 weeks

Diphtheria

Adjunct to antitoxin or to prevent carrier state: 2-3 million units/day IV divided q4-6hr x10-12 days

Anthrax

Minimum: 5 million units/day IV

12-20 million units/day IV have been used

Streptococcal Infections

Empyema, pneumonia, pericarditis, endocarditis, meningitis: 5-24 million units/day IV divided q4-6hr

Syphilis

Neurosyphilis: 18-24 million units/day IV x10-14 days

Streptococcal Group B Infection

Prophylaxis: 5 million units IV at the onset of labor or after membrane rupture followed by 2.5 million units IV q4hr until delivery

Lyme Disease (Off-label)

200,000-300,000 units/kg/day IV x 10-14 days

Renal Impairment

CrCl 10-50 mL/min: Decrease dose by 25%

CrCl <10 mL/min: Decrease dose by 50-70%

Hemodialysis: Removed by hemodialysis; administer after dialysis

Dosage Forms & Strengths

premixed injectable solution

  • 1 million units/50mL
  • 2 million units/50mL
  • 3 million units/50mL

potassium, powder for injectable solution

  • 5 million units/vial
  • 20 million units/vial

sodium, powder for injectable solution

  • 5 million units/vial
more...

Neonatal Bacterial Infection General Dosing Guidlines

<7 days & <2000 g: 50,000 units/kg/day IV divided q12hr  

<7 days & >2000 g: 75,000 units/kg/day IV divided q8hr

>7 days & <1200 g: 50,000 units/kg/day IV divided q12hr

>7 days & 1200-2000 g: 75,000 units/kg/day IV divided q8hr

>7 days & >2000 g: 100,000 units/kg/day IV divided q6hr

Infant & Children Bacterial Infection General Dosing Guidelines

Moderate Infection: 25,000-50,000 units/kg/day IV/IM divided q6hr  

Severe Infection: 250,000-400,000 units/kg/day IV/IM divided q4-6hr

Not to exceed 24 million units/day

Meningitis

Neonates <7 days & <2000 g: 100,000 units/kg/day IV divided q12hr 

Neonates <7 days & >2000 g: 150,000 units/kg/day IV divided q8hr

Neonates >7 days & <1200 g: 100,000 units/kg/day IV divided q12hr

Neonates >7 days & 1200-2000 g: 150,000 units/kg/day IV divided q8hr

Neonates >7 days & >2000 g: 200,000 units/kg/day IV divided q6hr

Infants & Children: 250,000-400,000 units/kg/day IV divided q4hr; not to exceed 24 million units/day

Group B Streptococcal Meningitis

Neonates <7 days: 250,000-450,000 units/kg/day IV divided q8hr 

Neonates >7 days: 450,000 units/kg/day IV divided q6hr

Congenital Syphilis

Neonates <7 days: 100,000 units/kg/day IV divided q12hr 

Neonates >7 days: 150,000 units/kg/day IV divided q8hr

Endocarditis

Infants and Children <45 kg: 250,000 units/kg/day IV divided q4hr 

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Interactions

Interaction Checker

penicillin G aqueous and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Seizure

            Anemia

            Interstitial nephritis

            Hypersensitivity

            Anaphylaxis

            Jarisch-Herxheimer reaction

            Positive Coombs' reaction

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            Warnings

            Contraindications

            Allergy to penicillins, cephalosporins, imipenem

            Cautions

            Renal/hepatic impairment: reduce dose based on severity of impairment

            Clostridium difficile associated with diarrhea (CDAD) ranging from mild diarrhea to fatal colitis; may occur over 2 months after the administration of antibacterial agents; may need to discontinue penicillin if CDAD is suspected or confirmed

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Half-Life: 20-50 min (ESRD 3-5 hr)

            Peak Plasma Time: IM 30 min, IV 1 hr

            Protein Bound: 65%

            Distribution: crosses placenta, poor blood brain barrier diffusion

            Metabolism: hepatic to active metabolites

            Excretion: urine

            Mechanism of Action

            Interferes with synthesis of cell wall mucopeptide during active multiplication, resulting in bactericidal activity against susceptible microorganisms.

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            Administration

            IV Incompatibilities

            Additive: floxacillin, quinidine

            Syringe: heparin

            Y-site: aminophylline, cefamandole, cefazolin(?), heparin, Na bicarb

            IV Compatibilities

            Additive: dobutamine, lidocaine, KCl, procainamide, propafenone, verapamil

            Y-site: cefazolin(?), clarithromycin, dobutamine, dopamine, erythromycin, gentamicin, lidocaine, morphine, norepinephrine, KCl, vancomycin

            IV Preparation

            Rapid loading: 150 mg/100 mL D5W (1.5 mg/mL)

            Slow infusions: 900 mg/500 mL D5W (1.8 mg/mL)

            IV Administration

            If infusion >2 hr: use glass or polyolefin bottles

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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