📋 Indications & Clinical Dosage
*Infections caused by some gram-positive and gram-negative organisms such as Neisseria, gonorrhea, endocarditis and meningococcal disease:*
BY IM OR IV INJ: Adults: 2-24 MIU per day in divided doses every 4 hr.
BY IM OR IV INJ: Children: 100,000 to 250,000 units/kg/day in divided doses every 4-6 hr. In severe infections, up to 400,000 units/ kg/day in divided doses every 4-6 hr; max 24 MIU/day.
*Neurosyphilis:*
BY IM OR IV INJ: Adults: 18-24 MIU/day in divided doses every 3-4 hr for 10-14 days.
💊 Mode of Administration
Administer by IV intermittent infusion over 15-60 min at a final concentration for administration of 100,000500,000 units/ml. A final concentration of 50,000 units/ml infused over 15-30 min is recommended for neonates and infants.
⛔ Contraindications
History of previous hypersensitivity reaction to penicillins and/or cephalosporins.
⚠️ Precautions & Warnings
Avoid small ineffective doses of penicillin as resistant organisms are more likely to emerge, therapy must be sufficient to eliminate the streptococcal organism (a minimum of ten days), otherwise the sequela of streptococcal disease (endocarditis, rheumatic fever) may occur. Serious fatal immediate hypersensitivity (anaphylactoid) reactions have been reported. Do not inject parenteral solutions into or near an artery or nerve
.4 MIU:
🔄 Drug Interactions
Concurrent administration of bacteriostatic anti-biotics (e.g. erythromycin, tetracycline) may diminish the bactericidal effects of penicillins. Probenecid prolongs penicillin blood levels. Oral contraceptives may be rendered less effective & an increased incidence of breakthrough bleeding may occur when administered with ampicillin or penicillin V
⚠️ Adverse Reactions / Side Effects
GI disturbances, anaemias, anaphylaxis, glossitis, stomatitis, gastritis, sore throat, dry mouth, furry tongue, Hemorrhagic manifestation, Interstitial nephritis (e.g oliguria, hematuria), nephrotoxicity. Accumulation of sodium from injection can occur in renal failure. High doses may causeneurotoxicity, including cerebral irritation, convulsions, orcoma.
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
No evidence of harm
Lactation / Breastfeeding:
Caution advised
🧪 Compatibility & Storage Stability
Compatibility: Sodium salts compatible in D5W, NS.
Stability & Storage: Penicillin potassium is stable at room temperature. Reconstituted solution is stable for 7 days when refrigerated at 2C-15C. Penicillin potassium for IV infusion in NS or D5W solution is stable for 24 hours at room temperature.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.