For use in the treatment of severe infections caused by penicillin G-susceptible microorganisms when rapid and high penicillin levels are required such as in the treatment of septicemia, meningitis, pericarditis, endocarditis and severe pneumonia.

Adult:

Oral: Susceptible infections: 125-312 mg 4-6 hrly.

IM/IV: Susceptible infections: 0.6-3.6 g/day in 4-6 divided doses.

IV:

• Bacterial endocarditis: 7.2-12 g/day in divided doses.
• Intrapartum prophylaxis against group B Streptoccocal infection in neonates Initial: 3 g, followed by 1.5 g 4 hrly until delivery.
• Meningococcal meningitis; Pneumococcal meningitis: 2.4 g 4 hrly. Max: 18 g/day in meningococcal meningitis.

Child:

IV: Meningococcal meningitis, Pneumococcal meningitis: 

• Newborn infants: 100 mg/kg daily in 2 divided doses;
• 1-4 wk: 150 mg/kg daily in 3 divided doses;
• >1 mth to 12 yr: 180-300 mg/kg daily in 4-6 divided doses.

Parenteral: susceptible infections: 

• Newborn infants: 50 mg/kg daily in 2 divided doses;
• 1-4 wk: 75 mg/kg daily in 3 divided doses;
• >1 mth to 12 yr: 100 mg/kg daily in divided doses, not exceeding 4 g/day.

Administration

Should be taken on an empty stomach. Take with a full glass of water on an empty stomach 1 hr before or 2 hr after meals. Do not take acidic beverages within 1 hr of a dose.

Hypersensitivity to benzylpenicillin and other penicillins.

Nausea, vomiting, stomatitis, black or hairy tongue, rash, fever, serum-like sickness, convulsions, interstitial nephritis, haemolytic anaemia, granulocytopenia, agranulocytosis, leucopenia, thrombocytopenia

Overdose Effects

Symptoms: Agitation, confusion, asterixis, hallucinations, stupor, coma, multifocal myoclonus, seizures and encephalopathy, hyperkalaemia.

Management: Symptomatic and supportive treatment.

Patient with history of allergy esp β-lactam allergy and/or asthma, seizure disorder. Diabetic patients. Renal impairment. Pregnancy and lactation.

Pregnancy & Lactation

Pregnancy category B. Either animal-reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect that was not confirmed in controlled studies in women in the 1st trimester.

Lactation: Monitor electrolyte, hepatic, renal, cardiac and haematologic function; signs and symptoms of anaphylaxis during 1st dose.