Benzathine penicillin ฉ ด im ม คราบเหล อ

Background: Regular intramuscular (i.m.) benzathine penicillin G (BPG) injections have been the cornerstone of rheumatic heart disease (RHD) secondary prophylaxis since the 1950s. Patient adherence to IM BPG is poor, largely due to pain, the need for regular injections every 3–4 weeks and health sector delivery challenges in resource-limited settings. There is an urgent need for new approaches for secondary prophylaxis, such as an implant which could provide sustained penicillin concentrations for more than 6 months. Methods: In this study we developed and evaluated a slow release implant with potential for substantially extended treatment. The side wall of a solid drug rich core was coated with polycaprolactone which acts as an impermeable barrier. The exposed surfaces at the ends of the implant defined the release surface area, and the in vitro release rate of drug was proportional to the exposed surface area across implants of differing diameter. The in vivo pharmacokinetics and tolerability of the implants were evaluated in a sheep model over 9 weeks after subcutaneous implantation. Results: The absolute release rates obtained for the poorly water-soluble benzathine salt were dependent on the exposed surface area demonstrating the impermeability of the wall of the implant. The implants were well-tolerated after subcutaneous implantation in a sheep model, without adverse effects at the implantation site. Gross structural integrity was maintained over the course of the study, with erosion limited to the dual-exposed ends. Steady release of penicillin G was observed over the 9 weeks and resulted in approximately constant plasma concentrations close to accepted target concentrations. Conclusion: In principle, a long acting BPG implant is feasible as an alternative to i.m. injections for secondary prophylaxis of RHD. However, large implant size is currently a significant impediment to clinical utility and acceptability.

• Benzathine penicillin G
• Dissolution, in vivo release
• Polycaprolactone
• Rheumatic heart disease
• Secondary prophylaxis, long acting implant
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Penicillin G benzathine injection is used to treat bacterial infections (eg, mild to moderate infections of the upper respiratory tract, syphilis, yaws, bejel, pinta). It is also used to prevent rheumatic fever, chorea, rheumatic heart disease, or acute glomerulonephritis. This medicine is an antibiotic. It works by killing bacteria or preventing their growth.

This medicine is to be given only by or under the direct supervision of your doctor.

This product is available in the following dosage forms:

• Suspension

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of penicillin G benzathine injection in children. Safety and efficacy have been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of penicillin G benzathine injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Chlortetracycline
• Cholera Vaccine, Live
• Demeclocycline
• Doxycycline
• Eravacycline
• Lymecycline
• Meclocycline
• Methacycline
• Minocycline
• Oxytetracycline
• Rolitetracycline
• Sarecycline
• Tetracycline
• Tigecycline

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy (eg, cephalosporin antibiotic), history of or
• Asthma, history of—Use with caution. May increase risk for more side effects.
• Kidney disease—Use with caution. The effects may be increased because of the slower removal of the medicine from the body.

Proper Use

A nurse or other trained health professional will give you this medicine in a medical facility. It is given as a shot into one of your muscles, usually in the upper buttock or hip area.

Missed Dose

This medicine needs to be given on a fixed schedule. If you miss a dose or forget to use your medicine, call your doctor or pharmacist for instructions.

It is very important that your doctor check your or your child's progress closely while receiving the medicine to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

This medicine may cause a serious allergic reaction, called anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you or your child has a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

This medicine may cause serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS), or acute generalized exanthematous pustulosis (AGEP). Check with your doctor right away if you or your child has black, tarry stools, blistering, peeling, loosening of the skin, chest pain, chills, cough, diarrhea, fever, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in them mouth or on the lips, swollen glands, trouble breathing, unusual bleeding or bruising, or unusual tiredness or weakness.

Call your doctor if your symptoms do not improve or get worse.

This medicine may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop receiving this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues, or gets worse, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine 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:

Incidence not known

1. Agitation
2. anxiety
3. back pain, sudden and severe
4. back, leg, or stomach pains
5. black, tarry stools
6. bleeding gums
7. blindness
8. bloating
9. bloody or cloudy urine
10. bluish color of the fingernails, lips, skin, palms, or nail beds
11. blurred vision
12. burning, tingling, numbness, or pain in the hands, arms, feet, or legs
13. chest pain or discomfort
14. chills
15. confusion
16. continuing ringing or buzzing or other unexplained noise in the ears
17. cough
18. dark urine
19. decreased frequency or amount of urine
20. diarrhea, watery and severe, which may also be bloody
21. difficult or painful urination
22. difficulty breathing
23. difficulty swallowing
24. dizziness or lightheadedness
25. dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
26. euphoria
27. fainting
28. fast, pounding, or irregular heartbeat or pulse
29. fever
30. general body swelling
31. general feeling of illness or discomfort
32. headache
33. hearing loss
34. hives, itching, skin rash
35. increased blood pressure
36. increased thirst
37. joint swelling loss of appetite
38. lower back or side pain
39. muscle cramps, pain, stiffness, or spasms
40. muscle weakness, sudden and progressing
41. nausea
42. nosebleeds
43. painful or difficult urination
44. pale skin
45. pinpoint red spots on the skin
46. puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
47. rigidity
48. seeing or hearing things that are not there
49. seizures
50. sensation of pins and needles
51. skin blisters
52. sore throat
53. sores, ulcers, or white spots on the lips or in the mouth
54. stabbing pain
55. stomach cramps or tenderness
56. sudden decrease in the amount of urine
57. sweating
58. swelling of the face, fingers, or lower legs
59. swollen, painful, or tender lymph glands in the neck, armpit, or groin
60. swollen glands
61. tightness in the chest
62. tremors
63. unusual bleeding or bruising
64. unusual tiredness or weakness
65. unusual weight loss
66. vomiting
67. weight gain
68. yellowing of the eyes or skin

Some side effects 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

1. Bad unusual or unpleasant (after)taste
2. 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
3. change in taste
4. decreased interest in sexual intercourse
5. inability to have or keep an erection
6. loss in sexual ability, desire, drive, or performance
7. painful or prolonged erection of the penis
8. sleepiness or unusual drowsiness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: April 01, 2023

Original article: https://www.mayoclinic.org/drugs-supplements/penicillin-g-benzathine-intramuscular-route/precautions/drg-20506360

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Benzathine Penicillin G เป็นยาฉีดหนึ่งจัดอยู่ในกลุ่มยาปฏิชีวนะใช้ในการรักษาโรคซิฟิลิส ที่สามารถรักษาซิฟิลิส ให้หายขาดได้ โดยรูปแบบยาที่ใช้ในการรักษามีหลากหลายบริษัทยา การฉีดยา Benzathine Penicillin G 2.4.

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