DOSAGE AND ADMINISTRATION
Do not inject into or near an artery or nerve. Injection into or near a nerve may result in permanent neurologic damage (see WARNINGS).
Penicillin G procaine (aqueous) is for intramuscular injection only.
Administer by DEEP INTRAMUSCULAR INJECTION in the upper, outer quadrant of the buttock (dorsogluteal) or the ventrogluteal site. In neonates, infants and small children, the midlateral aspect of the thigh may be preferable. Administration in the anterolateral thigh is not recommended due to the adverse effects observed (see WARNINGS section), and vascularity of this region. When doses are repeated, vary the injection site.
Because of the high concentration of suspended material in this product, the needle may be blocked if the injection is not made at a slow, steady rate.
Pneumonia (pneumococcal), moderately severe (uncomplicated): 600,000 to 1,000,000 units daily.
Streptococcal infections (Group A), moderately severe to severe tonsillitis, erysipelas, scarlet fever, upper respiratory tract, skin and soft tissue: 600,000 to 1,000,000 units daily for 10-day minimum.
Staphylococcal infections, moderately severe to severe: 600,000 to 1,000,000 units daily.
In pneumonia, streptococcal (Group A) and staphylococcal infections in pediatric patients under 60 pounds: 300,000 units daily.
Bacterial endocarditis (Group A streptococci) only in extremely sensitive infections: 600,000 to 1,000,000 units daily.
Penicillin G procaine is not recommended for prophylaxis against bacterial endocarditis. For prophylaxis against bacterial endocarditis in patients with congenital heart disease or rheumatic or other acquired valvular heart disease when undergoing dental procedures or surgical procedures of the upper respiratory tract, use penicillin V. For patients unable to take oral medications, aqueous penicillin G is recommended.
Primary, secondary, and latent with a negative spinal fluid in adults and pediatric patients over 12 years of age: 600,000 units daily for 8 days-total 4,800,000 units.
Late (tertiary, neurosyphilis, and latent syphilis with positive spinal-fluid examination or no spinal-fluid examination): 600,000 units daily for 10 to 15 days-total 6 to 9 million units.
Congenital syphilis under 70-lb. body weight: 50,000 units/kg/day for 10 days.
Yaws, Bejel, and Pinta: Treatment as for syphilis in corresponding stage of disease.
Diphtheria-adjunctive therapy with antitoxin: 300,000 to 600,000 units daily.
Diphtheria carrier state: 300,000 units daily for 10 days.
Anthrax-cutaneous: 600,000 to 1,000,000 units/day.
Anthrax-inhalational (post-exposure): 1,200,000 units every 12 hours in adults, 25,000 units per kilogram of body weight (maximum 1,200,000 unit) every 12 hours in children. The available safety data for penicillin G procaine at this dose would best support a duration of therapy of 2 weeks or less. Treatment for inhalational anthrax (post-exposure) must be continued for a total of 60 days. Physicians must consider the risks and benefits of continuing administration of penicillin G procaine for more than 2 weeks or switching to an effective alternative treatment.
Vincent's infection (fusospirochetosis): 600,000 to 1,000,000 units/day.
Erysipeloid: 600,000 to 1,000,000 units/day.
Streptobacillus moniliformis and Spirillum minus (rat-bite fever): 600,000 to 1,000,000 units/day.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.