Uses of Benzapen: - Bacterial infections - Syphilis - Prevention of rheumatic fever Anthrax, Group A Strep. infections, Neurosyphilis, Fusobacterium infections, Diphtheria, Erysipeloid, Uncomplicated pneumococcal pneumonia, Rat bite fever, Rheumatic fever, Syphilis, Streptococcal pharyngitis Hypersensitivity to penicillins or cephalosporins. IM inj (ischaemic reactions may occur).

Long acting penicillin

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

How to use Benzathine Penicillin: Your doctor or nurse will give you this medicine. Kindly do not self administer. Adult Dose: Adult: IM: 0.3 to 1.2 million units up to 2.4 million units as a single dose repeated every five to seven days. Specific dosage schedule: Treatment of group-A beta-haemolytic streptococcal infections: A single intramuscular dose of 600,000 units. Prevention of rheumatic fever: Monthly injection of a single dose of 1.2 million units is the most effective regimen for preventing further attacks of rheumatic fever. Treatment of acute otitis media: A single injection of 600,000 units. Treatment of syphilis: Early syphilis- 2.4 million units as a single dose. Late syphilis- 2.4 million units weekly for three successive weeks. Neurosyphilis- Benzylpenicillin, intravenously, 2 to 4 million units every 4 hours for 10 days, followed by benzathine penicillin intramuscularly, 2.4 million units weekly for three successive weeks. Congenital syphilis: Asymptomatic infants with normal cerebrospinal fluid, intramuscularly 50,000 units per kg in a single dose. Primary and secondary syphilis have been treated with single injections of 2.4 million units of long acting benzathine penicillin (Benzapen) weekly for 2 to 4 weeks with satisfactory results. Child Dose: Child: IM 50,000 U/kg for newborns and infants, Child: IM 50,000 U/kg for newborns and infants, children <60 lb: 300,000–600,000 U, children >60 lb: 900,000 U 1 dose for treatment

Probenecid prolongs T1/2 of benzathine benzylpenicillin. Bacteriostatic drugs e.g. chloramphenicol, tetracyclines; other antibacterials; anticoagulants.

Hypersensitivity to penicillins or cephalosporins. IM inj (ischaemic reactions may occur).

Common - Rash - Allergic reaction - Injection site reactions (pain, swelling, redness) Hypersensitivity reactions including uticaria; fever; joint pains; rashes; angioedema; serum sickness-like reactions; haemolytic anaemia; interstitial nephritis; neutropenia; thrombocytopenia; CNS toxicity including convulsions; diarrhoea; antibiotic-associated colitis. Potentially Fatal: Anaphylaxis

Pregnancy category B. Benzathine Penicillin should not be administered during pregnancy unless in the judgment of the physician such administration is clinically justifiable. Special care should be taken in the first three months of pregnancy.As penicillin appears in breast milk, it is probably best for a mother to stop breast-feeding while being given penicillin to avoid exposing the infant to the drug unnecessarily.

Precaution: Very high doses in poor renal function (risk of neurotoxicity) or heart failure. Avoid contact, skin sensitization may occur. Monitor serum potassium concentration, renal and haematological status. Spirochete infections particularly syphilis; suprainfection with penicillin-resistant organisms with prolonged use; avoid intrathecal route. Lactation: Excreted into breast milk, caution advised

Store between 2-8°C. Do not freeze.

Long acting penicillin

Benzathine benzylpenicillin has the same antimicrobial action as benzylpenicillin which exerts its bactericidal action on growing and dividing bacteria by inhibiting bacterial cell wall synthesis. IM admin results in a prolonged effect, but because of its relatively low blood concentrations, its use should be restricted to microorganisms that are highly susceptible to it.

Pregnancy Category: B Lactation: Excreted into breast milk, caution advised