Indications for BICILLIN L-A:
Susceptible infections, including mild to moderate upper respiratory strep infections, syphilis. Follow-up prophylaxis of rheumatic heart disease, acute glomerulonephritis.
Give by deep IM inj into upper outer quadrant of buttock; rotate inj sites. Upper respiratory Group A strep: 1.2 million units once. Syphilis (primary, secondary, latent): 2.4 million units once; (tertiary and neurosyphilis): 2.4 million units every 7 days for 3 doses. Rheumatic heart disease, acute glomerulonephritis: 1.2 million units once per month, or 600,000 units every 2 weeks.
Give by deep IM inj into upper outer quadrant of buttock or midlateral thigh; rotate inj sites. Upper respiratory Group A strep (<60 lbs): 300,000 to 600,000 units once; (>60 lbs): 900,000 units once. Congenital syphilis (<2yrs): 50,000 units/kg once; (≥2yrs): individualize.
BICILLIN L-A Contraindications:
Avoid intraarterial, intravascular, or intraneural injection.
Not for IV use. Do not admix with other IV solutions. Reports of inadvertent IV administration has been associated with cardiorespiratory arrest and death.
BICILLIN L-A Warnings/Precautions:
Not for IV use. Cephalosporin, imipenem, or other allergy: not recommended. Discontinue if severe cutaneous adverse reaction (eg, SJS, TEN, DRESS, AGEP) is suspected; consider alternative therapy. Asthma. Monitor renal and hematopoietic function in prolonged use. Elderly. Pregnancy. Nursing mothers.
BICILLIN L-A Classification:
BICILLIN L-A Interactions:
Potentiated by probenecid. May cause false (+) glucose test with Clinitest.
Rash, serum sickness, anaphylaxis, blood dyscrasias, neuropathy, nephropathy, inj site reactions; severe cutaneous adverse reactions.
Disposable syringe 600,000 or 1.2 million units/syr (1mL, 2mL)—10 (w. 1 or 1.5 inch needles); Disposable syringe 2.4million units/syr (4mL)—10 (w. 1.5 inch needles)