PENTIDS '200'
Clinical safety rating: caution
Comprehensive clinical and safety monograph for PENTIDS '200' (PENTIDS '200').
Penicillin G is a beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), thereby inhibiting transpeptidation and activating autolytic enzymes.
| Metabolism | Primarily metabolized in the liver by hydrolysis to penicilloic acid; also undergoes renal tubular secretion; t1/2 is approximately 30-60 minutes. |
| Excretion | Renal: 60-90% unchanged; biliary/fecal: 10-40% |
| Half-life | 0.5-1 hour; prolonged in renal impairment; anuric patients up to 10 hours |
| Protein binding | 60-80% bound primarily to albumin |
| Volume of Distribution | 0.3-0.4 L/kg; distributes into extracellular fluid, low CNS penetration |
| Bioavailability | Oral: 20-40% (due to acid lability); IM: 70-85% |
| Onset of Action | IM: 15-30 minutes; IV: immediate; Oral: 30-60 minutes |
| Duration of Action | IM: 4-6 hours; IV: 2-4 hours; Oral: 4-6 hours; dose-dependent |
| Molecular Weight | 388.48 |
| Action Class | Cell wall active agent - Narrow spectrum Penicillin |
| Brand Substitutes | Pencip 200000IU Tablet, Pentas 200 Tablet |
Penicillin G benzathine: 1.2 million units intramuscularly as a single dose.
| Dosage form | FOR SOLUTION |
| Renal impairment | For CrCl <10 mL/min: administer 50% of usual dose every 12-24 hours; for CrCl 10-50 mL/min: administer 75% of usual dose every 12-24 hours. |
| Liver impairment | No dose adjustment required for hepatic impairment. |
| Pediatric use | For body weight <27 kg: 300,000-600,000 units intramuscularly as a single dose; for body weight ≥27 kg: 900,000 units intramuscularly as a single dose. |
| Geriatric use | No specific adjustment; monitor renal function and reduce dose if CrCl <50 mL/min. |
| 1st trimester | Penicillin V crosses the placenta. Use only if clearly needed due to risk of maternal infection. Avoid in history of penicillin allergy. |
| 2nd trimester | Generally considered safe. Penicillin V is the drug of choice for many infections in pregnancy. Monitor for allergic reactions. |
| 3rd trimester | Safe for use. No known fetal harm. Adjust dose if renal impairment. |
Clinical note
Comprehensive clinical and safety monograph for PENTIDS '200' (PENTIDS '200').
| Placental transfer | Penicillin V crosses the placenta with fetal serum concentrations 5-50% of maternal levels. No known teratogenicity. |
| Breastfeeding | Penicillin V is excreted into breast milk in low amounts. No known adverse effects in nursing infants. Consider potential for allergic sensitization. |
■ FDA Black Box Warning
No FDA black box warning exists for Penicillin G.
| Serious Effects |
Hypersensitivity to penicillinsHistory of severe allergic reaction to beta-lactam antibiotics
| Precautions | Severe and occasionally fatal hypersensitivity reactions (anaphylaxis) have been reported. Use caution in patients with a history of allergies, asthma, or renal impairment. Prolonged use may result in bacterial or fungal superinfection. |
| Food/Dietary | Avoid acidic foods and beverages (e.g., citrus fruits, colas) for 1 hour before and after administration as they may reduce antibiotic absorption. No other significant food interactions. |
| Clinical Pearls |
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| Lactation Rating |
| L1 (Safe) |
| Teratogenic Risk | FDA Category B. No evidence of teratogenicity in animal studies. Inadequate human studies; theoretically low risk for major malformations. Caution recommended in first trimester. Possible risk of kernicterus in neonates if administered near term due to bilirubin displacement. |
| Fetal Monitoring | Monitor maternal renal function, hepatic function, and CBC. Assess for hypersensitivity reactions. In pregnancy, monitor for premature labor or fetal distress if used for streptococcal infections. No specific fetal monitoring required. |
| Fertility Effects | No known adverse effects on fertility. Penicillin is not associated with impairment of spermatogenesis or oogenesis. |
| PENTIDS '200' is a penicillin G procaine formulation. Administer deep IM only; inadvertent IV injection can cause severe neurovascular reactions. Always aspirate before injection. Monitor for procaine reactions (flushing, anxiety, seizures). Use with caution in renal impairment due to risk of neurotoxicity. |
| Patient Advice | Complete the full course even if you feel better. · Take on an empty stomach 1 hour before or 2 hours after meals for best absorption. · Report any severe diarrhea, rash, or difficulty breathing immediately. · This medication must be injected by a healthcare professional; do not attempt self-injection. · Inform your doctor if you have kidney problems or a history of allergies to penicillins or procaine. |