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 |
| 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 | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for PENTIDS '200' (PENTIDS '200').
| Breastfeeding | Enters breast milk in low concentrations; M/P ratio approximately 0.2. Considered compatible with breastfeeding; monitor infant for rash, diarrhea, and potential sensitization. |
| 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 |
■ FDA Black Box Warning
No FDA black box warning exists for Penicillin G.
| Serious Effects |
Hypersensitivity to penicillins or any component of the formulation.
| 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. |
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| 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. |