In the United States, Bicillin C-R (an injectable suspension which 1.2 million units of
benzathine penicillin and 1.2 million units of procaine penicillin per 4 ml) is not recommended for treating syphilis, since it contains only half the recommended dose of benzathine penicillin. Medication errors have been made due to the confusion between Bicillin L-A & Bicillin C-R.[7] As a result, changes in product packaging have been made; specifically, the statement "Not for the Treatment of Syphilis" has been added in red text to both the Bicillin CR and Billin CR 900/300 syringe labels.[8]
Respiratory tract infections where compliance with oral treatment is unlikely
Alongside Pen V and Erythromycin, Bicillin C-R is used to treat
strep throat, given as one IM injection
At high doses procaine penicillin can cause seizures and CNS abnormalities due to procaine present in it.[citation needed]
Mechanism
It is a form of
penicillin which is a combination of
benzylpenicillin and the
local anaesthetic agent
procaine.[9] Following deep
intramuscular injection, it is slowly absorbed into the circulation and
hydrolysed to benzylpenicillin — thus it is used where prolonged low concentrations of benzylpenicillin are required.
^World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization.
hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.