Everything You Need to Know About Penicillin Allergies
Penicillin allergies are common and often go away on their own. Learn how healthcare providers test for penicillin allergies and what alternative antibiotics you can take.
Bicillin L-A
Used for Bacterial Infection, Ear Infection, Pneumonia, Skin Infection, Upper Respiratory Infection
Used for Bacterial Infection, Ear Infection, Pneumonia, Skin Infection, Upper Respiratory Infection
Bicillin L-A (penicillin G benzathine) is a medication used to treat a variety of bacterial infections including syphilis and strep throat. It's an antibiotic shot that's injected into your muscle (intramuscular). Depending on what you need it for, you might only need to receive it once. People of all ages can receive this antibiotic from a healthcare professional (HCP) at a hospital or clinic. The most common side effect is pain at the site of the injection.
What is Bicillin L-A (penicillin G benzathine)?
What is Bicillin L-A (penicillin G benzathine) used for?
- Certain upper respiratory tract infections like strep throat
- Syphilis
- Syphilis-like infections: bejel, yaws, and pinta
- Prevention of rheumatic fever and kidney damage
How Bicillin L-A (penicillin G benzathine) works
Bicillin L-A (penicillin G benzathine) is a penicillin antibiotic. It kills bacteria by preventing them from making their own protective covering.
After it's injected into the muscle, this form of penicillin releases very slowly over many days, so it can be given less frequently or even as a single dose.
Drug facts
| Common Brands | Bicillin L-A |
|---|---|
| Drug Class | Penicillin antibiotic |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Bicillin L-A (penicillin G benzathine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Pain at the injection site
Less Common Side Effects
- Nerve problems
- Kidney problems
- Headache
- Fast heart rate
- Fainting or dizziness
- Nausea
- Vomiting
- Joint problems
- Nervousness
- Breathing problems
- Sweating
- Blurred vision
- Bladder problems
Bicillin L-A (penicillin G benzathine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reaction: trouble breathing, itchiness, hives, fast heart rate
- Severe skin reaction: rash, fever, unexplained blisters, skin peeling, sores inside your mouth
When do Bicillin L-A (penicillin G benzathine) possible side effects begin and end?
Time passed since treatment started:
M
H
D
W
M
Injection site pain
The following Bicillin L-A (penicillin G benzathine) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Stop taking this medicine and get emergency help immediately if any of the following effects occur:
Less common
Fast or irregular breathing
joint pain
lightheadedness or fainting (sudden)
puffiness or swelling around the face
red, scaly skin
shortness of breath
Check with your doctor immediately if any of the following side effects occur:
Rare
Abdominal or stomach cramps and pain (severe)
abdominal tenderness
convulsions (seizures)
decreased amount of urine
diarrhea (watery and severe), which may also be bloody
mental depression
pain at place of injection
sore throat and fever
unusual bleeding or bruising
yellow eyes or skin
Rare
For penicillin G procaine only
Agitation or combativeness
confusion
fear of impending death
feeling, hearing, or seeing things that are not real
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
$2522.01
GoodRx discount
$2331.14
Pros and cons of Bicillin L-A (penicillin G benzathine)
Pros
- First-choice antibiotic for syphilis
- Might only need a single dose for treatment
- A good choice if you can't take medications by mouth
Cons
- Only available as a deep muscle injection, usually in the buttock or thigh
- Typically needs to be given in a hospital or clinic
- Can cause diarrhea like most other antibiotics
Pharmacist tips for Bicillin L-A (penicillin G benzathine)
- Bicillin L-A (penicillin G benzathine) is injected deep into the upper, outer part of the buttock muscle or in the thigh.
- Pain at the injection site is a common side effect of Bicillin L-A (penicillin G benzathine). To minimize pain, try either a warm compress or ice pack to soothe the area. If the pain is severe, or if you experience swelling or nerve issues, let your prescriber know.
- It's normal to have diarrhea from Bicillin L-A (penicillin G benzathine). Tell your prescriber if the diarrhea doesn't go away, if it becomes watery or bloody, or if it causes stomach cramping.
- If you're taking Bicillin L-A (penicillin G benzathine) for syphilis, you might feel a reaction to the treatment with symptoms including fever, headache, muscle pain. This is a normal sign that the antibiotic is killing the syphilis bacteria, and should go away within a few hours. Your prescriber might recommend some acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to help with this.
- It's very important to tell your prescriber if you have had an allergic reaction to an antibiotic because serious allergic reactions have occurred in people who received Bicillin L-A (penicillin G benzathine). These reactions include trouble breathing, hives, and fast heart rate.
- If you need more than one dose of Bicillin L-A (penicillin G benzathine), make sure you make it to all your appointments to receive the injection. If you miss it, your infection can come back and become harder to treat.
Risks and warnings for Bicillin L-A (penicillin G benzathine)
Bicillin L-A (penicillin G benzathine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Deep muscle injection only
You should only receive an injection of Bicillin L-A (penicillin G benzathine) deep into a large muscle. The medication should never be injected directly into a vein or mixed with other medications through the vein, as this can cause serious injury and possibly death. The safest places to receive an injection are the upper, outer part of the buttock or the thigh. Injecting it in those areas helps to avoid accidentally placing the medication in an artery or nerve, which can lead to serious harm. Let your prescriber know if you experience unusual pain or swelling after a Bicillin L-A (penicillin G benzathine) injection.
Severe allergic reaction (anaphylaxis)
- Risk factors: History of allergy to penicillin or cephalosporin antibiotics | History of allergies | History of asthma
If you've had a serious allergic reaction from taking penicillin-type or cephalosporin antibiotics, such as trouble breathing, or swelling in your face and neck, let your prescriber know before taking this medication. Bicillin L-A (penicillin G benzathine) might not be right for you and your HCP might prescribe another antibiotic. If you experience those allergy symptoms after starting Bicillin L-A (penicillin G benzathine), seek medical attention right away. Serious allergic reactions, called anaphylaxis, are rare but can be life-threatening.
Severe skin reactions
Although rare, you can get a really bad, potentially life-threatening skin reaction from penicillin-type antibiotics like Bicillin L-A (penicillin G benzathine). These are types of allergic rashes that are painful and create blisters all over the body. Get medical help right away if you notice a new rash, have a rash and a fever, unexplained blisters, skin peeling, or new sores inside your mouth.
Severe diarrhea
- Risk factors: Taking Bicillin L-A (penicillin G benzathine) for a long time | Recent use of other antibiotics
In rare cases, taking antibiotics like Bicillin L-A (penicillin G benzathine) can raise your chance of getting a serious bacterial infection that causes severe diarrhea. This can happen up to 2 or more months after you finish taking antibiotics. If you develop severe diarrhea with watery stools after you finish the medication, let your prescriber know.
Bicillin L-A (penicillin G benzathine) dosage
The average cost for 1 package of 10 syringes of 1.2 million units per 2ml of Bicillin L-A (penicillin G benzathine) is $4,019.25 with a free GoodRx coupon. This is 10.14% off the average retail price of $4,472.68. 
Package
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10 pediatric syringes of 600000 units per ml | 1 package | $2,331.14 | $2,331.14 |
| 10 syringes of 1.2 million units per 2ml | 1 package | $4,019.25 | $4,019.25 |
| 10 syringes of 2.4 million units per 4ml | 1 package | $6,068.36 | $6,068.36 |
Typical dosage for Bicillin L-A (penicillin G benzathine)
Upper respiratory tract infections (e.g., strep throat):
- Adults: The typical dose is 1,200,000 units injected into the muscle once as a single dose.
- Older children: The typical dose is 900,000 units injected into the muscle once as a single dose.
- Children under 60 lbs: The typical dose is 300,000 to 600,000 units injected into the muscle once as a single dose.
Syphilis:
- Adults with earlier stages of syphilis: The typical dose is 2,400,000 units injected into the muscle once as a single dose.
- Adults with later stages of syphilis: The typical dose is 2,400,000 units injected into the muscle every 7 days for 3 doses.
- Children who were born with syphilis: Your child's pediatrician will determine the right dose based on their weight.
Yaws, bejel, or pinta: The typical dose is 1,200,000 units injected into the muscle once as a single dose.
Prevention of rheumatic fever and kidney damage: The typical dose is 1,200,000 units injected into the muscle once a month OR 600,000 units every 2 weeks.
Interactions between Bicillin L-A (penicillin G benzathine) and other drugs
Bicillin L-A (penicillin G benzathine) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Bicillin L-A (penicillin G benzathine). Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alfentanil
- Amifampridine
- Amiodarone
- Avapritinib
- Axitinib
- Benzhydrocodone
- Brigatinib
- Buprenorphine
- Bupropion
- Capmatinib
- Chlortetracycline
- Cholera Vaccine, Live
- Clarithromycin
- Codeine
- Cyclosporine
- Daclatasvir
- Darunavir
- Deflazacort
- Demeclocycline
- Desogestrel
- Dienogest
- Dihydrocodeine
- Donepezil
- Doxorubicin
- Doxorubicin Hydrochloride Liposome
- Doxycycline
- Dronedarone
- Drospirenone
- Elbasvir
- Encorafenib
- Entrectinib
- Eravacycline
- Erdafitinib
- Estradiol
- Ethinyl Estradiol
- Ethynodiol
- Etonogestrel
- Fedratinib
- Fentanyl
- Gestodene
- Glasdegib
- Grazoprevir
- Hemin
- Hydrocodone
- Lefamulin
- Lemborexant
- Levonorgestrel
- Lorlatinib
- Lumateperone
- Lurbinectedin
- Lymecycline
- Meclocycline
- Medroxyprogesterone
- Meperidine
- Mestranol
- Methacycline
- Methadone
- Methotrexate
- Minocycline
- Mycophenolate Mofetil
- Neratinib
- Nifedipine
- Nomegestrol
- Norelgestromin
- Norethindrone
- Norgestimate
- Norgestrel
- Olaparib
- Omadacycline
- Oxycodone
- Oxytetracycline
- Pemigatinib
- Pentazocine
- Perampanel
- Piperaquine
- Pretomanid
- Rimegepant
- Rolitetracycline
- Sarecycline
- Segesterone
- Selpercatinib
- Selumetinib
- Simeprevir
- Sufentanil
- Sulfasalazine
- Tacrolimus
- Tazemetostat
- Tetracycline
- Tigecycline
- Tramadol
- Ubrogepant
- Ulipristal
- Vancomycin
- Vecuronium
- Velpatasvir
- Venetoclax
- Venlafaxine
- Voclosporin
- Voxelotor
- Voxilaprevir
- Warfarin
- Zanubrutinib
How much does Bicillin L-A (penicillin G benzathine) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Bicillin L-A (brand)
$2,331.14
Bicillin L-A (penicillin G benzathine) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Bicillin L-A (penicillin G benzathine) will not be safe for you to take.
What are alternatives to Bicillin L-A (penicillin G benzathine)?
There are a number of medications that your doctor can prescribe in place of Bicillin L-A (penicillin G benzathine). Compare a few possible alternatives below.
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