provider image
Welcome! You’re in GoodRx for healthcare professionals. Now, you’ll enjoy a streamlined experience created specifically for healthcare professionals.
Skip to main content

Bicillin L-A

penicillin G benzathine
Used for Skin Infection, Ear Infection, Bacterial Infection, Upper Respiratory Infection, Pneumonia
Used for Skin Infection, Ear Infection, Bacterial Infection, Upper Respiratory Infection, Pneumonia

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.

Reviewed by:
reviewer
Aileen Chu, PharmD, BCPS
reviewer
Allison Gourley, PharmD
Last reviewed on June 25, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsReferencesPricesMedicare
basics-icon

What is Bicillin L-A (penicillin G benzathine)?

What is Bicillin L-A (penicillin G benzathine) used for?

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.

Are you looking for information on Bicillin CR (penicillin G benzathine / penicillin G procaine) injection, penicillin v potassium (Penicillin VK) taken by mouth, or penicillin G potassium (Pfizerpen) for injection instead?

Drug Facts

Common BrandsBicillin L-A
Drug ClassPenicillin antibiotic
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
coupon-save-icon

Get your GoodRx coupon

Avg retail price
$7838.74(save 72.93%)
GoodRx discount
$2121.67
See prices
basics-icon

What are the 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

Other 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

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:
MINUTES
HOURS
DAYS
WEEKS
MONTHS
Injection site pain

Source: DailyMed

The following 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

fever

joint pain

lightheadedness or fainting (sudden)

puffiness or swelling around the face

red, scaly skin

shortness of breath

skin rash, hives, itching

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

nausea and vomiting

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

anxiety

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:

More common

Diarrhea (mild)

headache

sore mouth or tongue

vaginal itching and discharge

white patches in the mouth and/or on the tongue

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.

pros-and-cons

Pros and cons of Bicillin L-A (penicillin G benzathine)

thumbs-up

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

thumbs-down

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

Pharmacist tips for Bicillin L-A (penicillin G benzathine)

pharmacist

  • 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.

              faqs

              Frequently asked questions about Bicillin L-A (penicillin G benzathine)

              Where does Bicillin L-A (penicillin G benzathine) get injected?
              Bicillin L-A (penicillin G benzathine) is injected deep into the muscle. Adults receive it in the upper, outer part of the buttock. Small children might get it in the middle of the thigh. The injection location is very important in order to avoid hitting an artery or nerve, which can cause severe injury.
              Does Bicillin L-A (penicillin G benzathine) make you drowsy?
              It's possible that Bicillin L-A (penicillin G benzathine) can cause sleepiness. Since it's usually given at a hospital or clinic, it might be best to arrange for a ride home after your dose so that you don't drive yourself home while drowsy.
              How do you relieve pain from a Bicillin L-A (penicillin G benzathine) shot?
              If you're experiencing discomfort at the injection site, applying a warm compress can help. If there's redness, warmth, or swelling, you might want to try an ice pack instead to calm the area. Check with your healthcare professional (HCP) to see if it's okay for you to take an over-the-counter (OTC) pain reliever like acetaminophen (Tylenol) or ibuprofen (Advil).
              Does Bicillin L-A (penicillin G benzathine) need to be refrigerated?
              If a healthcare professional (HCP) is going to give you Bicillin L-A (penicillin G benzathine) at home, store the syringe in the refrigerator until it's time for your dose.
              Is Bicillin L-A (penicillin G benzathine) the same as penicillin?
              Bicillin L-A is a brand-name medication for a specific form of penicillin that's only given as a muscle injection. There are other types of penicillins, such as penicillin V potassium (Penicillin VK) and penicillin G potassium (Pfizerpen), which are used for different types of bacterial infections.
              What's the difference between Bicillin L-A (penicillin G benzathine) and Bicillin CR (penicillin G benzathine / penicillin G procaine)?
              Although both Bicillin CR and Bicillin L-A are types of penicillin antibiotics given by injection into your muscle, they don't treat all the same conditions. Most importantly, Bicillin CR shouldn't be used to treat syphilis, but Bicillin L-A is approved to do so. Your HCP will help make sure you're getting the correct form to treat your condition.
              How long does it take for Bicillin L-A (penicillin G benzathine) to cure syphilis?
              You usually need just one dose of Bicillin L-A (penicillin G benzathine) to cure early syphilis, but you should speak with your HCP afterwards to make sure your sores are healed and that you're no longer at risk of spreading syphilis to others. If you have late syphilis, you'll need to complete a course of 3 doses to treat the infection.
              GoodRxEducationalIcon

              How to save using GoodRx

              Compare Prices
              1. Compare PricesSpecify your dosage and quantity to find out exactly how much you can save.
              Select your free coupon
              2. Select your free couponYou can use the displayed coupon, or compare prices at other pharmacies near you.
              Show coupon to your pharmacist
              3. Show coupon to your pharmacistPresent your printed or electronic coupon when you pick up your prescription.
              Get free couponLearn more
              warings-icon

              What are the 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.

              risk-warning

              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.

              risk-warning

              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.

                risk-warning

                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.

                risk-warning

                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.

                  dosage

                  Bicillin L-A (penicillin G benzathine) dosage forms

                  The average cost for 1 package of 10 syringes of 2.4 million units per 4ml of Bicillin L-A (penicillin G benzathine) is $7466.17 with a free GoodRx coupon. This is 4.75% off the average retail price of $7838.74.
                  package
                  Package
                  DosageQuantityPrice as low asPrice per unit
                  10 pediatric syringes of 600000 units per ml1 package$2121.67$2121.67
                  10 syringes of 1.2 million units per 2ml1 package$3656.30$3656.30
                  10 syringes of 2.4 million units per 4ml1 package$7466.17$7466.17

                  Typical dosing 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

                  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.

                  drug-cost

                  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)
                  GoodRx lowest price

                  $2121.67

                  (save 72.93%)
                  View prices & coupons
                  contraindications-icon

                  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.
                  alternatives

                  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.
                  Bicillin L-A (penicillin G benzathine)
                  Used for:
                  $2121.67 Lowest GoodRx priceView Prices
                  Augmentin (amoxicillin / clavulanate)
                  Used for:
                  $13.79 Lowest GoodRx priceView Prices
                  Amoxicillin (Amoxil)
                  Used for:
                  $2.94 Lowest GoodRx priceView Prices

                  Get savings updates for Bicillin L-A (penicillin G benzathine)

                  Receive price alerts, news, and other messages from GoodRx about Bicillin L-A (penicillin G benzathine) and other healthcare topics and relevant savings offers.

                  By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx.

                  References

                  Best studies we found

                  Centers for Disease Control and Prevention. (2005). Inadvertent use of Bicillin® C-R to treat syphilis infection --- Los Angeles, California, 1999--2004. Morbidity and Mortality Weekly Report. 

                  Centers for Disease Control and Prevention. (2021). Primary and secondary syphilis.

                  Centers for Disease Control and Prevention. (2021). Tertiary syphilis.

                  View All References (8)

                  Centers for Disease Control and Prevention. (2024). About rheumatic fever.

                  Centers for Disease Control and Prevention. (2024). Syphilis.

                  National Kidney Foundation. (n.d.). What is glomerulonephritis?

                  National Organization for Rare Disorders. (2008). Pinta.

                  National Organization for Rare Disorders. (2009). Bejel.

                  Pelone, F., et. al. (2024). Local anaesthetic to reduce injection pain in patients who are prescribed intramuscular benzathine penicillin G: a systematic review and meta-analysis. The Lancet.

                  Pfizer Laboratories Div Pfizer Inc. (2024). Bicillin L-A- penicillin g benzathine injection, suspension [package insert]. DailyMed.

                  World Health Organization. (n.d.). Yaws (endemic treponematoses).

                  GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
                  Was this page helpful?

                  Browse medications

                  View All

                  Research prescriptions and over-the-counter medications from A to Z, compare drug prices, and start saving.