Course of treatment with bicillin 5. Geotar medicinal reference book. Deciphering analyzes online

Country of origin

Product group

Antibiotic of the penicillin group, destroyed by penicillinase

Release forms

• Bottles of 10 ml - 50 pieces per pack., Cardboard packs.

Description of the dosage form

• Powder for the preparation of a suspension for intramuscular administration is white, odorless, bitter in taste, which, when water, sodium chloride solution 0.9% or novocaine solution 0.25% -0.5% is added, forms a homogeneous suspension of milky turbidity; with prolonged contact with water or other above-mentioned solutions of saline

pharmachologic effect

Pharmacokinetics

Special conditions

Compound

• 1 bottle contains: benzathine benzylpenicillin 1.2 million units benzylpenicillin novocaine salt 300 thousand units

Bicillin-5 indications for use

• - treatment of infectious diseases caused by pathogens sensitive to penicillin (especially in cases where it is necessary to create a long-term therapeutic concentration in the blood); - year-round prevention of rheumatism in adults and children.

Producer: SYNTHESIS, JSC (Russia)

Description and photo update: 11/14/2017

Prices in pharmacies: from 17 rubles.

Bicillin-5 is an antibiotic (biosynthetic penicillin).

Release form and composition

The drug is produced in the form of a powder for the preparation of a suspension for intramuscular administration: a white or white with a yellowish tint powdery mass prone to clumping, with the addition of water forms a stable suspension (10 ml in vials; in a pack of cardboard 1, 5, 10 or 50 vials) .

Powder composition (for 1 vial):

• benzylpenicillin procaine (benzylpenicillin novocaine salt) -ED;
• benzathine benzylpenicillin - ED.

Pharmacological properties

Pharmacodynamics

Bicillin-5 is a bactericidal combination antibiotic containing two long-acting benzylpenicillin salts. Inhibits the synthesis of the cell wall of pathogenic microorganisms.

Active against the following microbes:

• Gram-positive: Streptococcus spp. (including Streptococcus pneumoniae), Staphylococcus spp. (not forming penicillinase), Bacillus anthracis, Clostridium spp., Corynebacterium diphtheriae, anaerobic spore-forming rods, Actinomyces israelii;
• gram-negative: Treponema spp., Neisseria gonorrhoeae, Neisseria meningitidis.

Penicillinase-producing strains of Staphylococcus spp. are resistant to the drug.

Pharmacokinetics

Bicillin-5 is an antibiotic with prolonged action, its high concentration in the blood persists for 4 weeks.

Benzathine benzylpenicillin hydrolyzes very slowly after intramuscular injection, releasing benzylpenicillin. The maximum concentration (Cmax) in the blood serum is reached after 12-24 hours after administration. The long half-life ensures a long and stable concentration of the drug in the blood: on the 14th day after the injection of ME, the concentration of the drug in serum is 0.12 μg / ml; on the 21st day after administration - ME concentration is 0.06 μg / ml (1 ME = 0.6 μg). Diffusion of a substance in a tissue is very weak, in a liquid it is complete. Communication with plasma proteins is 40-60%. Benzathine benzylpenicillin passes in small volumes through the placental barrier, and also penetrates into breast milk. Biotransformation is insignificant, mainly excreted by the kidneys unchanged, up to 33% of the administered dose is excreted in 8 days.

Benzylpenicillin reaches its maximum plasma concentration when administered intramuscularly after 20-30 minutes. The half-life is 0.5-1 hour, in the presence of renal failure, this figure increases to 4-10 hours or more. Association with plasma proteins

60%. The substance penetrates into tissues, organs and biological fluids, except for the tissues of the eye, cerebrospinal fluid and prostate gland. Passes through the blood-brain barrier during inflammation of the meningeal membranes. Penetrates through the placenta and enters breast milk. The kidneys are excreted unchanged.

Indications for use

Bicillin-5 is used to treat the following infectious and inflammatory diseases / conditions provoked by pathogens sensitive to the drug:

• rheumatism - for year-round long-term prevention of relapses;
• syphilis;
• yaws;
• streptococcal infections (with the exception of infections caused by group B streptococci) - scarlet fever, acute tonsillitis, erysipelas, wound infections.

Contraindications

• breastfeeding period;
• hypersensitivity to any components of the drug and other beta-lactam antibiotics.

• bronchial asthma;
• aggravated allergic anamnesis;
• pregnancy;
• kidney failure;
• pseudomembranous colitis.

Instructions for use Bicillin-5: method and dosage

A suspension prepared from a powder is administered intramuscularly (IM).

• children under 8 years: EED +ED 1 time in 3 weeks;
• children from 8 years: eat + ED 1 time in 4 weeks;
• adults: ED + ED 1 time in 4 weeks.

The suspension is prepared under aseptic conditions, immediately before use (ex tempore): 5–6 ml of the solvent is slowly (at a rate of 5 ml in 20–25 seconds) injected into the vial with Bicillin-5 under pressure. The contents are mixed and shaken along the longitudinal axis of the vial until a homogeneous suspension is formed. There may be bubbles near the walls of the vial on the surface of the suspension.

The finished product must be injected into the upper outer quadrant of the gluteus muscle immediately after preparation, deep intramuscularly. It is not recommended to rub the gluteal muscle after the injection. With a delay in administration after preparation, the colloidal and physical properties of the suspension change, as a result of which its movement through the syringe needle may be difficult.

Side effects

• allergic reactions: anaphylactoid reactions, fever, urticaria, angioedema, arthralgia, exfoliative dermatitis, erythema multiforme exudative, anaphylactic shock;
• laboratory parameters: leukopenia, thrombocytopenia, anemia, hypocoagulation;
• others: glossitis, stomatitis.

Overdose

There is no information on overdose.

special instructions

Intravenous, endolumbar and subcutaneous administration of the suspension, as well as injections into the body cavities, are not allowed. In case of inadvertent intravascular injection, a transient feeling of anxiety, depression and visual disturbances (Wanyer's syndrome) may occur. To avoid inadvertent intravascular administration of the drug, aspiration should be performed before intramuscular injection in order to identify a possible needle entry into the vessel.

In the treatment of syphilis, serological and microscopic studies should be carried out before starting treatment and for 4 months. Due to the development of fungal infections, it is advisable to simultaneously prescribe vitamin C and B vitamins, and if necessary, the appointment of antifungal agents for systemic use is required. It is important to consider that too early termination of therapy or the use of an insufficient dosage of Bicillin a-5 can lead to the emergence of resistant strains of pathogens.

Use during pregnancy and lactation

According to the instructions, Bicillin-5 in small quantities penetrates into the mother's milk and through the placental barrier. Its use during pregnancy is allowed only if the expected benefit to the mother outweighs the potential risk to the fetus.

If necessary, the appointment of the drug during lactation, breastfeeding should be discontinued.

drug interaction

• bactericidal antimicrobials, including vancomycin, cephalosporins, aminoglycosides, rifampicin: have a synergistic effect;
• bacteriostatic antimicrobials, including chloramphenicol, macrolides, tetracyclines, lincosamides: have an antagonistic effect;
• indirect anticoagulants: their effectiveness increases due to the inhibition of intestinal microflora and a decrease in the prothrombin index;
• oral contraceptives, drugs whose metabolism occurs with the formation of para-aminobenzoic acid, ethinyl estradiol: the antibiotic reduces their effectiveness, increasing the risk of breakthrough bleeding;
• tubular secretion blockers, diuretics, allopurinol, non-steroidal anti-inflammatory drugs, phenylbutazone: reduce tubular secretion, increase the concentration of benzylpenicillin in tissues and blood;
• allopurinol: increases the risk of developing allergic reactions, such as skin rashes.

Analogues

Bicillin-5 analogues are: Benzylpenicillin, Benzylpenicillin sodium salt, Benzylpenicillin sodium salt-Vial, Benzylpenicillin novocaine salt.

Terms and conditions of storage

Store at a temperature not exceeding 25 °C. Keep away from children.

Shelf life - 3 years.

Terms of dispensing from pharmacies

Released by prescription.

Reviews about Bicillin-5

In positive reviews about Bicillin-5, it is most often said about its high efficiency at a relatively low cost. The antibiotic is characterized as low-toxic, noting the super-long action. Those who received Bicillin-5 injections warn that the procedure must be carried out with caution, with certain skills. Sometimes such negative effects as painful injections and the depressing effect of therapy on the intestinal microflora are noted.

The price of Bicillin-5 in pharmacies

The price of Bicillin-5 is approximately 730 rubles.

Bicillin-5 powder for application. solution for injectionED No. 1 vial.

Bicillin-5 powder 1.5 million units 10 ml

Bicillin-5 times. d / adj. susp. for i / m input. 1.2 million units + 300 thousand units No. 50

Bicillin-5 powder for application. solution for injectionED No. 50 vial.

Education: First Moscow State Medical University named after I.M. Sechenov, specialty "Medicine".

Information about the drug is generalized, provided for informational purposes and does not replace the official instructions. Self-medication is dangerous to health!

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Bicillin 5 how to breed and inject

"Bicillin" is an antibiotic of the penicillin series with prolonged action. Its difference from other drugs of the group is that daily injections are not required, since the concentration of the antibiotic in the body remains quite high during the week. Usually injections are done once a week in the treatment room. In the absence of allergic reactions, it is allowed to inject at home.

Preparing for an injection

Dilute the drug immediately before use, storage of the diluted antibiotic is not permissible. For dilution, use sterile water for injection, physiological sodium chloride solution in

or 0.25-0.5% novocaine solution. In the latter case, pain due to the anesthetic effect of novocaine will be less pronounced. Do not use cold dilution solution. It is better to warm the ampoule in the palms for 5-8 minutes.

How to breed bicillin

Bicillin-1 contains the active substance: benzathine benzylpenicillin.

The composition of Bicillin-3, in addition to benzathine benzylpenicillin, also includes benzylpenicillin novocaine salt and benzylpenicillin sodium.

Bicillin-5 contains benzathine benzylpenicillia and benzylpenicillin novocaine salt.

Bitsillin is produced in the form of a powder for the preparation of an injection solution, which is intended for intramuscular administration. The drug is packaged in glass bottles of 10 ml.

Bicillin has a bactericidal and antibacterial effect.

Pharmacodynamics and pharmacokinetics

The activity of this drug is aimed at various gram-positive microorganisms, anaerobic spore-forming rods, some gram-negative microorganisms, and so on. The effectiveness of Bitsillin against viruses that cause poliomyelitis, smallpox, influenza, fungi, most gram-negative microorganisms, as well as strains that produce penicillinase is not shown.

With the / m administration of Bicillin-1, its slow absorption was noted. Then the drug is hydrolyzed, releasing benzylpenicillin, which will continuously enter the bloodstream. The maximum concentration is reached later, and the therapeutic effect appears after 3-6 hours.

Bicillin-3 is also characterized by slow-release hydrolysis of benzylpenicillin. A single injection allows you to maintain a therapeutic concentration in the blood for 6-7 days, the maximum concentration is reached later from the moment of administration. At the same time, a high penetration of the substance into physiological fluids was established, and a low one into tissues. Also, the drug passes through the placental barrier, enters breast milk. To a small extent, the drug is biotransformed, excretion occurs mainly through the kidneys.

As a result of the intramuscular injection of Bicillin-5, its increased concentration in the blood is detected already in the first hours. In this case, the therapeutic effect persists from 28 days.

Indications for use Bicillin

The main indications for the use of Bicillin are the treatment of various infectious diseases that cause microorganisms that are sensitive to the drug.

Therefore, the drug is prescribed for:

Contraindications for use

The drug is not prescribed for hypersensitivity to its components and other penicillins.

Care must be taken during the treatment of patients with bronchial asthma, hay fever, urticaria and other allergic diseases, intolerance to various drugs.

In the treatment of Bicillin, various side effects can develop that affect the activity of the cardiovascular system and hematopoiesis, manifesting themselves in the form of anemia, thrombocytopenia, leukopenia and hypocoagulation.

Allergic reactions are also possible, for example: irritation and rash on the mucous membranes and skin, urticaria, joint pain, exfoliative dermatitis, swelling, and so on.

General undesirable manifestations are not excluded: headache, high fever, arthralgia, glossitis, stomatitis, pain at the injection site. Long-term therapy can cause superinfections, the causative agents of which are microorganisms and fungi that are resistant to the drug.

Bicillin - instructions for use (Method and dosage)

According to the instructions for use of Bicillin-1, this drug is used as a prophylactic and therapeutic agent for infectious diseases. At the same time, the features of the introduction are that the injections are made deep, in the upper part of the gluteal muscle. Dosage and treatment regimen for various conditions is established by the attending physician.

Bicillin-3 instructions for use recommends administering at a dosage of ED, if necessary - in different buttocks. Repeat injections after 3 days, as a result, you can enter 6 days before the ED. Therapy for primary or secondary syphilis involves the introduction of a single dose of 1.8 million units. In total, 7 injections are made according to a certain scheme: the first and second meals with an interval of a day, then 2 times a week. Other diseases, according to indications, also involve the use of certain dosages, regimens and duration of treatment.

Suspension preparation is allowed strictly before use, subject to aseptic conditions. The annotation for each type of drug accurately describes how to dilute and how to dilute Bicillin-5, and so on. Usually the contents of the vial are dissolved in sterile distilled water, sodium chloride solution 0.9% or 0.25-0.5% novocaine solution. The resulting mixture is then shaken well and injected immediately.

This drug is also actively used in veterinary medicine. It is suitable for cats and dogs, and it also treats fish and small mammals.

No cases of overdose have been reported in clinical practice.

Simultaneous use of this drug with bactericidal antibiotics, for example: cephalosporins, cycloserine, vancomycin, rifampicin, aminoglycosides may cause a synergistic effect. The combination with bacteriostatic agents: macrolides, chloramphenicol, lincosamides and tetracyclines causes an antagonistic effect.

In addition, there was a decrease in the effectiveness of oral contraceptives or ethinyl estradiol. Diuretics, phenylbutazone, allopurinol and NSAIDs can reduce tubular secretion or increase the concentration of the drug. The combination with allopurinol often causes allergic reactions, mainly in the form of skin manifestations.

Before starting treatment, you need to clarify how to dilute Bicillin-3 or other types of the drug. Usually a prescription is written in Latin, so it is best to immediately find out from the doctor how to inject the medicine, in what dosage and other features of therapy.

If blood appears in the syringe during an injection, it means that the needle has entered a blood vessel. In such cases, you need to remove the syringe and make an injection in another place. After that, the injection site is pressed with a cotton swab, but do not rub it.

Termination of therapy requires the development of allergic reactions, regardless of the form of manifestation.

During the period of treatment of sexually transmitted diseases, especially syphilis, microscopic and serological studies should be carried out before the start of therapy and in the next 4 months.

To prevent the development of fungal infections, it is recommended to take vitamins B and C, as well as nystatin and levorin. When the drug is used in insufficient dosages or therapy is stopped prematurely, this can cause the development of resistant strains of pathogens.

When using Bicillin-3 in veterinary medicine, it is also necessary to take into account all the appointments of specialists for animals, which have many features.

The medicine is dispensed by prescription.

To store the drug, a dry, dark, cool place is intended, inaccessible to children.

AnalogsCoincidences for the ATX code of the 4th level:

The main analogues are represented by drugs: Benzathine benzylpenicillin, Benzicillin, Moldamine, Retarpen and Extencillin.

When treating with Bicillin, it is not recommended to drink alcohol, as this can significantly reduce or enhance the therapeutic effect.

Reviews about Bicillin

In most cases, reviews of Bicillin-5 are found on various medical forums and websites, the topics of which are related to the treatment of infectious diseases that require a long stay inside the body.

As the reviews on Bicillin-3 show, it is this drug that is prescribed in the treatment of various ENT infections. In this case, almost always therapy is quite successful.

However, before starting treatment with this antibiotic, it is necessary to check the sensitivity of the causative agent of the disease to this drug.

In addition, allergic reactions often occur during treatment with Bicillin. If they are manifested by complex side effects, then the drug is canceled. In any case, both the appointment and cancellation of treatment remain within the competence of the attending physician.

Bicillin price, where to buy

You can buy this drug in pharmacies or online pharmacies.

At the same time, the price of Bicillin-5 in the form of a powder for preparing a suspension is from 10 rubles per bottle.

The price of Bicillin-3 varies between 7-10 rubles.

• Internet pharmacies in RussiaRussia
• Internet pharmacies of UkraineUkraine
• Internet pharmacies of KazakhstanKazakhstan

WER.RU

Bicillin-3 powder 600 thousand U 10 ml Syntez OAO

Bicillin-5 powder 1.5 million units 10 ml Synthesis OAO

ZdravZone

Bicillin-5 powder for application. solution for injections ED No. 1 vial. Synthesis OJSC

Bicillin-3 powder for application. solution for injections ED No. 50 vial. Synthesis JSC

Bicillin-3 powder for application. solution for injections ED No. 1 vial. Synthesis OJSC

Bicillin-5 powder for application. solution for injections ED No. 50 vial. Synthesis JSC

Pharmacy24

Bicillin-3Kievmedpreparat (Ukraine, Kyiv)

Bicillin-5Kievmedpreparat (Ukraine, Kyiv)

PaniApteka

Bicillin-5 times. d/in.ED

BIOSPHERE

Bicillin ED No. 1 (50 pieces in a box) then. d / in.fl. Sintez OJSC (Russia)

BicillinED No. 1 then. d / in.fl. Sintez OJSC (Russia)

NOTE! Information about medicines on the site is a general reference, collected from publicly available sources and cannot serve as a basis for making a decision on the use of medicines in the course of treatment. Before medicine use Bicillin surely consult with the attending physician.

How to administer bicillin 3 correctly

asterisk1. Please tell me what is the secret. It’s impossible to make a normal, full-fledged injection of the drug Bicillin 3. Probably, there are some nuances?

zubari. Method of application and doses: Introduce deeply into / m into the upper outer quadrant of the gluteus muscle (in / in the introduction is prohibited) at a dose of 300 thousand units. If necessary, 2 injections are made in different buttocks. Repeated injections are made 4 days after the previous injection. At a dose of 600 thousand units administered 1 time in 6 days. The main thing here is not to get into the vessel.

zubari. asterisk1 says: It's impossible to make a normal, full-fledged injection And why doesn't it work?

Maura. asterisk1 and how do you breed? Sometimes a poorly dissolved drug clogs the needle. Or is the dog twitching and you are unable to inject the contents of the syringe?

asterisk1. I dilute with novocaine 05%. 4 ml. I dissolve very carefully. but only half can be entered, because solution #34; thickens #34; and the needle is stuck. I took another needle from 10 cu. syringe, it has a larger hole, and somewhere else I read that the needle should be absolutely dry, but the result is the same. Maybe you need to dissolve a certain amount of time or something else?

Yenish. asterisk1. take a needle from a 20cc syringe. Even better is a veterinary needle and a glass syringe. And why do you make bicillin with a modern wide choice of antibiotics? Half of the strains Pat. microflora has long been resistant to it.

asterisk1. I see. Thank you very much. We will try.

vasyl. bicillin3. 5. dissolve with distilled water. but it hurts a lot. therefore in to lay down. institutions, it is diluted with 0.25% novocaine solution. there is no such 5 novocaine on sale. but you can breed dist. water 0.5% novocaine. The diameter of the needle does not matter. since at a higher concentration than 0.25% it still coagulates.

asterisk1. The fact that the diameter of the needle does not play a big role, I have already made sure. Maybe less concentration is really needed, otherwise it coagulates instantly. But it’s impossible to give an injection quickly, I’m afraid to hit the bone.

Yenish. asterisk1 says: I'm afraid to hit the bone. What place are you doing? If it’s done intramuscularly to the place where dogs are usually done, then you won’t get into the bone, for sure. asterisk1 says: The fact that the diameter of the needle does not play a big role, I have already made sure. It has. At one time, they worked a lot with bicillin - a cow's needle never clogged

Marisha. When you dilute the drug bitsilin 5, the bottle should be shaken up? And how then to dial, it foams and nothing is visible. got air in the syringe or not

Yenish. should not be shaken vertically, but rolled in the palms. then it won't foam. crystallizes even more strongly in the needle than bicillin-3, therefore, choose a large diameter needle.

Bilkis. Personally, I inject this drug with a veterinary syringe, with a thick needle. Normally typed, the needle does not clog. such syringes and needles are reusable, you have to boil.

Martha Kemerovo. And the reason to put it? What kind of pain do you have? Enish already wrote to you that there are already modern preparations. Write and veterinarians will answer you.

Bicillin 3 - application

Bicillin 3 is an antibacterial agent and is used against gram-positive and gram-negative bacteria, as well as other microorganisms susceptible to penicillin. Bicilin 3, the use of which does not require daily injections, has gained great popularity. After all, there is no need to constantly visit the treatment room, and in the absence of contraindications, injections can be done at home.

Indications for use Bitsillin 3

A drug is prescribed to treat infections that are susceptible to this medication bacteria. It is especially important to use Bicillin 3 in therapy that requires long-term maintenance of the concentration of active substances in the body. These include:

The drug is widely used for the treatment of rheumatism and its prevention.

How to breed Bicillin 3?

The preparation of the composition should take place immediately before its use; it is impossible to store the diluted agent. For dilution, physiological saline, water for injection is used. It is recommended to warm the ampoules in your hands for some time, since it is impossible to inject cold formulations. In addition to the listed funds, Bicillin 3 can be diluted with Novocaine. To do this, an anesthetic solution (0.25-0.5%) is drawn into a syringe (5 ml), poured into a vial with an antibiotic and stirred until a uniform structure is obtained. Thanks to the use of such a solution, the pain of the procedure is significantly reduced.

How to inject Bicillin?

The suspension is administered intramuscularly, intravenous use of the drug is not allowed. After preparing the solution, the medicine is drawn into a syringe and injected deep into the muscle layer of the buttocks. Make two injections at once, one for each buttock. During the procedure, you need to ensure that the needle does not touch the blood vessel. If there is blood, then you need to choose another place for the injection.

Bicillin is used by adults once every six days per ED. To prevent recurrence of rheumatism, along with an antibiotic, the doctor prescribes Aspirin or Analgin, one gram per day.

With syphilis, the dosage is 1.8 million units. The first injection is given at a dosage of 0.3 million units, a day later they are given in full. Subsequent treatment involves the introduction of the drug twice a week.

Contraindications to the use of the drug are:

How to breed bicillin

Preparing for an injection

Dilute the drug immediately before use, storage of the diluted antibiotic is not permissible. For dilution, sterile water for injection, saline sodium chloride solution in ampoules or 0.25-0.5% novocaine solution are used. In the latter case, pain due to the anesthetic effect of novocaine will be less pronounced. Do not use cold dilution solution. It is better to warm the ampoule in the palms for 5-8 minutes.

For the introduction of "Bicillin" it is necessary to use syringes with long needles. You will also need sterile needles in individual packaging, since the drug is diluted using one needle, and it is injected with another. This is due to the fact that the drug crystallizes quickly and can clog the needle.

Dilution of the drug and its introduction intramuscularly

It is necessary to wash your hands, wipe the ampoule with the solvent with an alcohol wipe, open the ampoule, collect 5 ml of the solvent. Wipe the stopper of the vial at the site of the needle insertion, carefully insert the needle and slowly, pressing the syringe plunger, inject the liquid. Without pulling out the syringe, quickly shake the components, after complete mixing, turn the vial upside down, pull the syringe barrel so that only the end of the needle touches the liquid, and draw up the required amount of antibiotic. The dose is calculated in medical units and may vary depending on the type of disease and the age of the patient.

After the medicinal substance is drawn into the syringe, it is necessary to replace the needle with a new sterile one and immediately inject the drug into the gluteal muscle, into its upper outer square. The needle is inserted as deep as possible, leaving about 0.5-1 cm to the cannula, "Bicillin" is injected slowly, without jerking. The last 0.1-0.2 ml is not injected to prevent accidental entry of air into the muscle. If the drug crystallized during administration, it is necessary to pull out the needle, dilute a new dose of the drug and inject the drug again.

Before the introduction of "Bicillin", the skin on the buttock is wiped with an alcohol wipe, which can be purchased at a pharmacy. It is recommended to wear sterile gloves during the injection to prevent the risk of infection.

Injections are placed alternately in each buttock to reduce the likelihood of painful bumps. After the injection, the used syringes and ampoules are disposed of, it is better to put the disassembled syringe and needle into a disinfectant solution for one hour, for example, into liquid chlorine bleach. It is recommended to break or bend the needle so that children who accidentally find a syringe cannot harm themselves with it.

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The antibacterial drug Bicillin belongs to the group of natural penicillins. It has a bactericidal effect and has a wide range of effects. Gram-positive and gram-negative bacteria, some protozoa, are susceptible to destructive influence. The product is produced only in vials with a white powder for dilution. Method of application - exclusively intramuscular injection.

Compound

The tool has several generations, which include a different combination of penicillin salts.

• Bicillin 1 - the first generation, which includes only one salt of benzathine benzylpenicillin. In pharmacies, you can find 2 dosages: iED (units of action: the video below explains how to correctly calculate the dosage and bring the injection solution).
• Bicillin 3 - the second generation. It contains 3 salts: benzathine benzylpenicillin, sodium benzylpenicillin and novocaine salt of benzylpenicillin. The dosage also has 2 gradations: iED.
• Bicillin 5 is the latest generation of the drug, the composition of which has been corrected. The powder now contains benzathine benzylpenicillin ED and novocaine salt of benzylpenicillin ED. The drug is available in only one dose.

Characteristic

Any type of medicine is available in identical 10 ml vials. The package contains 50 vials. Inside is a homogeneous white powder. Bicillin 3 has its own characteristics. In this generation of the drug, the color may be white, it may be light yellow.

The powder is practically odorless. The taste is bitter. After contact with water, it takes on a homogeneous structure, forming a stable suspension. If the resulting solution was not introduced within 1 hour, the properties change. The solution becomes friable with many small lumps, which makes further administration impossible.

The price of the antibiotic Bicillin is quite low. Now Bitsillin 1 has practically gone out of circulation, since the similar Bitsillin 5 came to replace it. But if you can find it, then the average price for 1 bottle of such salt will be 10 rubles. Bicillin 3 and 5 do not differ much in the price category, the range ranges from rubles per 1 bottle.

Shelf life must be indicated on each individual vial. The duration of possible use is 3 years. Store preferably at a temperature of 8-15°C in a dark place protected from children. In case of violation of the conditions, the active substance may lose its properties.

Mechanism of action and elimination time

Pharmacodynamics is the same and does not depend on the generation used. The drug has a bactericidal effect of many strains due to beta-lactams. These particles are inhibitors of peptidoglycan synthesis. Beta-lactams and the mentioned complex proteins have a similar "key" structure to the receptor. In the case of exposure to the antibiotic Bicillin, beta-lactams are integrated into the synthesized genetic chain, blocking further production.

Peptidoglycan is a complex protein that is part of the protective shell of many bacteria. Without this protein, the cell cannot function properly and defend itself. Therefore, it is quickly found by the macrophages of the human body, and the pathogenic agent lends itself to lysis (splitting with the help of enzymes).

It has a great influence on the gram-positive flora (Staphylococci, streptococci, diphtheria bacilli, anthrax pathogens), inhibits the growth of anaerobic microorganisms. And in some cases it is sensitive to gram-negative representatives (meningococci, pale treponema, the causative agent of gonorrhea).

Pharmacokinetics is also an important link. Since it is the slow elimination of the drug from the body that makes it indispensable in the prevention of streptococcal complications.

Therapeutic concentration in the blood is achieved in the first hours after injection (2-6 hours). The maximum figures can be seen after 12 hours. It is important that Bicillin 3 is in a therapeutic dose in the blood for at least 6-7 days after administration, and Bicillin 5 is stored for 28 days. This is due to the slow biotransformation of the drug and its gradual release. The antibiotic is excreted mainly by the kidneys in the form of inactivated forms.

Indications for use

During the long existence of antibiotics, the bacterial microflora has managed to mutate and develop resistance to their action. In our case, the bacteria have learned to produce beta-lactamases that can break down beta-lactams. To protect against inactivation of action, clavulanic acid and sulbactam with tazobactam are added to penicillins.

Since this remedy does not have protection, it is more often used to combat the consequences of the vital activity of group A beta-hemolytic streptococcus, gonorrhea and pale treponema.

Indications for use are:

• syphilis;
• gonorrhea;
• erysipelas;
• severe scarlet fever;
• prevention of rheumatism after a complex course of angina;
• tonsillitis;
• leishmaniasis;
• treatment of streptococcal carditis and glomerulonephritis.

The advantage in the treatment of the above diseases is given to Bicillin due to its long-term cumulative ability.

Application rules

The instructions for use indicate the required dosages and the principle of administration, but do not specify how to dilute bicillin, how to inject the medicine. Since parents often give injections of Bicillin at home, some details that were missed in the instructions for use need to be specified. To begin with, let's clarify how to dilute the drug.

Bicillin 1 and 3 are diluted exclusively with saline or water for injection. Dilution of the powder with novocaine is contraindicated. Bicillin 5 is the only representative that can be diluted with an anesthetic. But under the age of 8, this is also not allowed.

Let's get down to the question of how to breed bicillin. To do this, you need to draw 5 ml of the solvent into the syringe, pierce the rubber cap of the bottle with a needle, and inject it inside under pressure. After shake for 20 seconds until the suspension is homogenized. Draw the prepared solution back into the syringe.

Inject immediately after dilution. The injection is given intramuscularly in the upper outer quadrant deep into the buttock. After inserting the needle, you need to make sure that you do not get into the vessel. To do this, pull the piston towards you. If blood has not entered the syringe, then slowly inject the solution.

The instructions for use indicate the average dosage of the drug. It must be remembered that the doctor will select the optimal dose of the drug, taking into account the individual characteristics of the patient and the disease that needs to be fought.

On average, doses are used:

• Bicillin 1 - 1.2 million IU 2 times a month or IU 1 time per week;
• Bicillin 3 - 1 day - IU, 4 days - IU, then every 6 days;
• Bicillin 5 - 1.5 million IU once a month.

Contraindications

The main contraindication to admission is individual intolerance to the components. Attention should be paid to the presence of a history of allergy to sulfonamides and cephalosporins. They have a similar structure and principle of operation.

Do not take patients with bronchial asthma and hay fever during lactation. Particular attention should be paid to patients suffering from other allergic diseases (hay fever, food and contact allergies). With caution, the drug is prescribed to pregnant women, patients with chronic renal failure and pseudomembranous colitis.

Alcohol is also prohibited. In case of ingestion of acetaldehyde, the effect of the drug is minimized or may be distorted. This will slow down the achievement of the desired result and increase the risk of developing resistance.

Side effects

The main side effect is the development of an allergic reaction:

Rarely there is a reaction from the hematopoietic system:

• coagulopathy;
• anemic syndrome;
• thrombocytopenic purpura;
• leukopenia.

Common symptoms associated with antibiotics:

• headache;
• unmotivated weakness;
• diarrhea;
• dysbacteriosis;
• glossitis and stomatitis;
• joint pain;
• fever of unknown origin.

Long-term use of an antibiotic with non-compliance with the indicated dosages and frequency of use can lead to the development of superinfection due to the development of bacterial resistance to antibacterial drugs from the beta-lactam group.

Features of use in various population groups

Children, pregnant women and the elderly have their own individual physiological characteristics. Therefore, the pharmacokinetics, the direct effect of the drug can be perverted.

The period of pregnancy and lactation

Penicillins are not included in the list of teratogenic factors. But their use is not recommended. Therefore, during pregnancy there are strict guidelines. It is prescribed only when the benefit to the mother far outweighs the risk to the fetus. Dosages are selected individually by the attending physician, taking into account the characteristics.

The lactation period is a contraindication, as a small concentration penetrates into breast milk. This can cause an allergic reaction or the development of resistance to the bacterial flora.

Elderly people

Analogues

Pharmacies offer many analogues of each drug, and this remedy is no exception. Depending on the constituent components, a number of other drugs are isolated.

Bicillin is a natural antibiotic of the penicillin series.

This drug is active against gram-negative microbes that can cause meningitis or gonorrhea, as well as against gram-positive staphylococci, streptococci, diphtheria microbes and anaerobic spore-forming bacteria.

In this article, we will consider why doctors prescribe Bitsillin, including instructions for use, analogues and prices for this drug in pharmacies. Real REVIEWS of people who have already used Bicillin can be read in the comments.

Composition and form of release

Clinical and pharmacological group: an antibiotic of the penicillin group, which is destroyed by penicillinase. The antibiotic Bicillin is produced in the form of a powder for injection:

• Bicillin-1 is a white powder, odorless or almost odorless, which forms a stable suspension when water is added.
• Bicillin-3 is a white or white with a slightly yellowish tinge powder, which forms a stable suspension when water is added.
• Bicillin-5 is an odorless white powder with a bitter taste, which, when water, saline or 0.25–0.5% novocaine solution is added, forms a homogeneous suspension of milky turbidity. With prolonged contact with water or other solutions, the physical and colloidal properties of the drug change (the suspension becomes uneven and difficult to pass through the syringe needle).

Bicillin 1 is absorbed into the blood after administration for a long time: it begins to act within three to six hours after administration, and the maximum concentration of Bicillin 1 in the blood is reached within 12-24 hours. Bicillin 3 is also characterized by slow hydrolysis. After one application of Bicillin 3, the therapeutic concentration in the blood is maintained for six to seven days.

The fastest acting is Bicillin 5. Its maximum concentration in the blood is observed immediately after administration and persists for 28 days. A small amount of Bicillin 5 is transformed and excreted by the kidneys. Bicillin 5 can pass into breast milk and through the placenta.

What is Bicillin used for?

Indications for the use of Bicillin 3 and 5 are infections caused by bacteria that are sensitive to penicillin, especially when long-term treatment is prescribed:

• scarlet fever;
• erysipelas;
• syphilis primary, secondary, of unknown origin;
• yaws (tropical syphilis);
• rheumatism, rheumatoid arthritis, rheumatic heart disease, rheumatoid diseases;
• tonsillitis, lacunar tonsillitis, catarrhal tonsillitis;
• wound infection: infected wounds, burns, purulent wounds, wound botulism.

Instructions for use

According to the instructions, Bicillin is used only through intramuscular injection to a sufficient depth. The powder is diluted before direct use.

Instructions for use Bicillin-5:

• Bicillin-5, instructions for use recommends administering at a dose of 1.5 million units once a month - for adult patients, 600 thousand units every 3 weeks - for children under 8 years old, 1.2–1.5 million units 1 once a month - for children from 8 years.
  The Bicillin-5 suspension is prepared aseptically, immediately before use: 5-6 ml of the solvent is slowly (at a rate of 5 ml in 20-25 seconds) injected into the vial with the drug under pressure. The contents of the vial are mixed and shaken along the longitudinal axis of the vial until a homogeneous suspension is formed. The presence of bubbles on the surface of the suspension near the walls of the vial is allowed.
• Bicillin-5 suspension immediately after preparation is injected deep intramuscularly into the upper outer quadrant of the gluteal muscle. Rubbing the gluteal muscle after injection is not recommended. With a delay in administration immediately after preparation, the physical and colloidal properties of the suspension change, as a result of which its movement through the syringe needle can be difficult.

Instructions for use Bicillin-3:

• Bicillin-3 instructions for use recommends administering at a dosage of 300,000 IU, if necessary, into different buttocks. You need to repeat the injections after 3 days, as a result, you can enter 6 days before 600,000 IU. Therapy for primary or secondary syphilis involves the introduction of a single dose of 1.8 million units. In total, 7 injections are made according to a certain scheme: the first and second, 300,000 IU each, with an interval of a day, then 2 times a week. Other diseases, according to indications, also involve the use of certain dosages, regimens and duration of treatment.
• Bicillin-3 suspension is prepared immediately before use. 2-3 ml of sterile water for injection or isotonic sodium chloride solution is injected into the vial with the drug. The mixture in the vial is shaken for 30 seconds (in the direction of the longitudinal axis) until a homogeneous suspension (or suspension) is formed, which is injected deep intramuscularly into the upper outer quadrant of the buttock. Rubbing the buttocks after the injection is not recommended.

Contraindications

The use of Bicillin is prohibited for patients with hypersensitivity to penicillins. Patients with hypersensitivity to novocaine are not prescribed Bicillin 3 and Bicillin 5.

Caution is necessary when using the drug in patients suffering from:

• hives;
• bronchial asthma;
• hay fever.

Side effects

In general, Bicillin is normally tolerated and can rarely cause any undesirable effects. However, the use of such a medical product as Bicillin can provoke additional side effects, namely:

• headache;
• diarrhea;
• eosinophilia;
• swelling;
• hives;
• dizziness;
• inflammation of the tongue (glossitis);
• bronchospasm;
• hemolytic anemia;
• noise in ears;
• leukopenia;
• fluctuations in blood pressure;
• dermatitis;
• arthralgia;
• superinfection;
• vaginal candidiasis;
• nausea;
• stomatitis;
• interstitial nephritis;
• thrombocytopenia;
• feverish conditions;
• angioedema angioedema;
• skin rashes;
• dysfunction of the myocardium;
• agranulocytosis;
• increase in body temperature;
• liver dysfunction;
• chills;
• anaphylactic shock.

Pregnancy and lactation

Bicillin in small quantities penetrates the placental barrier and into the mother's milk. Use during pregnancy is possible only if the intended benefit to the mother outweighs the potential risk to the fetus.
It is recommended to stop breastfeeding if necessary, the appointment of the drug.

Analogues

The main analogues are represented by drugs: Benzathine benzylpenicillin, Benzicillin, Moldamine, Retarpen and Extencillin.

Prices

The average price of BICILLIN-5 in pharmacies (Moscow) is 665 rubles. BICILLIN-3 costs around 470 rubles.

Terms and conditions of storage

List B. In a dry place at a temperature not exceeding 20 ° C. Keep out of the reach of children. Shelf life - 3 years.

Terms of dispensing from pharmacies

On prescription.

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Becillin-5 - a penicillin antibiotic - is active against various microorganisms.

Mostly those that provoke the occurrence of gonorrhea, staphylococcus infections, meningitis, streptococcus, diphtheria, and other anaerobic infections.

Powerless against the effects of microorganisms that produce penicillinase. Many gram-negative bacteria, viruses and fungi are resistant to the influence of the agent.

On this page you will find all the information about Bicillin 5: complete instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews of people who have already used Bicillin 5. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

An antibiotic of the penicillin group, which is destroyed by penicillinase.

Terms of dispensing from pharmacies

Released by prescription.

Prices

How much does Bicillin 5 cost? The average price in pharmacies is at the level of 700 rubles.

Release form and composition

Powder for suspension for intramuscular injection 1200000 IU + 300000 IU. One vial contains

• active substances: benzathine benzylpenicillin - 1200000 units.
• benzylpenicillin novocaine salt - 300,000 units.

White or white with a slightly yellowish tint powder, prone to clumping, forming a stable suspension when water is added.

Pharmacological effect

Bicillin-5 is a combined bactericidal antibiotic consisting of two benzylpenicillin salts that have a long-term effect. The drug inhibits the synthesis of the bacterial cell wall.

It is active against the following microorganisms: gram-positive bacteria (Streptococcus spp., including Streptococcus pneumoniae; Staphylococcus spp., not producing penicillinase), gram-negative bacteria (Neisseria meningitidis, Neisseria gonorrhoeae, Treponema spp.), anaerobic spore-forming rods (Clostridium spp., Bacillus anthracis , Actinomyces israelii).

Strains of Staphylococcus spp., which produce penicillinase, are resistant to its action.

Indications for use

The main indications for the use of Bicillin are the treatment of various infectious diseases that cause microorganisms that are sensitive to the drug.

Therefore, the drug is prescribed for:

• wound infections;
• , yaws, leishmaniasis and so on.

Contraindications

The drug has contraindications:

• lactation period;
• hypersensitivity to the components of the drug, as well as to other beta-lactam antibacterial drugs.

Bicillin-5 should be used with caution in the following conditions / diseases:

• aggravated allergic anamnesis;
• pseudomembranous colitis;
• kidney failure;
• pregnancy.

Use during pregnancy and lactation

It has been established that Bicillin-5 penetrates into mother's milk and through the placental barrier. During pregnancy, the drug is allowed to be used only if the expected benefit of treatment for the mother clearly outweighs the possible risk to the fetus.

If the use of the drug is necessary during lactation, breastfeeding must be discontinued.

Instructions for use

The instructions for use indicate that Bicillin 5 is prescribed intramuscularly.

• Adults: 1.2 million IU + 300 thousand IU 1 time in 4 weeks.
• Preschool children - 480 thousand IU + 120 thousand IU 1 time in 3 weeks, children over 8 years old - 960 thousand IU + 240 thousand IU 1 time in 4 weeks.

To prepare the suspension, sterile water for injection, isotonic sodium chloride solution or 0.25-0.5% solution of procaine (novocaine) is used.

The Bicillin-5 suspension is prepared aseptically, immediately before use (ex tempore): 5-6 ml of the solvent is slowly (at a rate of 5 ml in 20-25 seconds) injected into the vial with the drug under pressure. The contents of the vial are mixed and shaken along the longitudinal axis of the vial until a homogeneous suspension is formed. The presence of bubbles on the surface of the suspension near the walls of the vial is allowed. Bicillin-5 suspension immediately after preparation is injected deep intramuscularly into the upper outer quadrant of the gluteal muscle.

Rubbing the gluteal muscle after injection is not recommended. With a delay in administration immediately after preparation, the physical and colloidal properties of the suspension change, as a result of which its movement through the syringe needle can be difficult.

Side effects

Before diluting the medicinal powder, it is important to familiarize yourself with the negative consequences of its presence in the complex treatment regimen. Side effects of Bicillin-5 occur after a single dose, cause CNS instability and general malaise. After the introduction of the first injection, the reaction of the body may be the most unpredictable.

Here are the potential side effects from the instructions for use:

• violation of laboratory parameters: anemia, leukopenia, hypocoagulation, thrombocytopenia;
• on the part of the skin: anaphylactic shock, fever, urticaria;
• others: glossitis, stomatitis.

Overdose

In case of non-compliance with the norms of use in units and doses, allergic reactions and other side effects during injection are possible.

special instructions

The drug is forbidden to be administered intravenously, subcutaneously, into the body cavity and endolumbally (into the spinal canal).

When prescribing the drug to patients with syphilis, serological and microscopic studies should be carried out before starting treatment, and then within 4 months. It is advisable to simultaneously prescribe vitamin C and B vitamins, as well as systemic antifungal agents (as fungal infections may occur). It should be borne in mind that when using insufficient dosages of Bicillin-5 or stopping therapy too early, resistant strains of pathogens may appear.

With the accidental introduction of Bicillin-5 into the vessel, visual impairment, the appearance of a feeling of anxiety and depression (Wanyer's syndrome) are possible. In order to avoid accidental intravascular administration of the suspension, it is recommended to aspirate before the injection in order to identify a possible entry of the syringe needle into the vessel.

drug interaction

Simultaneous use of this drug with bactericidal antibiotics, for example: cephalosporins, cycloserine, vancomycin, rifampicin, aminoglycosides may cause a synergistic effect. The combination with bacteriostatic agents: macrolides, chloramphenicol, lincosamides and tetracyclines causes an antagonistic effect.

In addition, there was a decrease in the effectiveness of oral contraceptives or ethinyl estradiol. Diuretics, phenylbutazone, allopurinol and NSAIDs can reduce tubular secretion or increase the concentration of the drug. The combination with allopurinol often causes allergic reactions, mainly in the form of skin manifestations.

active substance:

1 bottle contains: bicillin-5, powder 1500000 IU (a mixture of benzathine benzylpenicillin sterile (bicillin-1) - 1200000 IU, benzylpenicillin novocaine salt sterile - 300000 IU).

Dosage form. Powder for suspension for injection.

Basic physical and chemical properties: powder white or white with a slightly yellowish tint.

Pharmacotherapeutic group.

Antibacterial drugs for systemic use. Combinations of penicillins sensitive to the action of β-lactamases. ATX code J01C EZ0.

Pharmacological properties

Pharmacodynamics.

The drug has a bactericidal effect by inhibiting the synthesis of mucopeptides of the cell wall of microorganisms. Active against Gram-positive microorganisms : Staphylococcus spp. (except producing penicillinase), Streptococcus spp. (incl. Streptococcus pneumoniae), Corynebacterium diphtheriae, Bacillus anthracis; Gram-negative : Neisseria gonorrhoae, Neisseria meningitidis, Аtinomyces israelii, as well as Treponema spp., anaerobic sporeformers. Most gram-negative bacteria, mycobacteria, fungi, viruses, and protozoa are resistant to the drug.

Pharmacokinetics.

The drug has a prolonged effect. With intramuscular injection, a depot of the drug is formed in muscle tissue. A high level of drug concentration is created already in the first hours after the injection, the therapeutic concentration of benzylpenicillin remains in the blood for 28 days or more in the vast majority of patients (children and adults). It is excreted from the body mainly by the kidneys, a small amount of the drug is excreted with sputum, sweat, saliva, lacrimal fluid, penetrates into breast milk.

clinical characteristics.

Indications

Treatment of infections caused by microorganisms sensitive to the drug, in cases where it is necessary to maintain a constant concentration of the drug in the blood for a long time.

The use of Bicillin ® -5 is especially indicated for year-round prevention of recurrence of rheumatism in adults and children.

Contraindications

Hypersensitivity to β-lactam antibiotics (penicillins, cephalosporins, carbapenems), novocaine;

Bronchial asthma, urticaria, hay fever and severe allergic reactions.

Interaction with other medicinal products and other forms of interaction.

With simultaneous use with bactericidal antibiotics (including cephalosporins, cycloserine, vancomycin, rifampicin, aminoglycosides), synergism of action is noted; with bacteriostatic antibiotics (including macrolides, chloramphenicol, lincosamides, tetracycline) - antagonism.

Bicillin ® -5 reduces the effectiveness of oral contraceptives and ethinyl estradiol (risk of breakthrough bleeding). It is not recommended to combine with non-steroidal anti-inflammatory drugs. Benzylpenicillin lowers the clearance and increases the toxicity of methotrexate.

With simultaneous use with allopurinol, the risk of developing allergic reactions increases.

Pharmacokinetic interaction. With the simultaneous use of diuretics, allopurinol, phenylbutazone, NSAIDs reduce tubular secretion and increase the concentration of penicillin.

It should be borne in mind the possibility of competitive inhibition of the excretion process from the body with the simultaneous use of benzylpenicillin with anti-inflammatory and antipyretic drugs (indomethacin, phenylbutazone, salicylates in high doses). Aspirin, probenecid, thiazide diuretics, furosemide, ethacrynic acid increase the half-life of benzylpenicillin, increasing its concentration in the blood plasma, resulting in an increased risk of developing its toxic effect by influencing tubular secretion of the kidneys. Allopurinol increases the risk of developing allergic reactions (skin rash).

Avoid simultaneous use with chloramphenicol, erythromyuin, tetracycline, sulfonamides.

With simultaneous use with methotrexate, the excretion of the latter decreases and the risk of its toxicity increases.

Penicillins can interfere with diagnostic tests, such as copper sulphate urine glucose testing, direct antiglobulin testing (Coombs' test), and some serum or urine protein tests. Penicillins can also interfere with tests that use bacteria, such as the Guthrie test for phenylketonuria, which uses microorganisms. Bacillus subtilis.

Application features

It is necessary to find out if there were any reactions to drugs of the group (β-lactam and / or novocaine) during their previous use. For patients prone to allergic reactions, the drug should be administered with caution. If signs of allergic reactions appear, Bicillin ® -5 should be discontinued and appropriate therapy prescribed.

In order to prevent the occurrence of adverse reactions, only intramuscular administration of the drug should be observed.

In patients with known hypersensitivity to cephalosporins, the possibility of cross-allergy should be taken into account.

Severe and sometimes fatal cases of hypersensitivity (anaphylactic reaction) have been observed in patients who were on penicillin therapy. Such reactions occur more frequently in patients with a known history of severe allergic reactions.

For the treatment of symptoms of an anaphylactic reaction, it may be necessary: ​​immediate administration of adrenaline, steroids (intravenously) and emergency treatment of respiratory failure.

With particular caution, the drug should be used in patients with hay fever, urticaria and other allergic diseases.

Neutropenia was widespread in patients treated with high doses of β-lactams and morbidity was noted in patients treated for 10 days or more. Monitoring of leukocytes is recommended for a long time in the treatment of high doses.

The drug is not recommended for the treatment of patients with acute lymphocytic leukemia or infectious mononucleosis due to an increased risk of erythematous skin rashes. It should be borne in mind that patients with diabetes mellitus may have reduced absorption of the active substance from the intramuscular depot.

In severe disorders of kidney function, large doses of penicillin due to neurotoxic effects can cause cerebral disorders, convulsions, coma.

Caution should be exercised when using the drug in patients with severe cardiopathy, hypovolemia, epilepsy, impaired renal or hepatic function. Hepatic, renal and hematological status should be monitored during long-term therapy with high doses.

Prolonged use of the drug may lead to the development of colonization of resistant microorganisms or yeasts. Superinfection may occur, which requires careful monitoring of such patients.

If severe diarrhea occurs, characteristic of pseudomembranous colitis (in most cases caused by Clostridium difficile), it is recommended to stop the use of the drug and take appropriate measures. The use of drugs that inhibit peristalsis is contraindicated. In the treatment of sexually transmitted diseases with suspected syphilis, a serological study should be carried out before the start of therapy and for 4 months after its completion.

To suppress or alleviate the Jarisch-Herxheimer reaction, it is recommended to administer 50 mg of prednisolone or its equivalent during the first use of the drug.

In patients with syphilis at the stage of cardiovascular, vascular, and meningeal syphilis, the Jarisch-Herxheimer reaction can be avoided by prednisone 50 mg daily or an equivalent steroid for 1 to 2 weeks. Freshly prepared solutions for injection or infusion should be used immediately. Even when stored in a refrigerator, aqueous solutions of the sodium salt of benzylpenicillin decompose with the formation of degradation products and metabolites.

Skin contact with penicillins should be avoided as sensitization may occur.

Use during pregnancy or lactation.

Data on the use of the drug Bicillin ® -5 are not available.

The ability to influence the reaction rate when driving vehicles or operating other mechanisms.

At the moment, there are no reports, but the possibility of adverse reactions from the central nervous and cardiovascular systems should be taken into account.

Dosage and administration

Before the introduction, it is necessary to collect an anamnesis of the tolerance of the drug and local anesthetic from the patient!

Bicillin ® -5 administered intramuscularly only! Intravenous administration of the drug is prohibited!

For children from 3 to 8 years of age, Bicillin ® -5 is administered once at a dose of 600,000 IU once every 3 weeks.

Children from 8 years old - at a dose of 1200000 units 1 time in 4 weeks.

Adults administer a single dose of 1,500,000 IU once every 4 weeks.

More frequent injections of Bicillin ® -5 are contraindicated. Usually the duration of treatment depends on the severity of the disease and ranges from 3 to 12 months.

Rules for the preparation and administration of the solution. Suspension Bicillin ® -5 prepare aseptically, immediately before use. Inject 9 ml of sterile water for injection or 0.9% sodium chloride solution or 0.25-0.5% novocaine solution into the vial with the drug under pressure. Stir the contents of the vial until a homogeneous suspension is formed. Inject the suspension deep into the upper outer quadrant of the gluteal muscle (2 injections should be made in different buttocks).

Before the introduction of a suspension of Bicillin ® -5, it is necessary to make sure that the needle does not enter the blood vessel. If blood appears, the needle must be pulled out and the injection carried out in another place.

Children.

The drug is prescribed for children from 3 years. With the introduction of Bicillin ® -5 to children under 18 years of age, the preparation of a suspension of Bicillin ® -5 using a novocaine solution is contraindicated.

Overdose

It is manifested by a toxic effect on the central nervous system: reflex excitation, headache, nausea, vomiting, convulsions, myalgia, arthralgia, symptoms of meningism, coma. In such cases, the administration of the drug should be discontinued.

Treatment is symptomatic, including hemodialysis, peritoneal dialysis, and special attention should be paid to restoring fluid and electrolyte balance.

Adverse reactions

From the immune system: skin rash, itching, edema, exfoliative dermatitis, erythema multiforme exudative, fever, arthralgia, urticaria, contact dermatitis, anaphylactic or anaphylactoid reactions, including bronchial asthma; thrombocytopenic purpura, symptoms of the gastrointestinal tract, angioedema angioedema, anaphylactic shock, which can be fatal in case of untimely and poor-quality medical care; serum sickness, reactions at the injection site are possible.

From the side of the respiratory system: bronchospasm, laryngospasm.

From the side of the central and peripheral nervous system: dizziness, tinnitus, headache.

From the digestive tract: nausea, vomiting, stomatitis, glossitis, black coloration of the tongue, diarrhea, pseudomembranous colitis, hepatitis, bile stasis.

From the genitourinary system: interstitial nephritis.

From the side of the cardiovascular system: violations of the pumping function of the myocardium, fluctuations in blood pressure, tachycardia.

From the blood and lymphatic system: positive Coombs test results, hemolytic anemia, leukopenia, neutropenia, thrombocytopenia, agranulocytosis, eosinophilia.

Local reactions: possible pain at the injection site.

Other: in debilitated patients, newborns, the elderly with long-term treatment, superinfection may occur caused by drug-resistant microflora (yeast-like fungi, gram-negative microorganisms). Patients who are being treated for syphilis may also experience a Jarisch-Herxheimer reaction secondary to bacteriolysis, which is characterized by the following symptoms: fever, chills, myalgia, headache, exacerbation of skin symptoms, tachycardia, vasodilation with changes in blood pressure .

The reaction can be dangerous in cardiovascular syphilis or in conditions where there is a serious risk of increased local damage, such as optic nerve atrophy.

Best before date

Storage conditions

In original packaging at a temperature not exceeding 25 °C.

Incompatibility. Bicillin ® -5 solution should not be mixed with other injection solutions.

Package

1500000 IU in vials.

Manufacturer

PJSC "Kyivmedpreparat"

Location of the manufacturer and its address of the place of business.

Ukraine, 01032, Kyiv, st. Saksaganskogo, 139.