Bicillin-3, 600000 units, 50 pcs.

Combined antibacterial drug of the group of prolonged-acting penicillins that are degraded by penicillinase.

Indications

Infections (in adults) caused by susceptible microorganisms: syphilis and other diseases caused by pale treponemes (yaws), streptococcal infections (excluding infections caused by group B streptococci) – acute tonsillitis, scarlet fever, wound infections, rust inflammation; rheumatism (prevention).

Active ingredient

Composition

Active ingredients:

benzathine benzylpenicillin 200,000 units.

Benzylpenicillin sodium (benzylpenicillin sodium salt) or benzylpenicillin potassium (benzylpenicillin potassium salt) 200000 IU.

Benzylpenicillin procaine (benzylpenicillin novocaine salt) 200000 IU.

How to take, the dosage

Injected deeply intramuscularly into the upper outer quadrant of the gluteal muscle at a dose of 300,000 IU. If two injections are necessary, they are made in different buttocks. Repeated injections are made 4 days after the previous injection. A dose of 600,000 units is administered once every 6 days.

In the treatment of primary and secondary syphilis a single dose of the drug is 1.8 million units. The treatment course consists of 7 injections. The first injection is carried out in a dose of 300,000 units; the second injection after 1 day in a full dose; subsequent injections are carried out 2 times a week.

In treatment of secondary relapsed and latent early syphilis a dose of 300,000 units is used for the first injection, for subsequent injections – 1.8 million units. Injections are given twice a week. The course of treatment is 14 injections. The suspension is prepared using sterile water for injection, isotonic sodium chloride solution or 0.25-0.5% novocaine solution (5-6 ml) prepared ex tempore.

The solvent in the vial is injected slowly, at a rate of 5 ml in 20-25 seconds. The vial with the mixture is shaken gently in the direction of its longitudinal axis until a homogeneous suspension (or slurry) is formed. Bubbles on the surface of the suspension at the walls of the vial are allowed.

The suspension is injected immediately and deeply into the upper outer quadrant of the buttock. Rubbing of the buttock after injection is not recommended. Prolonged contact with water or the other solutions mentioned above changes the physical and colloidal properties of the drug, causing the suspension to become uneven and difficult to pass through the syringe needle.

Interaction

Bactericidal antibiotics (including cephalosporins, vancomycin, rifampicin, aminoglycosides) have a synergistic effect; bacteriostatic (including macrolides, chloramphenicol, lincosamides, tetracyclines) – antagonistic.

Decreases the effectiveness of oral contraceptives and ethinyl estradiol – risk of breakthrough bleeding.

Diuretics, allopurinol, phenylbutazone, nonsteroidal anti-inflammatory drugs, by reducing tubular secretion, increase the concentration of penicillins.

Allopurinol increases the risk of allergic reactions (skin rash).

Special Instructions

If any allergic reaction occurs, immediate discontinuation of treatment is required.

The drug should not be administered subcutaneously, intravenously, endolumbaneously or into body cavities.

Inadvertent intravascular administration may cause transient feelings of depression, anxiety and visual disturbances (Wanier syndrome). In order to avoid intravascular injection, it is recommended that aspiration be performed prior to the intravascular injection to detect possible needle entry into the vessel.

In the treatment of venereal diseases, if syphilis is suspected, microscopic and serological tests should be performed before the start of therapy and then for 4 months.

In connection with the possibility of fungal lesions it is advisable to prescribe B vitamins and ascorbic acid, and if necessary – nystatin and levorin, with signs of generalization of infection – fluconazole.

Please note that use of the drug in insufficient doses or stopping treatment too early often leads to the emergence of resistant strains of the pathogen.

In rare cases, anaphylactic shock may develop. At the first signs of anaphylactic shock the patient should be taken urgent measures for resuscitation of this state: norepinephrine injection, glucocorticosteroids, artificial lung ventilation if necessary.

Contraindications

Hypersensitivity to drugs of the group of penicillin and other beta-lactam antibiotics, to procaine.

With caution: pregnancy, lactation, renal failure, allergic diseases, including bronchial asthma, pollinosis (including anamnesis), pseudomembranous colitis.

Side effects

Allergic reactions: urticaria, angioneurotic edema, erythema multiforme, rarely anaphylactic shock.

Arthralgia, fever, exfoliative dermatitis; stomatitis, glossitis; anemia, thrombocytopenia, leukopenia, hypocoagulation.

In long-term therapy – superinfection with resistant microorganisms and fungi.