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Bicillin L-A: Uses, Side Effects and Dosage

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Facts
Status:
Prescription (Rx)
Strength:
1200000 UNIT
Active ingredient:
ATC code:
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Source: Health Canada – Drug Product Database (DPD) and product monographs · About this document

Patient Medication Information: uses, side effects, how to take - Bicillin L-A

What is Bicillin® L-A used for?

Bicillin® L-A is used to treat bacterial infections such as:

  • strep throat [a disease that causes a sore throat (pharyngitis)]
  • syphilis (a disease transmitted during sex)
  • yaws, bejel and pinta (skin diseases transmitted by skin-to-skin contact)

Bicillin® L-A is also used to prevent infections that may occur after a strep throat such as:

  • rheumatic fever which can cause illness in the heart, joints, skin, and brain
  • glomerulonephritis (an inflammation of the kidney).

Antibacterial drugs like Bicillin® L-A treat only bacterial infections. They do not treat viral infections such as the common cold. Although you may feel better early in treatment, Bicillin® L-A should be used exactly as directed. Misuse or overuse of Bicillin® L-A could lead to the growth of bacteria that will not be killed by Bicillin® L-A (resistance). This means that Bicillin® L-A may not work for you in the future. Do not share your medicine.

How does Bicillin® L-A work?

Serious Warnings and Precautions

  • Your healthcare professional will inject Bicillin® L-A with an injection inside the muscle. Unintended injections of Bicillin® L-A into the blood vessels are associated with serious or life-threatening side effects. Injection into or near a nerve may result in permanent nerve damage.
  • Some people taking beta-lactam antibiotics including penicillin have reported severe skin reactions and serious allergic reactions, including death.
  • If you have had an allergic reaction to penicillin, or other beta-lactam antibiotics, tell your healthcare professional before you start treatment with Bicillin® L-A.

  • For further information and symptoms see:

    • the “To help avoid side effects and ensure proper use…” section
    • the “What are possible side effects from using…” section

Bicillin® L-A is an antibiotic that belongs to the penicillin class. It works by killing or stopping the growth of the bacteria that cause your infection.

What are the ingredients in Bicillin® L-A?

Medicinal ingredients: penicillin G benzathine

Non-medicinal ingredients: lecithin, methylparaben, povidone, propylparaben, sodium carboxymethylcellulose, sodium citrate, water for injection

Bicillin® L-A comes in the following dosage forms:

Bicillin® L-A comes as a suspension (liquid) in a 2 mL prefilled disposable syringe

Each 2 mL prefilled syringe contains 1,200,000 IU penicillin G benzathine

Do not use Bicillin® L-A if you are allergic to:

  • penicillin G benzathine
  • other penicillin antibiotics from the same group
  • any other ingredients of Bicillin® L-A (see Serious Warnings and Precautions and What are the ingredients in Bicillin® L-A?)

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take Bicillin® L-A. Talk about any health conditions or problems you may have, including if you:

  • are allergic to other penicillin antibiotics, cephalosporin antibiotics such as cefazolin, cephalexin etc., or any other medications. Ask your healthcare professional if you are not sure if a medication you are allergic to belongs to one of these groups of medications.
  • have allergies to any food, dyes, preservative etc., hay fever, hives or asthma.
  • have kidney problems.

  • are pregnant or planning to become pregnant.

  • are breastfeeding or planning to breastfeed. Penicillin is passed to the infant through human breast milk.

Other warnings you should know about:

Call your healthcare professional if:

  • your symptoms do not improve or get worse while taking Bicillin® L-A
  • you develop a severe skin rash or blisters with or without fever
  • you experience any of the following symptoms during or over 2 months after your treatment with Bicillin® L-A: severe diarrhea (watery or bloody stools) with or without fever and stomach cramps

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

The following may interact with Bicillin® L-A:

  • tetracycline (an antibiotic)
  • probenecid* (to treat gout)

*Product is not marketed in Canada.

How to take Bicillin® L-A:

Your healthcare professional will inject Bicillin® L-A into a muscle of the buttocks or the hip. In infants and small children, the healthcare professional may inject Bicillin® L-A into a muscle of the thigh.

Usual dose:

The dose of Bicillin® L-A will depend on the type of infection you may have.

Your healthcare professional will calculate the right dose for you.

Your healthcare professional will also tell you how long to use Bicillin® L-A.

Ask your healthcare professional if you have any questions about how many doses of Bicillin® L-A you will need or when you will receive them.

Overdose:

If you think you, or a person you are caring for, have taken too much Bicillin® L-A, contact a healthcare professional, hospital emergency department, or regional poison control centre immediately, even if there are no symptoms.

What are possible side effects from using Bicillin® L-A?

These are not all the possible side effects you may have when taking Bicillin® L-A. If you experience any side effects not listed here, tell your healthcare professional.

If you are taking this medication to treat syphilis, you may experience side effects a few hours after the beginning of the treatment, including fever, chills, headache, muscle pain and skin reactions (Jarisch-Herxheimer reaction).

Other side effects may include:

  • Itching
  • Skin rash
  • General tiredness
  • Pain
  • Headache
  • Nausea, vomiting
  • Swollen glands
  • Pain, inflammation, infection, bleeding, bruising in the area where the medication was injected
  • Sweating
  • Pain in your joints and bones
  • Loss of muscle mass
  • Nervousness
  • Unintentional shaking (tremors)
  • Dizziness
  • Sleepiness
  • Confusion
  • Memory loss
  • Anxiety
  • Euphoria
  • Ringing in your ears
  • Difference in taste
  • Difficulty obtaining an erection or orgasm
  • Persistent and painful erection

If they occur, they are likely to be minor and temporary. However, some may be serious and need medical attention.

Serious side effects and what to do about them

Symptom / effectTalk to your healthcare professionalStop taking drug and get immediate medical help
Only if severeIn all cases
COMMON
Clostridioides difficile colitis (bowel inflammation): severe diarrhea (bloody or watery) with or without stomach cramps and fever√
RARE

Severe allergic reaction: with symptoms such as:

  • Itching, skin redness
  • Widespread scaling, peeling and flaking of the skin
  • Flat red area on the skin
  • Burning or prickling feeling on your skin
  • Flu like symptoms (chills, fever, swelling, joint pain and weakness, etc.)
  • Anaphylaxis (swelling of the face, lips, tongue, back of throat, difficulty breathing or swallowing)
√

Heart Problems:

  • Heart attack
  • Abnormal heart rhythm
  • Irregularities of the heartbeat (palpitations)
  • Sudden drop in blood pressure and fainting
  • Stroke
√

Serious side effects and what to do about them

Symptom / effectTalk to your healthcare professionalStop taking drug and get immediate medical help
Only if severeIn all cases

Lung Problems:

  • High blood pressure in your lungs
  • Blood clots in your lungs
  • Difficulty breathing when awake or sleeping
√

Nerve and blood circulation problems in the area where the medication was injected:

  • Loss of sensation and movement
  • Pallor (pale skin)
  • Blotchiness
  • Death of skin (e.g. gangrene) (Skin symptoms may include a blue or black color, pain, numbness, and sores that produce a foul-smelling discharge)
  • Numbness of the arm or leg
  • Blue or black skin on the arm or leg
√
Seizures√
Hallucinations: (seeing, hearing or even feeling something that is not really there)√

Blood Problems:

Hemolytic Anemia (a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is over)

  • Dark Urine
  • Fatigue
  • Pale skin color
  • Rapid heart rate
  • Shortness of breath
  • Yellow skin and whites of the eyes (jaundice)

Low white blood cells

  • Fever
  • Frequent infections that can be serious
  • Flu-like illnesses
√

Serious side effects and what to do about them

Symptom / effectTalk to your healthcare professionalStop taking drug and get immediate medical help
Only if severeIn all cases

Low platelets (cells in the blood that help the blood clot)

  • Abnormal bleeding
  • Bleeding when you brush your teeth
  • Easy bruising
  • Pinpoint red spots on the skin (petechiae)

Abnormal Muscle Breakdown: (Rhabdomyolysis)

Symptoms may include:

  • Dark or cola-colored urine
  • Muscle pain and weakness
√

Kidney Problems:

Symptoms may include:

  • Any change in the amount, frequency or colour of urine
  • Fluid buildup
  • Loss of sleep
  • Poor appetite
  • Upset stomach
  • Weakness
  • Difficulty concentrating
√

Vision Changes:

Blurred vision

√
Blindness√

Severe cutaneous adverse reactions (SCAR) (severe skin reactions that may also affect other organs):

  • skin peeling, scaling, or blistering (with or without pus) which may also affect your eyes, mouth, nose or genitals, itching, severe rash, bumps under the skin, skin pain, skin color changes (redness, yellowing, purplish)
  • swelling and redness of eyes or face
  • flu-like feeling, fever, chills, body aches, swollen glands, cough
√

Serious side effects and what to do about them

Symptom / effectTalk to your healthcare professionalStop taking drug and get immediate medical help
Only if severeIn all cases
  • shortness of breath, chest pain or discomfort
NOT KNOWN
Kounis syndrome (heart problems caused by an allergic reaction): Symptoms of anaphylaxis (see above), chest pain, chest pressure or discomfort, heart palpitations, nausea or vomiting, sweating, shortness of breath, fatigue, clammy skin, feeling anxious or faint, disorientation, upset stomach.√

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.

Reporting Side Effects

You can report any suspected side effects associated with the use of health products to Health Canada by:

  • Visiting the Web page on Adverse Reaction Reporting (https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada.html) for information on how to report online, by mail or by fax; or
  • Calling toll-free at 1-866-234-2345.

NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.

Storage:

Store under refrigeration (2°C to 8°C). May be removed from refrigerator and stored for 7 days at a temperature not exceeding 30°C. Protect from freezing.

Keep out of reach and sight of children.

If you want more information about Bicillin® L-A:

  • Talk to your healthcare professional

  • Find the full product monograph that is prepared for healthcare professionals and includes this

    • atient Medication Information by visiting the Health Canada website: (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website http://www.pfizer.ca, or by calling 1-800-463-6001.

Last Revised MAY 24, 2024

About this document

Source: Health Canada – Drug Product Database (DPD) and product monographs · DIN (Drug Identification Number): 02291924

Revision date stated in the text: May 24, 2024

Found a mistake? Write to us via the contact page.

The information on this site does not replace the advice of a doctor or pharmacist.

Drug information for Bicillin L-A

Rx or OTC
Prescription (Rx)?
DIN 02291924
Schedule(s) PRESCRIPTION
Active ingredient(s) Penicillin g benzathine 1200000 UNIT
Dosage form(s) Suspension
Route(s) of administration Intramuscular
Drug class (WHO ATC)
  1. J Antiinfectives for systemic use
    1. J01 Antibacterials for systemic use
      1. J01C Beta-lactam antibacterials, penicillins
        1. J01CE Beta-lactamase sensitive penicillins
          1. J01CE08 Benzathine benzylpenicillin
Company PFIZER CANADA ULC
Current status Marketed
Current status date September 23, 2014

Source: Health Canada – Drug Product Database (DPD) and product monographs, data as of November 1, 2026. Data from the Health Canada Drug Product Database, as published there. Not a substitute for the advice of a doctor or pharmacist.