Parenteral Manual

Penicillin G sodium

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Classification: 
Antibiotic
Original Date: 
August 2005
Revised Date: 
December 2019
Indications: 
  • Treatment of bacterial infections susceptible to penicillin
Reconstitution and Stability: 

VIAL SIZE

STERILE WATER for INJECTION REQUIRED

FINAL CONCENTRATION

1,000,000 IU

1.8 mL

500,000 units/mL

5,000,000 IU

8.2 mL

500,000 units/mL

10,000,000 IU

16.2 mL

500,000 units/mL
  • Powder is stable at room temperature
  • Reconstituted solution stable 7 days refrigerated or 24 hours at room temperature
  • Diluted solutions stable 24 hours at room temperature
Compatibility: 

- Solutions Compatible: D5W, 0.9% NaCl, ringer's solution, ringer's lactate

- Additive/Above Cassette Compatible: chloramphenicol, heparin, KCl (up to 40 mmol/L), streptomycin

- Y-site Compatible: TPN (amino acids/dextrose)

- Incompatible: pH below 5.5 or 8.0 [e.g. high pH: aminophylline, sodium bicarbonate, barbiturates (phenytoin, phenobarbital, pentobarbital, thiopental)], vancomycin

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM YES
Usual dilution: 500,000 units/mL
IV Direct

NO
IV Intermittent Infusion

YES
Usual dilution: 100,000 units/mL
Infusion time: 15-60 minutes
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:    

  • 150,000-300,000 units/kg/day IM/IV ÷ Q4 - 6 H

- meningitis:

  • 400,000 units/kg/day IV ÷ Q 4 hours   (Maximum 24 million units/day)

Adult:

  • 1 - 2 million units/dose  Q 4 - 6 hours

DOSING INTERVAL IN RENAL IMPAIRMENT: 

  • CrCl 10-30 mL/minute: Administer Q 8-12 hours
  • CrCl <10 mL/minute: Administer Q 12-18 hours
Potential hazards of parenteral administration: 
  • Hypersensitivity reactions - urticaria, rash, chills, fever, anaphylaxis (possibility of cross sensitivity with other penicillins, cephalosporins)
  • Convulsions with very high doses particularly in renal insufficiency
  • Hypernatremia
  • Thrombophlebitis
Notes: 
  • Monitor serum electrolytes, renal and hematologic function tests
  • Evaluate electrolyte levels frequently when using high doses because of sodium content
  • 1million units penicillin G sodium yield 2 mmol Na+
  • False positive or negative urinary glucose using Clinitest®
  • False positive urinary and/or serum proteins
  • 600 mg = 1 million units of penicillin G

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