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4/7/2024

Penicillin G Benzathine

Products Affected - Description

    • Bicillin L-A intramuscular suspension for injection, Pfizer, 1,200,000 units, 2 mL syringe, 10 count, NDC 60793-0701-10
    • Bicillin L-A intramuscular suspension for injection, Pfizer, 2,400,000 units, 4 mL syringe, 10 count, NDC 60793-0702-10
    • Bicillin L-A intramuscular suspension for injection, Pfizer, 600,000 units, 1 mL syringe, 10 count, NDC 60793-0700-10

Reason for the Shortage

    • Pfizer has Bicillin-LA on shortage due to increased demand. Pfizer is allocating resources towards manufacturing adult Bicillin-LA presentations due to increased syphilis infection rates. Once current supplies of the pediatric Bicillin-LA vials are depleted it is unclear when more product will be manufactured. A Dear Healthcare Professional Letter can be found at: https://www.fda.gov/media/169427/download.
    • Pfizer is the sole supplier of penicillin G benzathine injection.

Available Products

    • Extencilline intramuscular powder for solution for injection, Pfizer, 1,200,000 units, 20 mL vial of powder/5 mL water for injection in ampules vial, 10 count, NDC 81284-0521-01
    • Extencilline intramuscular powder for solution for injection, Pfizer, 2,400,000 units, 20 mL vial of powder/5 mL water for injection in ampules vial, 10 count, NDC 81284-0522-01

Estimated Resupply Dates

    • Pfizer has Bicillin-LA 600,000 units/mL 2 mL and 4 mL syringes available in limited supply. The 1 mL syringes are on back order and the company estimates a release date of February 2025.

Implications for Patient Care

Alternative Agents & Management

    • FDA is allowing temporary importation of Extencilline (benzathine benzylpenicilin) in units of 1,200,000 units and 2,400,000 units. This non-FDA approved product is marketed in France and manufactured by Delbert in Italy. The barcode may not register on US systems. The product is being distributed by Provepharm via Direct Success at [email protected] or 1-877-404-3338.
    • The main differences between Extencilline and Bicillin-LA are warnings that are not on the Extencilline labeling. Refer to the Bicillin-LA labeling. Extenciline contains soy phospholipids and may cause hypersensitivity reactions to patients with a history of allergy to soybeans. Extencilline comes as a powder for reconstitution while Bicillin-LA is a prefilled syringe. More details can be found at: https://www.fda.gov/media/175366/download.

Updated

Updated April 7, 2024 by Michelle Wheeler, PharmD, Drug Information Specialist. Created February 1, 2023 by Michelle Wheeler, PharmD, Drug Information Specialist. © 2024, Drug Information Service, University of Utah, Salt Lake City, UT.

Disclaimer

Drug Shortage Bulletins are copyrighted by the Drug Information Service of the University of Utah and provided by ASHP as its exclusive authorized distributor. ASHP and the University of Utah make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information, and specifically disclaim all such warranties. Users of this information are advised that decisions regarding the use of drugs and drug therapies are complex medical decisions and that in using this information, each user must exercise his or her own independent professional judgment. Neither ASHP nor the University of Utah assumes any liability for persons administering or receiving drugs or other medical care in reliance upon this information, or otherwise in connection with this Bulletin. Neither ASHP nor the University of Utah endorses or recommends the use of any particular drug. Any application of this information for any purpose shall be limited to personal, non-commercial use.

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