IM Bicillin LA substitute

[Guest guest]

Hey Tom,

About the Bicllin LA substititute. Did you find a compounding

pharmacy to mix the penicillin and .5% lidocaine solution. I'm

wanting to avoid the bicillin cost but the local compounding pharmacy

can't (or won't) mix it because they claim an equivalent to bicillin

la is impossible. I suspect they are more concerned with the

liability issue, since they mostly compound only topicals. My doc

wrote for a 2.4 mil I.U. of penicillin / 3ml for IM injection.

Any pharmacy recommendations appreciated.

Bud

>

> Bicillin is a real brand name and I used to sell it for Wyeth labs.

Both Bicillin and the generic version of premixed penicillin have

gone sky high in cost as much as $80/shot and the Wyeth brand

required the TUBEX syringe holder/plunger to make the cartridges

work.

>

> A cheaper option is to get vials of powdered penicillin (cost is

about $6.00 each) and mix it with 0.5 % lidocaine and use a 3 cc

syringe to give the shot.

>

> Probenecid will prolong the half life by helping resorption in the

kidney and should not be used if allergic to sulfa meds.

>

> Once you use the IM penicillin it provides 24/7 saturation of the

liver binding sites. The good news is you get steady but low blood

levels, the bad news is there are no high spikes to help cross into

the brain better. You can take oral amoxicillin once each night (1000

mg) and there will be a minimal 1st pass effect to the

liver & nbsp;because the liver is already saturated with penicillin.

This allows greater blood peaks of amoxicillin. Both drugs compete at

the same bacteria site at the & nbsp;50 s ribosome to dissrupt

bacterial cell wall sysnthesis.

>

> The penicillins should not be mixed with macrolides as they will

work against each other.

>

> Tom G

>

> I have had good luck with this regimen. Some have added Flagyl to

this as well.

>