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» LymeNet Flash » Questions and Discussion » Medical Questions » Bicillin CR vs Bicillin LA What is the difference?

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Author Topic: Bicillin CR vs Bicillin LA What is the difference?
lymebytes
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Does anyone have any good reasons from their LLMD's why Bicillin CR should not be used instead of LA?

The ingredients are the same (see my 2nd post below) they seem to be almost identical releasing slowly and having same levels in the blood. And CR is less painful due to the procaine.

Also, I just read these two drugs are on the national list of drugs mixed up at pharmacies frequently. If you are paying what seems to be a "great bargain" for LA, it may be CR you are receiving. They both read Penicillin G.

From what I have read there doesn't seem to be much difference at all except cost and LA lasting in the blood a few days longer.

Below is a good link to distinguish the different Bicillin's.

CR is much less expensive - yet no one has posted they are using it - or maybe I missed it??

I know LA means long acting, but the truth is if you study them, they both are pencillin G and released slowly.

This reminds me very much of Biaxin XL and regular Biaxin. The only difference is XL lasts a few more hours in the blood and has no generic, where as non-XL Biaxin has a generic and is MUCH less expensive.

Bicillin link: http://www.rxlist.com/drugs/alpha_b.htm#BiBn

Do any of you on Bicillin take oral Amoxicillin as well? If so at what dose?

Thanks in advance.

[ 10. July 2007, 09:18 PM: Message edited by: lymebytes ]

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James H
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Both have the same active ingredient, but the LA has it in a base that releases it very slowly over a couple of weeks.

CR on the other hand is released more quickly and reaches a higher level, but it is all gone within 24 hours. CR is normally administered DAILY or even twice daily. That is what is different about it, and probably why it isn't normally used for Lyme.

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lymebytes
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Well studying the link again this doesn't appear to be entirely accurate either check this out.

It appears to that it actually hits at a higher (released) dose at first then drops to the same levels of LA over a week period. Make sure to look at the seven day level.

The only differnce I note reading both is LA may remains in the blood up to 14 days with a 1.2mu shot and a 1.2 mu shot of CR 7 days, in our case that wouldn't matter with shots twice per week- or would it?

CR might hit faster at higher levels at first but read the following:

Bicillin CR

"Penicillin G benzathine and penicillin G procaine have a low solubility and, thus, the drugs are slowly released from intramuscular injection sites. The drugs are hydrolyzed to penicillin G. This combination of hydrolysis and slow absorption results in blood serum levels much lower but more prolonged than other parenteral penicillins. Intramuscular administration of 1,200,000 units of Bicillin C-R in adults usually produces peak blood levels of 2.1 to 2.6 units per mL within 3 hours; this level falls to an average concentration of 0.75 units per mL at 12 hours, 0.28 units per mL at 24 hours, and units per mL at 0.04 units per mL at seven days
Entire link can be read: http://www.rxlist.com/cgi/generic/bicillincr_cp.htm

If you notice in the next description, it also remains in the same units per mL between 0.03 -0.05. Compare here to LA:

Bicillin LA

"Penicillin G benzathine has an extremely low solubility and, thus, the drug is slowly released from intramuscular injection sites. The drug is hydrolyzed to penicillin G. This combination of hydrolysis and slow absorption results in blood serum levels much lower but much more prolonged than other parenteral penicillins. Intramuscular administration of 300,000 units of penicillin G benzathine in adults results in blood levels of 0.03 - 0.05 units per mL, which are maintained for 4 to 5 days. Similar blood levels may persist for 10 days following administration of 600,000 units and for 14 days following administration of 1,200,000 units." Entire link can be read at: http://www.rxlist.com/cgi/generic/bicillinla-disp_cp.htm

Doesn't seem to me that there is a big difference.

If they are this similar it seems that CR could be used instead of LA AND it is much more affordable (about 1/3 the cost of LA) and it is much less painful, here is another link regarding the pain difference of these injections: http://tinyurl.com/ywaros

Does anyone here have LLMD's that have explained why one is preferred over the other?

This tells us plainly that CR starts off stronger at day 7 is the same units per mL that LA is and depending on strength LA lasts from 4-14 days.

[ 10. July 2007, 10:11 PM: Message edited by: lymebytes ]

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lymebytes
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Couple of more links regarding comparing the two:

http://bicillin.net/bicillin/

http://bicillin.net/Bicillin/bicillin_at_a_glance.aspx

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James H
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I thought you were referring to the straight Procaine Penicillin, not the 50/50 mix of the Procaine and Benzathine forms which CR is. My mistake.

That sort of makes your point that there is alot of confusion, doesn't it!

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WildCondor
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You have to use Bicillin LA for Lyme treatment, not Bicillin CR.
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