GlobalRPh Renal Dosing Masterv6.6
GlobalRPh source record

Penicillin G

GlobalRPh source pageBase record retrieved 2026-09-05See the evidence for this drug3 sources available - open source summaries, references and comparisons
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Renal guidance at a glance

Cautions / source differences (1)
Review first - source-specific qualification

Before use: Penicillin G

Selected serious-infection rows agree with the retained UCSF summary; source-specific doses remain separate from other evidence.

Before applying: Choose the indication, potassium/sodium formulation and dialysis setting; do not use these schedules for benzathine or procaine penicillin.

Evidence for this qualification

Source-specific interpretation; independent clinician adjudication pending.

Confirm the product, indication and renal measure. The selected summary is not a complete prescribing monograph.

Choose a source to read (3)

Display order is not a clinical ranking. Date of retrieval is not the label revision date. Sources are never merged into one regimen. Other sources and conflicts remain below.

Professional source

Penicillin G potassium - aqueous IV, UCSF renal tables

Product / population
Adults; aqueous IV potassium salt. Selected serious-infection rows, not depot products.
Renal measure
Creatinine clearance, mL/min

Renal guidance and important limits

Limits that apply to these rows

Assess potassium load; sodium penicillin G may be preferable when available. Do not transfer to benzathine or procaine products.

Neurosyphilis, meningitis, necrotizing skin infection or toxic shock - IV
CrCl, mL/minSource-specific dose / instruction
>504 million units every 4 hours
10-503 million units every 4 hours
<103 million units every 6 hours
Endovascular infection or bacteremia - IV
CrCl, mL/minSource-specific dose / instruction
>503 million units every 4 hours
10-503 million units every 6 hours
<102 million units every 6 hours
Dialysis guidance - separate source-specific schedules
Penicillin G potassium IV - dialysis
Dialysis setting / indicationSource-specific schedule
Intermittent HD - neurosyphilis/meningitis/necrotizing infection/toxic shock4 million units once, then 2 million units every 4 hours
Continuous HD - same indications3 million units every 4 hours
Intermittent HD - endovascular infection/bacteremia3 million units once, then 2 million units every 6 hours
Continuous HD - endovascular infection/bacteremia3 million units every 6 hours
Read the retained text before reformatting

Neurosyphilis, meningitis, necrotizing skin infection or toxic shock - IV

CrCl, mL/minSource-specific dose / instruction
>504 million units every 4 hours
10-503 million units every 4 hours
<103 million units every 6 hours

Endovascular infection or bacteremia - IV

CrCl, mL/minSource-specific dose / instruction
>503 million units every 4 hours
10-503 million units every 6 hours
<102 million units every 6 hours

Penicillin G potassium IV - dialysis

Dialysis setting / indicationSource-specific schedule
Intermittent HD - neurosyphilis/meningitis/necrotizing infection/toxic shock4 million units once, then 2 million units every 4 hours
Continuous HD - same indications3 million units every 4 hours
Intermittent HD - endovascular infection/bacteremia3 million units once, then 2 million units every 6 hours
Continuous HD - endovascular infection/bacteremia3 million units every 6 hours

Assess potassium load; sodium penicillin G may be preferable when available. Do not transfer to benzathine or procaine products.

Source revision: Revision not established in selected retrieval | Retrieved: 2026-09-10. Retrieval date is not the revision date.

Source: https://idmp.ucsf.edu/content/penicillin-g-potassium-aqueous-iv

Scope: Selected source sections stored locally. Not a complete monograph or independent clinical approval. GlobalRPh v6.6.

Full source card / provenance

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Source-specific interpretation

What the dialysis evidence actually supports

Removal information alone does not define a maintenance dose, supplemental dose or dialysis schedule. A reported regimen still requires its product, indication, renal measure and dialysis assumptions to match the patient.

Penicillin G potassium - aqueous IV, UCSF renal tables

Authored v6.3; retrieved 2026-09-10 - retained source, not freshly reviewed in this release

A regimen is reported in selected content

Read the source and its limits

These manual classifications apply only to the identified selected sections, not every retained source or the entire prescribing information. They are not dosing clearance.

Source-first renal review

Evidence sources and renal implications

Choose a source to jump directly to its locally stored result. Qualitative precautions and evidence gaps remain visible even when no numerical clearance schedule is supplied.

Read 1 source difference / applicability notes

Preserved GlobalRPh source

Preserved original GlobalRPh source

Preserved historical content; not revalidated as current prescribing guidance.

Renal method: Read the measure and population stated in the original source sections.
Retrieved: 2026-09-05

Read local renal resultOpen original reference
Professional guidance

UCSF - aqueous penicillin G potassium IV

Adults; aqueous IV penicillin G potassium, not depot intramuscular products.

Renal method: CrCl in mL/min where specified; no equation inferred.
Retrieved: 2026-09-05

Read local renal resultOpen original reference
Professional guidance

Penicillin G potassium - aqueous IV, UCSF renal tables

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Before using this finding

Choose the indication, potassium/sodium formulation and dialysis setting; do not use these schedules for benzathine or procaine penicillin.

Dialysis evidence: A regimen is reported in selected content

Adults; aqueous IV potassium salt. Selected serious-infection rows, not depot products.

Renal method: Creatinine clearance, mL/min
Retrieved: 2026-09-10

Read local renal resultOpen original reference

Source presence is not independent validation. A label mirror is not a second independent source; review the original reference and exact formulation.

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Renal-context checklist: population, kidney trend and dialysis

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Read the exact source scope, renal metric and date before selecting a row. No applicability assessment has been performed.

See source-specific renal methods and the clinical interpretation guide for the supporting context.

Read before choosing a regimen

Source differences and product cautions

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These are specific issues found during source review, not an automated judgment that one source is universally correct. A label mirror and its original label are not independent evidence.

source scope and renal guidance

Before use: Penicillin G

Selected serious-infection rows agree with the retained UCSF summary; source-specific doses remain separate from other evidence.

How to use this: Choose the indication, potassium/sodium formulation and dialysis setting; do not use these schedules for benzathine or procaine penicillin.

Penicillin G potassium - aqueous IV, UCSF renal tables

Source-specific interpretation; independent clinician adjudication pending.

Go directly to the relevant source section

Renal dosing and precautions

Choose a source, then jump to its renal or dialysis section. These links locate stored text; they do not merge regimens or certify that sources agree.

No dialysis or renal heading shown? Read the complete source summary. Absence of a heading is not evidence that dose adjustment is unnecessary.

Compare or copy source versions

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Original content / product scopeUCSF - aqueous penicillin G potassium IVPenicillin G potassium - aqueous IV, UCSF renal tables
Choose two source checkboxes below.
Historical source content is not a current prescription. Original GlobalRPh recommendations are preserved, not automatically certified as current. Product-label and professional additions below are separately attributed. Confirm indication, population, kidney-function method, monitoring and the full prescribing information before applying a regimen.

Important source distinctions

Historical indication-specific regimens are preserved. Penicillin G potassium, benzathine penicillin G and oral penicillin VK are not interchangeable formulations.

Locally stored source content

Original GlobalRPh protocol

Clinical facts and comments transcribed into a structured reading format. This is not a byte-for-byte HTML archive. Original source: https://globalrph.com/renal/penicillin-g/

Usual dosing and product distinctions

Penicillin G: 1-4 million units every 4-6 hours. For susceptible infections the general source range is 2-24 million units/day IM/IV in doses every 4 hours, depending on susceptibility and severity. The potassium-injection label section specifies IV infusion, usually in doses every 4-6 hours except meningococcal meningitis/septicemia every 2 hours.

A separate penicillin VK note gives 250-500 mg orally every 6 hours; it is not the injectable penicillin G renal protocol.

GRPH-penicillin-g-01 · Source section: Usual dosing and product distinctionsRenal section finder

Adult indication-specific source regimens

All amounts below are million units per day unless otherwise specified; divide every 4-6 hours except where specified.

  • Serious susceptible streptococcal infection including S. pneumoniae, with septicemia, empyema, pneumonia, pericarditis, endocarditis or meningitis: 12-24.
  • The same serious susceptible staphylococcal infections: 5-24.
  • Anthrax: at least 8, divided every 6 hours; higher doses may be needed according to susceptibility.
  • Actinomycosis: cervicofacial 1-6; thoracic/abdominal 10-20.
  • Clostridial botulism, gas gangrene or tetanus: 20, with antitoxin, debridement/surgery, or human tetanus immune globulin as indicated.
  • Diphtheria: 2-3 for 10-12 days, adjunctive to antitoxin and to prevent carriage.
  • Erysipelothrix endocarditis: 12-20 for 4-6 weeks.
  • Severe oropharyngeal, lower-respiratory or genital fusospirochetosis: 5-10.
  • Listeria meningitis: 15-20 for 2 weeks; endocarditis: 15-20 for 4 weeks.
  • Pasteurella infection including bacteremia/meningitis: 4-6 for 2 weeks.
  • Haverhill/rat-bite fever: 12-20 for 3-4 weeks.
  • Disseminated penicillin-susceptible gonococcal infection: 10; duration depends on the infection.
  • Neurosyphilis: 12-24 as 2-4 million units every 4 hours for 10-14 days. The source notes that many experts recommend subsequent benzathine penicillin G 2.4 million units IM weekly for 3 doses.
  • Meningococcal meningitis/septicemia: 24 as 2 million units every 2 hours.
GRPH-penicillin-g-02 · Source section: Adult indication-specific source regimensRenal section finder

Renal Dosing

The source describes penicillin G as relatively nontoxic, with adjustment generally needed only for severe impairment. It quotes an APP Pharmaceuticals penicillin G potassium label revised September 2009.

CrCl below 10 mL/min/1.73 m2: full indication-specific loading dose, followed by half that loading dose every 8-10 hours.

Uremic patients with CrCl above 10 mL/min/1.73 m2: full loading dose, then half the loading dose every 4-5 hours.

Additional modification is needed with combined hepatic and renal impairment.

GRPH-penicillin-g-03 · Source section: Renal DosingRenal section finder

Hemodialysis

Use the below-10 regimen.

GRPH-penicillin-g-04 · Source section: HemodialysisRenal section finder
Separate professional-source layer

University and professional protocols

Professional

UCSF - aqueous penicillin G potassium IV

Open original reference

Open / share this exact local source

UCSF Infectious Diseases Management Program · Adults; aqueous IV penicillin G potassium, not depot intramuscular products.

Renal method: CrCl in mL/min where specified; no equation inferred.
Source date: Revision date not stated in the reviewed page.
Retrieved: 2026-09-05

Locally included source-specific summary. Regimen differences are not automatically resolved.

Dosing / renal protocol and limits

Limits that apply to these rows

Assess potassium load; sodium penicillin G may be preferable when available. Do not transfer to benzathine or procaine products.

Neurosyphilis, meningitis, necrotizing skin infection or toxic shock - IV
CrCl, mL/minSource-specific dose / instruction
>504 million units every 4 hours
10-503 million units every 4 hours
<103 million units every 6 hours
Endovascular infection or bacteremia - IV
CrCl, mL/minSource-specific dose / instruction
>503 million units every 4 hours
10-503 million units every 6 hours
<102 million units every 6 hours
Dialysis guidance - separate source-specific schedules
Penicillin G potassium IV - dialysis
Dialysis setting / indicationSource-specific schedule
Intermittent HD - neurosyphilis/meningitis/necrotizing infection/toxic shock4 million units once, then 2 million units every 4 hours
Continuous HD - same indications3 million units every 4 hours
Intermittent HD - endovascular infection/bacteremia3 million units once, then 2 million units every 6 hours
Continuous HD - endovascular infection/bacteremia3 million units every 6 hours
Read the retained text before reformatting

For neurosyphilis, meningitis, necrotizing skin infection or toxic shock, CrCl >50 / 10-50 / <10 mL/min: 4 million units every 4 hours / 3 million every 4 hours / 3 million every 6 hours, all IV. IHD: 4 million units initially, then 2 million every 4 hours. Continuous HD: 3 million every 4 hours.

For endovascular infection or bacteremia, corresponding non-dialysis schedules are 3 million every 4 hours / 3 million every 6 hours / 2 million every 6 hours. IHD: 3 million initially then 2 million every 6 hours; continuous HD: 3 million every 6 hours.

Assess potassium load; sodium penicillin G may be preferable when available. Do not transfer to benzathine or procaine products.

RDM30-056-penicillin-g-1 · Source locator: UCSF - aqueous penicillin G potassium IV; renal/dosing sections and stated qualifiers

Source identity and provenance
Source
https://idmp.ucsf.edu/content/penicillin-g-potassium-aqueous-iv
Retrieved
2026-09-05
Renal-function method
CrCl in mL/min where specified; no equation inferred.
Source date/version
Revision date not stated in the reviewed page.
Hash meaning
Locally authored summary text; not original SPL, HTML or PDF bytes
Local summary SHA-256
968ff856e208006954cd16aef90de4dde25d99cf30e20e6d61130368628179ae
Professional

Penicillin G potassium - aqueous IV, UCSF renal tables

Open original reference

Open / share this exact local source

UCSF Infectious Diseases Management Program · Adults; aqueous IV potassium salt. Selected serious-infection rows, not depot products.

Renal method: Creatinine clearance, mL/min
Source date: Revision not established in selected retrieval
Retrieved: 2026-09-10

Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Before using this finding

Choose the indication, potassium/sodium formulation and dialysis setting; do not use these schedules for benzathine or procaine penicillin.

Dialysis evidence: A regimen is reported in selected content

Selected source sections stored locally. Not a complete monograph or independent clinical approval.

Renal guidance and important limits

Limits that apply to these rows

Assess potassium load; sodium penicillin G may be preferable when available. Do not transfer to benzathine or procaine products.

Neurosyphilis, meningitis, necrotizing skin infection or toxic shock - IV
CrCl, mL/minSource-specific dose / instruction
>504 million units every 4 hours
10-503 million units every 4 hours
<103 million units every 6 hours
Endovascular infection or bacteremia - IV
CrCl, mL/minSource-specific dose / instruction
>503 million units every 4 hours
10-503 million units every 6 hours
<102 million units every 6 hours
Dialysis guidance - separate source-specific schedules
Penicillin G potassium IV - dialysis
Dialysis setting / indicationSource-specific schedule
Intermittent HD - neurosyphilis/meningitis/necrotizing infection/toxic shock4 million units once, then 2 million units every 4 hours
Continuous HD - same indications3 million units every 4 hours
Intermittent HD - endovascular infection/bacteremia3 million units once, then 2 million units every 6 hours
Continuous HD - endovascular infection/bacteremia3 million units every 6 hours
Read the retained text before reformatting

Neurosyphilis, meningitis, necrotizing skin infection or toxic shock - IV

CrCl, mL/minSource-specific dose / instruction
>504 million units every 4 hours
10-503 million units every 4 hours
<103 million units every 6 hours

Endovascular infection or bacteremia - IV

CrCl, mL/minSource-specific dose / instruction
>503 million units every 4 hours
10-503 million units every 6 hours
<102 million units every 6 hours

Penicillin G potassium IV - dialysis

Dialysis setting / indicationSource-specific schedule
Intermittent HD - neurosyphilis/meningitis/necrotizing infection/toxic shock4 million units once, then 2 million units every 4 hours
Continuous HD - same indications3 million units every 4 hours
Intermittent HD - endovascular infection/bacteremia3 million units once, then 2 million units every 6 hours
Continuous HD - endovascular infection/bacteremia3 million units every 6 hours

Assess potassium load; sodium penicillin G may be preferable when available. Do not transfer to benzathine or procaine products.

RDM63-professional-penicillin-g-7ad94b974d-C1 · Source locator: Non-dialysis and intermittent/continuous hemodialysis tables; selected serious-infection indications

Source-specific limits

Assess potassium load; sodium penicillin G may be preferable when available. Do not transfer to benzathine or procaine products.

Source identity and provenance
Source family
professional_guidance
Source
https://idmp.ucsf.edu/content/penicillin-g-potassium-aqueous-iv
Retrieved
2026-09-10
Renal-function method
Creatinine clearance, mL/min
Source date/version
Revision not established in selected retrieval
Hash meaning
Local authored summary, not source HTML/XML/PDF bytes
Local summary SHA-256
f17431300215ffeff11a785b2b911f255453ab39176449e439bfb2002981492f

Provenance and preservation

Additional summaries stored on this page: 0 official-label, 0 RX List, 2 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://globalrph.com/renal/penicillin-g/
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
globalrph individual
Local text SHA-256
17c2604f86abea883516bae51ce038c623e3ec3c2c83ee07bb57f7db951a0954
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.

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