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Penstrep-400

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Procaine Benzylpenicillin + Dihydrostreptomycin · Interchemie werken "De Adelaar" B.V.

1 form: suspension. In force in Georgia: 1 of 1 (veterinary register).

Forms and doses1 of 1 in force in Georgia

The dose from the product's label, by species and weight. Check the label of the pack you use.

Choose species and weight; the matching row will be highlighted.
Form Species Dose Frequency Georgia
200 000 IU + 200 mg/ml, Suspension · Cat Cat 0.1 ml/kg
Comparator-derived off-label regimen, not the exact Interchemie label: current CBG-MEB Penstrep-ject contains the same 200,000 IU/ml procaine benzylpenicillin and 200 mg/ml dihydrostreptomycin in a suspension and authorises dogs and cats at 0.1 ml/kg IM or SC once daily for 3-5 days. Exact Interchemie Penstrep-400 is food-animal-only and IM-only; its excipient profile is not identical. Use IM only, after confirming product identity, susceptibility, renal suitability and a documented formulation bridge. Never substitute the Penstrep-400 LA 72-hour regimen.
 · once daily		 once daily Georgia Yes, veterinary
Veterinary (National Food Agency)
In the register: პენსტრეპი–400
№ 46-11, 291-11
Verified on: 15 Oct 2026
200 000 IU + 200 mg/ml, Suspension · Dog Dog 0.1 ml/kg
Comparator-derived off-label regimen, not the exact Interchemie label: current CBG-MEB Penstrep-ject contains the same 200,000 IU/ml procaine benzylpenicillin and 200 mg/ml dihydrostreptomycin in a suspension and authorises dogs and cats at 0.1 ml/kg IM or SC once daily for 3-5 days. Exact Interchemie Penstrep-400 is food-animal-only and IM-only; its excipient profile is not identical. Use IM only, after confirming product identity, susceptibility, renal suitability and a documented formulation bridge. Never substitute the Penstrep-400 LA 72-hour regimen.
 · once daily		 once daily Georgia Yes, veterinary
Veterinary (National Food Agency)
In the register: პენსტრეპი–400
№ 46-11, 291-11
Verified on: 15 Oct 2026
Details: pack, label wording, sources, registration

Penstrep-400 200 000 IU + 200 mg/ml, Suspension

suspension for injection
vetman assessment
vetman’s 10-point assessment brings together a product’s regulatory credibility, clinical efficacy, safety and practicality. Cost-effectiveness is assessed only when reliable data are available. It is informational and does not replace a veterinarian’s clinical judgment for an individual patient.
Dog Culture- and susceptibility-directed IM treatment of a bacterial infection susceptible to both procaine benzylpenicillin and dihydrostreptomycin in a dog; off-label use of exact Interchemie Penstrep-400
4.7/10
Weak evidence support
vetman assessment

Penstrep-400

200 000 IU + 200 mg/ml, suspension for injection
Assessed clinical scopeDog · Culture- and susceptibility-directed IM treatment of a bacterial infection susceptible to both procaine benzylpenicillin and dihydrostreptomycin in a dog; off-label use of exact Interchemie Penstrep-400 · Intramuscular
Care settingVeterinary clinic: verify the exact non-LA product and formulation bridge; obtain culture/susceptibility; assess renal and hydration status; give repeated IM injections and reassess within 48-72 hours
vetman score 4.7/10 Weak evidence support
Evidence confidence: Low Georgia: Yes, veterinary · № 46-11, 291-11 · Verified on 15 Oct 2026 Off-label use

A weak off-label option only when culture shows susceptibility to both components and the veterinarian accepts the documented cross-product formulation bridge. Exact Interchemie Penstrep-400 is not dog-labelled; the current comparator supplies the same active concentrations and IM regimen but not exact-product bioequivalence. Renal, otic and anaesthetic risks plus daily injections materially limit value. Prefer a narrower, dog-labelled or better-supported alternative whenever feasible.

Regulatory and scientific credibility5.0/10

Exact Penstrep-400 has current EU food-animal authorisations and Georgian veterinary registrations, and its manufacturer information transparently identifies composition, IM route and risks. It is not authorised for dogs or cats. The current CBG-MEB Penstrep-ject SPC authorises both species with the same active concentrations, suspension form and IM route, but it is a different product and its excipient list is not identical; the comparator supports a bridge, not regulatory transfer.

Clinical efficacy4.5/10

The active combination has a current regulator-approved dog/cat comparator regimen and plausible complementary Gram-positive/Gram-negative activity, but use must follow an organism-specific antibiogram. The fixed ratio cannot be independently PK/PD-optimised, resistance can remove either component, and no modern exact-Interchemie dog/cat clinical-outcome or bioequivalence study was found. Broad syndrome and pathogen lists do not justify empirical coverage.

Safety and tolerability4.0/10

The comparator label reports ototoxicity and nephropathy of unknown frequency and warns about aminoglycoside neuromuscular blockade during anaesthesia. Renal impairment, dehydration, concurrent nephrotoxins and repeated exposure increase concern; irreversible hearing loss is especially consequential in working dogs. Exact-product target-animal safety, reproductive safety and adverse-event frequency are not established, and formulation excipients differ from the comparator.

Clinical practicality5.5/10

A ready-to-use 200,000 IU + 200 mg/ml suspension and a simple 0.1 ml/kg comparator regimen make calculation straightforward. However, exact-product use is IM-only, requires shaking, aseptic withdrawal from a 50-100 ml multidose food-animal vial and daily clinic or supervised injections for 3-5 days. Injection discomfort, restraint, site rotation and renal/clinical monitoring create meaningful burden.

Full-course cost-effectiveness-

Price was not assessed and is excluded from the overall score.

Important safety and use flags

  • Verify exact plain Penstrep-400 (IPS): 200,000 IU/ml procaine benzylpenicillin + 200 mg/ml dihydrostreptomycin, without benzathine. Do not confuse it with Penstrep-400 LA; the LA concentration, depot kinetics, volume and 72-hour interval are different.
  • The 0.1 ml/kg IM once-daily, 3-5-day dog/cat regimen comes from current CBG-MEB Penstrep-ject, not the exact Interchemie label. Active concentrations, suspension and IM route match, but product dossiers and excipients are not identical. Use exact Penstrep-400 only by a documented off-label formulation-bridge decision; do not transfer the comparator SC route.
  • Use only for a diagnosed or strongly supported bacterial infection with a specific antibiogram showing susceptibility to both components. Obtain culture before treatment whenever feasible, prioritise source control and narrower first-line therapy, and reassess within 48-72 hours.
  • The fixed combination does not guarantee broad coverage. Penicillinase-producing staphylococci, resistant Enterobacterales, Pseudomonas and intrinsically nonsusceptible organisms may fail; the two components cannot be independently PK/PD-optimised.
  • Dihydrostreptomycin is nephrotoxic. Do not use in renal insufficiency; correct dehydration or hypovolaemia first and review urine, renal function and concurrent nephrotoxins. Stop and reassess for rising creatinine, urinary abnormalities, reduced appetite, vomiting or worsening hydration.
  • Aminoglycoside cochlear or vestibular damage can be irreversible. Monitor hearing, balance and gait; avoid where hearing is functionally critical, including working or guide dogs, unless the documented benefit clearly outweighs the risk.
  • Aminoglycosides can cause neuromuscular blockade and respiratory weakness. Anaesthesia, neuromuscular blockers and electrolyte abnormalities can increase risk; tell the anaesthesia team and monitor ventilation if exposure overlaps a procedure.
  • Do not use with penicillin, procaine or aminoglycoside hypersensitivity. Urticaria and anaphylaxis are possible; avoid accidental intravascular injection because acute procaine exposure can cause tremor, vomiting, incoordination and other neurologic signs.
  • The exact instruction contraindicates concurrent tetracyclines, chloramphenicol, macrolides and lincosamides because of possible antagonism. Avoid other aminoglycosides, loop diuretics and potentially nephrotoxic or ototoxic drugs unless a specialist documents the rationale and monitoring.
  • Exact-product dog/cat pregnancy, lactation, neonatal, geriatric and reproductive safety is not established. Neonates have immature renal clearance; use in pregnancy, lactation or growing animals only after an explicit benefit-risk decision and with a supported alternative considered first.
Assessment sources
  1. Interchemie Penstrep-4002026
  2. Penstrep-400 EU UPD2025
  3. Penstrep-400 GE register2026
  4. CBG Penstrep-ject SPC2025
  5. EMA AMEG 20252025
  6. MSD Vet Manual 20262026
  7. AAFP AAHA stewardship2022
Assessed: 22 Oct 2026The overall score uses 25/25/25/15/10 weights. An unassessed price is excluded and the remaining weights are proportionally renormalised.
Cat Culture- and susceptibility-directed IM treatment of a bacterial infection susceptible to both procaine benzylpenicillin and dihydrostreptomycin in a cat; off-label use of exact Interchemie Penstrep-400
4.5/10
Weak evidence support
vetman assessment

Penstrep-400

200 000 IU + 200 mg/ml, suspension for injection
Assessed clinical scopeCat · Culture- and susceptibility-directed IM treatment of a bacterial infection susceptible to both procaine benzylpenicillin and dihydrostreptomycin in a cat; off-label use of exact Interchemie Penstrep-400 · Intramuscular
Care settingVeterinary clinic: verify the exact non-LA product and formulation bridge; obtain culture/susceptibility; assess renal and hydration status; give repeated IM injections and reassess within 48-72 hours
vetman score 4.5/10 Weak evidence support
Evidence confidence: Low Georgia: Yes, veterinary · № 46-11, 291-11 · Verified on 15 Oct 2026 Off-label use

A weak off-label option only when culture shows susceptibility to both components and the veterinarian accepts the documented cross-product formulation bridge. Exact Interchemie Penstrep-400 is not cat-labelled; the current comparator supplies the same active concentrations and IM regimen but not exact-product bioequivalence. Feline vestibular sensitivity, renal toxicity and daily injections materially limit value. Prefer a narrower, cat-labelled or better-supported alternative whenever feasible.

Regulatory and scientific credibility5.0/10

Exact Penstrep-400 has current EU food-animal authorisations and Georgian veterinary registrations, and its manufacturer information transparently identifies composition, IM route and risks. It is not authorised for dogs or cats. The current CBG-MEB Penstrep-ject SPC authorises both species with the same active concentrations, suspension form and IM route, but it is a different product and its excipient list is not identical; the comparator supports a bridge, not regulatory transfer.

Clinical efficacy4.5/10

The active combination has a current regulator-approved dog/cat comparator regimen and plausible complementary Gram-positive/Gram-negative activity, but use must follow an organism-specific antibiogram. The fixed ratio cannot be independently PK/PD-optimised, resistance can remove either component, and no modern exact-Interchemie dog/cat clinical-outcome or bioequivalence study was found. Broad syndrome and pathogen lists do not justify empirical coverage.

Safety and tolerability3.5/10

The comparator label reports ototoxicity and nephropathy of unknown frequency and warns about aminoglycoside neuromuscular blockade during anaesthesia. MSD notes particular feline sensitivity to vestibular toxicity; renal impairment, dehydration, concurrent nephrotoxins and repeated exposure increase concern. Exact-product target-animal safety, reproductive safety and adverse-event frequency are not established, and formulation excipients differ from the comparator.

Clinical practicality5.5/10

A ready-to-use 200,000 IU + 200 mg/ml suspension and a simple 0.1 ml/kg comparator regimen make calculation straightforward. However, exact-product use is IM-only, requires shaking, aseptic withdrawal from a 50-100 ml multidose food-animal vial and daily clinic or supervised injections for 3-5 days. Injection discomfort, restraint, site rotation and renal/clinical monitoring create meaningful burden.

Full-course cost-effectiveness-

Price was not assessed and is excluded from the overall score.

Important safety and use flags

  • Verify exact plain Penstrep-400 (IPS): 200,000 IU/ml procaine benzylpenicillin + 200 mg/ml dihydrostreptomycin, without benzathine. Do not confuse it with Penstrep-400 LA; the LA concentration, depot kinetics, volume and 72-hour interval are different.
  • The 0.1 ml/kg IM once-daily, 3-5-day dog/cat regimen comes from current CBG-MEB Penstrep-ject, not the exact Interchemie label. Active concentrations, suspension and IM route match, but product dossiers and excipients are not identical. Use exact Penstrep-400 only by a documented off-label formulation-bridge decision; do not transfer the comparator SC route.
  • Use only for a diagnosed or strongly supported bacterial infection with a specific antibiogram showing susceptibility to both components. Obtain culture before treatment whenever feasible, prioritise source control and narrower first-line therapy, and reassess within 48-72 hours.
  • The fixed combination does not guarantee broad coverage. Penicillinase-producing staphylococci, resistant Enterobacterales, Pseudomonas and intrinsically nonsusceptible organisms may fail; the two components cannot be independently PK/PD-optimised.
  • Dihydrostreptomycin is nephrotoxic. Do not use in renal insufficiency; correct dehydration or hypovolaemia first and review urine, renal function and concurrent nephrotoxins. Stop and reassess for rising creatinine, urinary abnormalities, reduced appetite, vomiting or worsening hydration.
  • Cats are particularly sensitive to aminoglycoside vestibular toxicity. Monitor nystagmus, ataxia, head tilt, hearing and righting reflexes; cochlear or vestibular damage can be irreversible even when systemic therapeutic exposure makes it uncommon.
  • Aminoglycosides can cause neuromuscular blockade and respiratory weakness. Anaesthesia, neuromuscular blockers and electrolyte abnormalities can increase risk; tell the anaesthesia team and monitor ventilation if exposure overlaps a procedure.
  • Do not use with penicillin, procaine or aminoglycoside hypersensitivity. Urticaria and anaphylaxis are possible; avoid accidental intravascular injection because acute procaine exposure can cause tremor, vomiting, incoordination and other neurologic signs.
  • The exact instruction contraindicates concurrent tetracyclines, chloramphenicol, macrolides and lincosamides because of possible antagonism. Avoid other aminoglycosides, loop diuretics and potentially nephrotoxic or ototoxic drugs unless a specialist documents the rationale and monitoring.
  • Exact-product dog/cat pregnancy, lactation, neonatal, geriatric and reproductive safety is not established. Neonates have immature renal clearance; use in pregnancy, lactation or growing animals only after an explicit benefit-risk decision and with a supported alternative considered first.
Assessment sources
  1. Interchemie Penstrep-4002026
  2. Penstrep-400 EU UPD2025
  3. Penstrep-400 GE register2026
  4. CBG Penstrep-ject SPC2025
  5. EMA AMEG 20252025
  6. MSD Vet Manual 20262026
  7. AAFP AAHA stewardship2022
Assessed: 22 Oct 2026The overall score uses 25/25/25/15/10 weights. An unassessed price is excluded and the remaining weights are proportionally renormalised.
Composition / strength
Procaine Benzylpenicillin200000 IU/ml Dihydrostreptomycin200 mg/ml
Formulation Type
Suspension
Administration route
Intramuscular
Manufacturer
Interchemie werken "De Adelaar" B.V. · Netherlands
Registration
Georgia Yes, veterinary
Veterinary (National Food Agency)
In the register: პენსტრეპი–400
№ 46-11, 291-11
Verified on: 15 Oct 2026
 EU Yes, veterinary
Verified on: 15 Oct 2026
 UK No
Verified on: 15 Oct 2026
 US No
Verified on: 15 Oct 2026
Controlled in Georgia
No
Checked against the narcotics law, Annex 1, lists I-IV, and Order No. 22/n.
Verified on: 16 Oct 2026
DoseSpeciesWeightRouteFrequencySource
0.1 ml/kg
Comparator-derived off-label regimen, not the exact Interchemie label: current CBG-MEB Penstrep-ject contains the same 200,000 IU/ml procaine benzylpenicillin and 200 mg/ml dihydrostreptomycin in a suspension and authorises dogs and cats at 0.1 ml/kg IM or SC once daily for 3-5 days. Exact Interchemie Penstrep-400 is food-animal-only and IM-only; its excipient profile is not identical. Use IM only, after confirming product identity, susceptibility, renal suitability and a documented formulation bridge. Never substitute the Penstrep-400 LA 72-hour regimen.
 Cat Any weight Intramuscular once daily
CBG Penstrep-ject SPC
Official product label (SPC)
Approved by a medicines regulator as part of the product's authorisation. It applies to that product as authorised there.
Penstrep-ject suspension for injection - Summary of Product Characteristics
CBG-MEB Veterinary Medicines Information Bank, 2025
0.1 ml/kg
Comparator-derived off-label regimen, not the exact Interchemie label: current CBG-MEB Penstrep-ject contains the same 200,000 IU/ml procaine benzylpenicillin and 200 mg/ml dihydrostreptomycin in a suspension and authorises dogs and cats at 0.1 ml/kg IM or SC once daily for 3-5 days. Exact Interchemie Penstrep-400 is food-animal-only and IM-only; its excipient profile is not identical. Use IM only, after confirming product identity, susceptibility, renal suitability and a documented formulation bridge. Never substitute the Penstrep-400 LA 72-hour regimen.
 Dog Any weight Intramuscular once daily
CBG Penstrep-ject SPC
Official product label (SPC)
Approved by a medicines regulator as part of the product's authorisation. It applies to that product as authorised there.
Penstrep-ject suspension for injection - Summary of Product Characteristics
CBG-MEB Veterinary Medicines Information Bank, 2025
Active substance doses, with sources
Active substance Procaine Benzylpenicillin
Dose calculatorCalculates the active-substance amount; it is not a prescription.
PatientSpecies and weight will be filled in automatically in other calculators.
Selected dose
Dose Species Indication Route Frequency Source
20 mg/kg Dog, Cat Bacterial Infection Intramuscular once daily
EMA referral 2023
Official product label (SPC), EMA, EU
Approved by the European Medicines Agency (EMA) as part of the product's authorisation. It applies to that product as authorised there.
Procaine benzylpenicillin - Article 82 referral, Annexes I, II and III
European Medicines Agency, Committee for Veterinary Medicinal Products, 2023
30 mg/kg Dog, Cat Bacterial Infection Subcutaneous once daily
VMD SPC 2026
Official product label (SPC), VMD, UK
Approved by the UK Veterinary Medicines Directorate (VMD) as part of the product's authorisation. It applies to that product as authorised there.
Depocillin 300 mg/ml suspension for injection - Summary of Product Characteristics
UK Veterinary Medicines Directorate, Product Information Database, 2026
Active substance Dihydrostreptomycin
Dose calculatorCalculates the active-substance amount; it is not a prescription.
PatientSpecies and weight will be filled in automatically in other calculators.
Selected dose
Dose Species Indication Route Frequency Source
20 mg/kg Dog, Cat Bacterial Infection Intramuscular once daily
CBG Penstrep-ject SPC
Official product label (SPC)
Approved by a medicines regulator as part of the product's authorisation. It applies to that product as authorised there.
Penstrep-ject suspension for injection - Summary of Product Characteristics
CBG-MEB Veterinary Medicines Information Bank, 2025
11 mg/kg
off-label
 Dog Bacterial Infection Intramuscular 2 times daily
MSD Vet Manual 2026
Reference book
A veterinary reference written and reviewed by specialists, summarising accepted practice. The product label gives the authorised dose.
Aminoglycosides Use in Animals
MSD/Merck Veterinary Manual, 2026

Known Contraindications

  • Critical Dihydrostreptomycin
    Do not use the penicillin-dihydrostreptomycin combination in renal insufficiency because the aminoglycoside component is contraindicated.
    Sources: MSD Vet Manual
  • Critical Dihydrostreptomycin
    Dehydration and hypovolaemia directly increase aminoglycoside nephrotoxicity, as do acidosis, aciduria, hypomagnesaemia, severe sepsis, and endotoxaemia. Restore hydration before treatment; dehydration is a contraindication for some products.
    Sources: MSD Vet Manual
  • Warning Dihydrostreptomycin
    Safety during pregnancy and lactation has not been established. Because dihydrostreptomycin can be nephrotoxic and ototoxic, use only after a careful benefit-risk assessment.
  • Warning Dihydrostreptomycin
    Lengthen the dosing interval in neonates (especially puppies and foals), in animals with kidney failure and in obese animals.
    Sources: MSD Vet Manual
  • Warning Dihydrostreptomycin
    Safety of the penicillin-dihydrostreptomycin combination during pregnancy and lactation has not been established. The restriction is driven by the aminoglycoside component; use only after a careful benefit-risk assessment.
  • Warning Dihydrostreptomycin
    Aminoglycosides can cause neuromuscular blockade. This is particularly important during general anaesthesia and when other neuromuscular-blocking drugs are used.
    Sources: MSD Vet Manual
  • Warning Dihydrostreptomycin (Dog)
    Avoid aminoglycosides in working dogs that depend on hearing, such as guide dogs. Hearing loss begins at high frequencies, may progress to deafness, and can be permanent.
    Sources: MSD Vet Manual
  • Warning Dihydrostreptomycin (Cat)
    Cats are particularly sensitive to toxic vestibular effects, although these are unlikely at therapeutic concentrations after systemic administration. Vestibular injury can cause nystagmus, incoordination, and loss of the righting reflex and is often irreversible. Do not instil an aminoglycoside into the ear if the tympanic membrane is not intact.
    Sources: MSD Vet Manual
  • Critical Procaine Benzylpenicillin
    Do not use in animals hypersensitive to the active substance or any excipient. Rare reactions include life-threatening anaphylaxis. Avoid intravascular injection: sudden systemic procaine exposure may cause tremor, vomiting, incoordination, and fever.
    Sources: VMD SPC · VMD
  • Critical Procaine Benzylpenicillin
    Do not use procaine penicillin in rabbits, guinea pigs, hamsters, or gerbils. Guinea pigs, chinchillas, birds, snakes, and turtles are sensitive to procaine penicillin, and exposure may be fatal.
    Sources: VMD SPC · VMD · MSD Vet Manual

Known Drug Interactions

  • Contraindicated Furosemide + Dihydrostreptomycin
    Do not use concurrently with aminoglycoside antibiotic treatment. In cats, do not use furosemide with ototoxic antibiotics. Concomitant use with aminoglycosides or cephalosporins may increase the risk of nephrotoxicity.
    Recommendation: Do not administer concurrently. If an aminoglycoside is essential, choose a diuretic from another class.
    Sources: VMD SPC · VMD
  • Major warning Ampicillin + Dihydrostreptomycin
    Ampicillin and Sulbactam for Injection and aminoglycosides should not be reconstituted together due to the in vitro inactivation of aminoglycosides by the ampicillin component.
    Recommendation: Reconstitute and administer separately at different sites. Do not run them concurrently through the same line.
    Sources: FDA
  • Major warning Carprofen + Dihydrostreptomycin
    Avoid giving carprofen with potentially nephrotoxic drugs because renal toxicity may increase.
    Recommendation: Avoid concomitant use; if unavoidable, monitor renal function.
  • Major warning Robenacoxib + Dihydrostreptomycin
    Avoid combining robenacoxib with potentially nephrotoxic medicines because the risk of renal toxicity may increase.
    Recommendation: Avoid concomitant use; if unavoidable, monitor renal function.
  • Major warning Doxycycline + Procaine Benzylpenicillin
    Tetracyclines, chloramphenicol, macrolides, and lincosamides may antagonise the bactericidal action of benzylpenicillin.
    Recommendation: Do not administer concurrently. Choose one mechanism based on susceptibility testing.
    Sources: VMD SPC · VMD
  • Major warning Oxytetracycline + Procaine Benzylpenicillin
    Do not give oxytetracycline at the same time as bactericidal antimicrobials such as penicillins or cephalosporins because their antibacterial effects may be antagonistic.
    Recommendation: Do not administer concurrently.
  • Minor warning Amoxicillin + Dihydrostreptomycin
    Penicillins may increase the effect of aminoglycosides.
    Recommendation: An enhanced effect is expected; monitor for aminoglycoside toxicity. Do not mix in the same syringe.
    Sources: VMD SPC · VMD
  • Minor warning Trimethoprim/Sulfonamide + Procaine Benzylpenicillin
    Procaine (in procaine benzylpenicillin) is an ester of para-aminobenzoic acid (PABA). Like other PABA-ester local anaesthetics such as tetracaine, it can reduce the effect of potentiated sulfonamides, at least locally.
    Recommendation: Account for a reduced sulfonamide effect during concomitant administration.
    Sources: MSD Vet Manual

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