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Active substance

Dihydrostreptomycin

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Aminoglycoside. Registered in Georgia: 3 veterinary products. Forms: suspension.

Dose and use

Doses

Each dose comes with its source. Check the label of the product you use.

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
Before use

Safety information

Known Contraindications

  • Critical
    Do not use the penicillin-dihydrostreptomycin combination in renal insufficiency because the aminoglycoside component is contraindicated.
    Sources: MSD Vet Manual
  • Critical
    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
    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
    Lengthen the dosing interval in neonates (especially puppies and foals), in animals with kidney failure and in obese animals.
    Sources: MSD Vet Manual
  • Warning
    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
    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 (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 (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

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.
  • 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
Latin name
Dihydrostreptomycin
Georgian name
დიჰიდროსტრეპტომიცინი
Authorisation status
Authorised veterinary medicine
An authorised veterinary medicine containing this substance exists. Whether a particular use is on-label depends on the species and the indication - see each dose rule.
Registered in Georgia
3 of 3 forms
Products
Penstrep-400, Penstrep-400 LA, Shotapen
Controlled in Georgia
No
Checked against the narcotics law, Annex 1, lists I-IV, and Order No. 22/n.
Verified on: 16 Oct 2026
All forms and registration3

Registration in Georgia and abroad: the register, number, validity and source are behind (i).

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

Penstrep-400 LA 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 Proposed intramuscular treatment of a susceptible bacterial infection in a dog with exact Interchemie Penstrep-400 LA
Not rateable
No numerical score assigned
vetman assessment

Penstrep-400 LA

200 000 IU + 200 mg/ml, suspension for injection
Assessed clinical scopeDog · Proposed intramuscular treatment of a susceptible bacterial infection in a dog with exact Interchemie Penstrep-400 LA · Intramuscular
Care settingNot an established companion-animal pathway; use a product and regimen with exact dog/cat evidence rather than extrapolating a food-animal benzathine depot schedule
vetman score Not rateable No numerical score assigned
Evidence confidence: Medium Georgia: Yes, veterinary · № 001103 · Verified on 15 Oct 2026 Off-label use
Not rateable

A numerical canine product score cannot responsibly be calculated. Exact Interchemie Penstrep-400 LA is identifiable and registered in Georgia, but its current official instruction and register record cover food animals only. The published 0.1 ml/kg q72h regimen is a benzathine-containing depot schedule for cattle, calves, sheep, goats and pigs; no exact-product dog/cat dose, pharmacokinetic bridge, target-animal safety study or clinical outcome evidence was found. Shotapen has a different authorised product dossier and IM/SC dog/cat label, while Dutch dog/cat penicillin-dihydrostreptomycin products cannot establish equivalence to this Interchemie depot. The fixed aminoglycoside also adds renal, otic and neuromuscular risk. Assigning a low number would imply a quantifiable companion-animal benefit-risk that the evidence does not support.

The exact product is transparent enough to identify why it should not receive a dog/cat number: its public benefit-risk and 72-hour depot regimen belong to different target species. Georgian registration remains visible, but registration for food animals is not a companion-animal indication.

Important safety and use flags

  • Verify exact Interchemie Penstrep-400 LA (IPBS): 100,000 IU/ml procaine penicillin G + 100,000 IU/ml benzathine penicillin G + 200 mg/ml dihydrostreptomycin. Do not confuse it with plain Penstrep-400, Shotapen, Penstrep-ject or another similarly named product.
  • No dog or cat dose is established for this exact product. Do not use the food-animal 0.1 ml/kg every 72 hours regimen, and do not copy a daily two-component or another manufacturer’s dog/cat schedule; benzathine depot exposure is the unresolved difference.
  • Use systemic antibiotics only for a diagnosed or strongly supported bacterial infection. Obtain culture and susceptibility whenever feasible, prioritise source control and narrower first-line therapy, and reassess promptly rather than treating a broad syndrome list empirically.
  • The fixed combination does not guarantee coverage: penicillinase-producing staphylococci, resistant Enterobacterales, Pseudomonas and other resistant or intrinsically nonsusceptible organisms may fail. The two components cannot be independently PK/PD-optimised.
  • Dihydrostreptomycin is nephrotoxic. Avoid in dehydration, hypovolaemia or serious renal impairment and review renal function, urine findings and concurrent nephrotoxins before any aminoglycoside exposure; accumulation risk increases when clearance is reduced.
  • Aminoglycosides can cause irreversible cochlear/vestibular toxicity, neurotoxicity and neuromuscular blockade. Monitor hearing, balance, weakness and respiration; anaesthesia, neuromuscular blockers and electrolyte abnormalities can increase blockade risk.
  • Do not use with penicillin, procaine or aminoglycoside hypersensitivity. Urticaria and anaphylaxis are possible; accidental intravascular procaine exposure can cause tremor, vomiting, incoordination and other acute neurologic signs.
  • The exact instruction contraindicates concurrent tetracyclines, chloramphenicol, macrolides and lincosamides because of possible antagonism. Avoid other aminoglycosides, loop diuretics and potentially nephrotoxic/ototoxic drugs unless a specialist documents the rationale and monitoring.
  • Companion-animal pregnancy, lactation, neonatal, geriatric and reproductive safety is not established for this exact depot product. Do not infer it from food-animal withdrawal information or from a different penicillin preparation.
  • The exact product is IM-only and must be shaken well. Food-animal per-site volume limits, withdrawal periods and the 48-72-hour interval do not validate dog/cat injection volume, site tolerance, repeat dosing or handling; avoid accidental self-injection and seek urgent care for human hypersensitivity symptoms.
Assessment sources
  1. Interchemie Penstrep-400 LA2026
  2. Penstrep-400 LA GE register2026
  3. Kenya VMD Penstrep-400 LA2023
  4. Republika Srpska register 20252025
  5. UPD SPC 20242024
  6. EMA AMEG 20252025
  7. MSD Vet Manual 20262026
  8. AAFP AAHA stewardship2022
Assessed: 22 Oct 2026No axis or overall score is shown when the available evidence does not support a responsible numerical assessment.
Cat Proposed intramuscular treatment of a susceptible bacterial infection in a cat with exact Interchemie Penstrep-400 LA
Not rateable
No numerical score assigned
vetman assessment

Penstrep-400 LA

200 000 IU + 200 mg/ml, suspension for injection
Assessed clinical scopeCat · Proposed intramuscular treatment of a susceptible bacterial infection in a cat with exact Interchemie Penstrep-400 LA · Intramuscular
Care settingNot an established companion-animal pathway; use a product and regimen with exact dog/cat evidence rather than extrapolating a food-animal benzathine depot schedule
vetman score Not rateable No numerical score assigned
Evidence confidence: Medium Georgia: Yes, veterinary · № 001103 · Verified on 15 Oct 2026 Off-label use
Not rateable

A numerical feline product score cannot responsibly be calculated. Exact Interchemie Penstrep-400 LA is identifiable and registered in Georgia, but its current official instruction and register record cover food animals only. The published 0.1 ml/kg q72h regimen is a benzathine-containing depot schedule for cattle, calves, sheep, goats and pigs; no exact-product dog/cat dose, pharmacokinetic bridge, target-animal safety study or clinical outcome evidence was found. Shotapen has a different authorised product dossier and IM/SC dog/cat label, while Dutch dog/cat penicillin-dihydrostreptomycin products cannot establish equivalence to this Interchemie depot. The fixed aminoglycoside also adds renal, otic and neuromuscular risk. Assigning a low number would imply a quantifiable companion-animal benefit-risk that the evidence does not support.

The exact product is transparent enough to identify why it should not receive a dog/cat number: its public benefit-risk and 72-hour depot regimen belong to different target species. Georgian registration remains visible, but registration for food animals is not a companion-animal indication.

Important safety and use flags

  • Verify exact Interchemie Penstrep-400 LA (IPBS): 100,000 IU/ml procaine penicillin G + 100,000 IU/ml benzathine penicillin G + 200 mg/ml dihydrostreptomycin. Do not confuse it with plain Penstrep-400, Shotapen, Penstrep-ject or another similarly named product.
  • No dog or cat dose is established for this exact product. Do not use the food-animal 0.1 ml/kg every 72 hours regimen, and do not copy a daily two-component or another manufacturer’s dog/cat schedule; benzathine depot exposure is the unresolved difference.
  • Use systemic antibiotics only for a diagnosed or strongly supported bacterial infection. Obtain culture and susceptibility whenever feasible, prioritise source control and narrower first-line therapy, and reassess promptly rather than treating a broad syndrome list empirically.
  • The fixed combination does not guarantee coverage: penicillinase-producing staphylococci, resistant Enterobacterales, Pseudomonas and other resistant or intrinsically nonsusceptible organisms may fail. The two components cannot be independently PK/PD-optimised.
  • Dihydrostreptomycin is nephrotoxic. Avoid in dehydration, hypovolaemia or serious renal impairment and review renal function, urine findings and concurrent nephrotoxins before any aminoglycoside exposure; accumulation risk increases when clearance is reduced.
  • Aminoglycosides can cause irreversible cochlear/vestibular toxicity, neurotoxicity and neuromuscular blockade. Monitor hearing, balance, weakness and respiration; anaesthesia, neuromuscular blockers and electrolyte abnormalities can increase blockade risk.
  • Do not use with penicillin, procaine or aminoglycoside hypersensitivity. Urticaria and anaphylaxis are possible; accidental intravascular procaine exposure can cause tremor, vomiting, incoordination and other acute neurologic signs.
  • The exact instruction contraindicates concurrent tetracyclines, chloramphenicol, macrolides and lincosamides because of possible antagonism. Avoid other aminoglycosides, loop diuretics and potentially nephrotoxic/ototoxic drugs unless a specialist documents the rationale and monitoring.
  • Companion-animal pregnancy, lactation, neonatal, geriatric and reproductive safety is not established for this exact depot product. Do not infer it from food-animal withdrawal information or from a different penicillin preparation.
  • The exact product is IM-only and must be shaken well. Food-animal per-site volume limits, withdrawal periods and the 48-72-hour interval do not validate dog/cat injection volume, site tolerance, repeat dosing or handling; avoid accidental self-injection and seek urgent care for human hypersensitivity symptoms.
Assessment sources
  1. Interchemie Penstrep-400 LA2026
  2. Penstrep-400 LA GE register2026
  3. Kenya VMD Penstrep-400 LA2023
  4. Republika Srpska register 20252025
  5. UPD SPC 20242024
  6. EMA AMEG 20252025
  7. MSD Vet Manual 20262026
  8. AAFP AAHA stewardship2022
Assessed: 22 Oct 2026No axis or overall score is shown when the available evidence does not support a responsible numerical assessment.
Composition / strength
Procaine Benzylpenicillin100000 IU/ml Benzathine Benzylpenicillin100000 IU/ml Dihydrostreptomycin200 mg/ml
Formulation Type
Suspension
Administration route
Intramuscular
Registration
Georgia Yes, veterinary
In force until 11 May 2029
Veterinary (National Food Agency)
In the register: პენსტრეპ 400 ლა
№ 001103
Verified on: 15 Oct 2026
 EU No
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

Shotapen, Suspension

procaine benzylpenicillin 100 mg + benzathine benzylpenicillin 100 mg + dihydrostreptomycin 200 mg/ml, 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 Labelled treatment of infections caused by bacteria susceptible to the fixed penicillin-dihydrostreptomycin combination
6.5/10
Situational / acceptable
vetman assessment

Shotapen

procaine benzylpenicillin 100 mg + benzathine benzylpenicillin 100 mg + dihydrostreptomycin 200 mg/ml, suspension for injection
Assessed clinical scopeDog · Labelled treatment of infections caused by bacteria susceptible to the fixed penicillin-dihydrostreptomycin combination · IM,SC
Care settingVeterinary clinic treatment selected by likely pathogen, culture and patient renal status
vetman score 6.5/10 Situational / acceptable
Evidence confidence: Medium Georgia: Yes, veterinary · Verified on 18 Oct 2026

A legally well-documented but clinically narrow fixed antibiotic combination; reserve for a justified susceptible infection when safer, more targeted options are unsuitable.

Regulatory and scientific credibility8.0/10

The exact long-acting combination has a current valid French authorisation, transparent SPC and an active Georgian veterinary registration record.

Clinical efficacy5.5/10

The components can be active against susceptible organisms, but the fixed broad combination, old evidence base, resistance risk and inability to independently optimise beta-lactam and aminoglycoside exposure make it a narrow culture-directed choice.

Safety and tolerability5.0/10

Dihydrostreptomycin adds clinically important nephrotoxic and ototoxic risk, especially with dehydration or renal impairment; penicillin/procaine hypersensitivity is a hard contraindication.

Clinical practicality8.0/10

A single IM or SC injection, with at most one repeat after 72 hours, is operationally simple in clinic; the suspension must be shaken and the weight-based range selected carefully.

Full-course cost-effectiveness-

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

Important safety and use flags

  • Do not use with penicillin or procaine hypersensitivity; avoid accidental exposure in rabbits, guinea pigs, hamsters and gerbils.
  • Avoid or use only with strict monitoring in dehydration or renal impairment because the aminoglycoside component is nephrotoxic and ototoxic.
  • Reserve the fixed combination for a justified susceptible infection; culture and susceptibility are preferred whenever feasible.
Assessment sources
  1. UPD SPC 20242024
  2. EMA AMEG 20252025
  3. MSD Vet Manual 20262026
Assessed: 21 Oct 2026The overall score uses 25/25/25/15/10 weights. An unassessed price is excluded and the remaining weights are proportionally renormalised.
Cat Labelled treatment of infections caused by bacteria susceptible to the fixed penicillin-dihydrostreptomycin combination
6.5/10
Situational / acceptable
vetman assessment

Shotapen

procaine benzylpenicillin 100 mg + benzathine benzylpenicillin 100 mg + dihydrostreptomycin 200 mg/ml, suspension for injection
Assessed clinical scopeCat · Labelled treatment of infections caused by bacteria susceptible to the fixed penicillin-dihydrostreptomycin combination · IM,SC
Care settingVeterinary clinic treatment selected by likely pathogen, culture and patient renal status
vetman score 6.5/10 Situational / acceptable
Evidence confidence: Medium Georgia: Yes, veterinary · Verified on 18 Oct 2026

A legally well-documented but clinically narrow fixed antibiotic combination; reserve for a justified susceptible infection when safer, more targeted options are unsuitable.

Regulatory and scientific credibility8.0/10

The exact long-acting combination has a current valid French authorisation, transparent SPC and an active Georgian veterinary registration record.

Clinical efficacy5.5/10

The components can be active against susceptible organisms, but the fixed broad combination, old evidence base, resistance risk and inability to independently optimise beta-lactam and aminoglycoside exposure make it a narrow culture-directed choice.

Safety and tolerability5.0/10

Dihydrostreptomycin adds clinically important nephrotoxic and ototoxic risk, especially with dehydration or renal impairment; penicillin/procaine hypersensitivity is a hard contraindication.

Clinical practicality8.0/10

A single IM or SC injection, with at most one repeat after 72 hours, is operationally simple in clinic; the suspension must be shaken and the weight-based range selected carefully.

Full-course cost-effectiveness-

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

Important safety and use flags

  • Do not use with penicillin or procaine hypersensitivity; avoid accidental exposure in rabbits, guinea pigs, hamsters and gerbils.
  • Avoid or use only with strict monitoring in dehydration or renal impairment because the aminoglycoside component is nephrotoxic and ototoxic.
  • Reserve the fixed combination for a justified susceptible infection; culture and susceptibility are preferred whenever feasible.
Assessment sources
  1. UPD SPC 20242024
  2. EMA AMEG 20252025
  3. MSD Vet Manual 20262026
Assessed: 21 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 Benzylpenicillin100 mg/ml Benzathine Benzylpenicillin100 mg/ml Dihydrostreptomycin200 mg/ml
Formulation Type
Suspension
Administration route
Intramuscular, Subcutaneous
Manufacturer
Virbac · France
Registration
Georgia Yes, veterinary
Veterinary (National Food Agency)
In the register: შოტაპენი®
Verified on: 18 Oct 2026
 EU Yes, veterinary
№ FR/V/9639616 8/1991
Verified on: 18 Oct 2026
 UK No
Verified on: 18 Oct 2026
 US No
Verified on: 18 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

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The dose for the patient's weight, registration in Georgia and controlled status, right on the prescription.

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