Extended Benzanthine Penicillin G (Bicillin® L-A) shortage

Quick facts

• The Ministry of Health has notified local public health units that the ongoing national shortage of Benzathine Penicillin G (Bicillin® L-A) 1,200,000 IU/2mL, indicated as the first line treatment for syphilis, is now expected to continue until April 2026.
• Please continue to restrict the use of Bicillin® L-A to the following patient populations for the duration of the shortage.
  • Pregnant individuals (all stages) and their ongoing sexual contact(s).
  • Infectious cases (primary, secondary and early latent syphilis), regardless of HIV status, if adherence to alternative treatment and follow-up is uncertain.
  • Sexual contacts (within 90 days) of infectious cases of syphilis if pregnant OR adherence to treatment and follow-up is uncertain.
• Until the shortage is resolved, reassess treatment plans, determining whether to start treatment with alternative therapy or postpone treatment.

Key messages for healthcare providers

• Refer to the Public Health Agency of Canada’s recommendations on Interim Syphilis Treatment Guidelines in the event of a Benzathine Penicillin G (Bicillin L-A) Shortage (external link) for detailed information on alternative treatment options during the shortage.
• To order Bicillin® L-A and other publicly funded STI Medications, complete the STI Treatment Order Form (external link).

Additional resources

• Interim Syphilis Treatment Guidelines in the Event of a Benzathine Penicillin G (Bicillin® L-A) Shortage (external link), Public Health Agency of Canada (PHAC)
• Health Products Shortages Canada (external link)