Extension on Benzanthine Penicillin G (Bicillin® L-A) Shortage And Temporary Use of Lentocilin S 1200.

Article

Apr 09, 2026

The national shortage of Benzathine Penicillin G (Bicillin® L-A) 1,200,000 IU/2mL, indicated as the first line treatment for syphilis, continues to persist.
To help mitigate the shortage, Health Canada has permitted the exceptional, temporary use of Portuguese-authorized Lentocilin S 1200; 1 200 000 IU / 4 mL with English-only labels.
Lentocilin S 1200 is expected to arrive in the province by mid-April.
Clinicians who have been waiting to start patients on Bicillin should reconsider in light of the ongoing shortage and follow the interim federal guidelines (external link) which recommend both conservation of Penicillin for certain populations and alternative treatments for others.

Due to a critical shortage of the antibiotic Bicillin L-A 1 200 000 IU / 2 mL in Canada, and given the medical necessity of this drug, Health Canada has permitted the exceptional, temporary use of Portuguese-authorized Lentocilin S 1200; 1 200 000 IU / 4 mL with English-only labels.
Lentocilin S has the same active ingredient, strength (1 200 000 IU) and route of administration (intramuscular) as Bicillin L-A. However, Lentocilin S has a different formulation, dosage form, reconstitution requirement, and presentation than Bicillin L-A.

Key differences between Lentocilin S 1200; di1 200 000 IU / 4 mL and Bicillin L-A 1 200 000 IU / 2 mL are as follows:

	Lentocilin S 1200; 1 200 000 IU / 4 mL	Bicillin L-A 1 200 000 IU / 2 mL.
Product dosage form and strength	Each vial contains 1 200 000 IU of benzathine benzylpenicillin 1 200 000 IU / 4 mL, Powder and diluent for suspension.	Penicillin G benzathine, 1 200 000 IU per 2 mL suspension for injection.
Product presentation	Each unit consists of a clear glass vial for injection (powder) and an amber glass ampoule with diluent.	2 mL ready-to-use pre-filled syringe.
Reconstitution	Reconstitute immediately prior to use. Refer to Lentocilin S SmPC (external PDF) for instructions.	None.
Volume of injection	4mL Note: A needle with a minimum 18 gauge is required to administer Lentocilin S.	2ml
Storage	Store below 25ºC. Store in the original package in order to protect from light and moisture.	Store under refrigeration (2o-8oC). May be removed from refrigerator and stored for 7 days at a temperature not exceeding 30oC. Protect from freezing.

Lentocilin S contains soy phospholipids and may cause hypersensitivity reactions (urticaria, anaphylactic shock) in patients with a history of allergy to soybeans.
Please enhance the safety monitoring of the imported drug, including monitoring for potential adverse effects.
Refer to the Lentocilin S Summary of Product Characteristics (SmPC) (external PDF) in English and French for product specific information on dosing, preparation and administration, warnings and precautions, and storage and handling.
Halton Region Public Health will continue to fulfill your orders with Bicillin® L-A while supplies last; once depleted, all orders will be filled with Lentocilin S 1200.
To order publicly funded STI Medications, complete the STI treatment order form.