Updated: February 5, 2026

Lentocilin Shortage Update: What Patients Need to Know in 2026

Author

Peter Daggett

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Current Shortage Status (As of Mid-2026)
The Full Timeline of the Shortage
Why Does This Matter So Much?
What CDC and Health Departments Are Recommending
Action Steps for Patients Right Now
Further Reading

The Lentocilin (penicillin G benzathine) shortage continues into 2026. Here's the latest update on supply status, what it means for patients, and your options.

If you depend on Lentocilin (penicillin G benzathine) for syphilis treatment or rheumatic fever prevention, you already know firsthand how challenging the supply situation has become. This article provides the latest update on the Lentocilin and Bicillin L-A shortage as of 2026, what the timeline looks like, and the most important steps patients can take right now.

Current Shortage Status (As of Mid-2026)

The shortage of penicillin G benzathine products — including both Bicillin L-A (the US brand made by Pfizer) and Lentocilin (the Portuguese import) — remains a significant public health problem in 2026. Here's where things stand:

Bicillin L-A: In shortage since mid-2023. July 2025 voluntary recall of multiple 1.2 MU and 2.4 MU prefilled syringe lots. As of April 2026, Pfizer has extended the next delivery of 1.2 MU and 2.4 MU presentations to October 2026, with full recovery now projected for Q4 2027.

Lentocilin: Manufactured in Portugal, imported under FDA enforcement discretion. FDA re-authorized importation in March 2026. Supply has been intermittent — there were periods in late 2025 when Lentocilin was unavailable through its authorized U.S. distributor, TopRx. Supply is expected to continue as long as the FDA maintains its authorization.

Extencilline: Another imported penicillin G benzathine product (from France/Italy), Extencilline is no longer available for distribution as of January 5, 2026, leaving Lentocilin as the primary imported option.

The Full Timeline of the Shortage

Mid-2023: FDA first lists Bicillin L-A as being in shortage due to surging syphilis rates and manufacturing constraints at Pfizer

January 2024: FDA authorizes temporary importation of Extencilline (French product)

June/July 2024: FDA authorizes temporary importation of Lentocilin (Portuguese product) via Mark Cuban Cost Plus Drug Company; priced at ~$15 per dose

July 10, 2025: King Pharmaceuticals (Pfizer) issues voluntary recall of Bicillin L-A 1.2 MU and 2.4 MU lots due to particulates found in prefilled syringes

January 5, 2026: Extencilline is discontinued and no longer available for distribution

January 21, 2026: Pfizer updates shortage recovery timeline; next delivery of 1.2 MU and 2.4 MU prefilled syringes now expected October 2026

March 6, 2026: FDA re-announces authorization for temporary importation of Lentocilin due to ongoing Bicillin L-A shortage

April 14, 2026: Pfizer extends next delivery further; full shortage recovery pushed to Q4 2027

Why Does This Matter So Much?

Penicillin G benzathine is not just any antibiotic — it is the cornerstone of U.S. syphilis treatment and the ONLY recommended antibiotic for pregnant women with syphilis. The stakes are enormous:

Congenital syphilis rates in the U.S. are at a 30-year high, with rates in newborns 10 times the 10-year average

Untreated syphilis in pregnant women leads to miscarriage, stillbirth, and devastating health problems in newborns

For patients on monthly rheumatic fever prophylaxis, supply interruptions put them at risk of recurrent strep infections and heart damage

What CDC and Health Departments Are Recommending

Given the ongoing shortage, the CDC and state health departments have issued the following guidance for patients:

Pregnant patients with syphilis: Should receive penicillin G benzathine (Lentocilin or Bicillin L-A) as a top priority. Contact your local health department immediately if you cannot find it.

Non-pregnant adults with early syphilis: Doxycycline 100 mg twice daily for 14 days is an acceptable alternative when penicillin G benzathine is unavailable.

Patients with strep pharyngitis: Should use oral amoxicillin or Penicillin VK to conserve injectable supplies for syphilis patients.

Action Steps for Patients Right Now

Contact your local public health department or STI clinic. These facilities get priority penicillin G benzathine allocations.

Use medfinder to search for Lentocilin near you. medfinder contacts clinics and pharmacies on your behalf.

Talk to your provider about alternatives. If you're not pregnant and cannot find Lentocilin, ask about doxycycline as an alternative.

Don't wait. Syphilis is curable but can cause severe damage if left untreated. The longer treatment is delayed, the greater the health risk.

Frequently Asked Questions

Yes. The Bicillin L-A shortage continues in 2026, with Pfizer now projecting recovery for Q4 2027. Lentocilin (imported from Portugal) remains available under FDA enforcement discretion and was re-authorized in March 2026, but supply is intermittent. Extencilline, the other imported option, is no longer available as of January 2026.

The domestic Bicillin L-A shortage, which Lentocilin was imported to address, now has a recovery date of Q4 2027 as of Pfizer's April 2026 update. Lentocilin importation is expected to continue as a bridge. Patients should prepare for ongoing limited availability through at least late 2027.

Extencilline, a penicillin G benzathine product imported from France/Italy, is no longer available for distribution in the U.S. as of January 5, 2026. Lentocilin is now the only imported penicillin G benzathine product authorized by the FDA.

In July 2025, King Pharmaceuticals (Pfizer) voluntarily recalled multiple lots of Bicillin L-A 1.2 MU and 2.4 MU prefilled syringes due to particulates. This recall removed significant inventory from the market and pushed the shortage recovery timeline from 2026 into Q4 2027. It substantially worsened an already difficult supply situation.

Yes. Pregnant women face a uniquely severe impact from this shortage because penicillin G benzathine (Lentocilin or Bicillin L-A) is the ONLY safe and recommended treatment for syphilis in pregnancy. There is no adequate alternative. CDC and state health departments have directed providers to prioritize pregnant women and newborns for all available penicillin G benzathine supplies.

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