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chlorhexidine

A01AB03

Forms & Strengths

Oral rinse: 0.12%
Skin cleanser/surgical scrub: 2%, 4%
Solution/concentrate: 5%, 20%

Adult Dosing

Oral rinse: 15 mL of 0.12% undiluted, rinse for 30 seconds twice daily (morning and evening) after brushing
Skin/wound cleansing: Apply small amount to affected area and wash gently, rinse thoroughly
Surgical hand scrub: Wet hands, apply 5 mL, scrub for 3 minutes, rinse thoroughly

Pediatric Dosing

Oral rinse (Children >= 12 years): 15 mL of 0.12% undiluted, rinse twice daily for 30 seconds
Pediatric < 12 years: Safety and efficacy not established for oral rinse

Indications

Treatment of gingivitis characterized by redness, swelling, and bleeding gums
Pre-operative surgical hand scrub
Skin wound and general skin cleansing
Catheter site care

Mechanism of Action

Cationic bisbiguanide antimicrobial agent
Binds to negatively charged bacterial cell walls, causing disruption of cell membrane integrity
At low concentrations, causes leakage of intracellular components (bacteriostatic)
At high concentrations, causes precipitation of cytoplasmic proteins and cell death (bactericidal)
Effective against a wide range of gram-positive and gram-negative bacteria, facultative anaerobes, aerobes, and yeasts

Contraindications

Hypersensitivity to chlorhexidine gluconate or any component of the formulation

Adverse Reactions

Staining of teeth, restorations, and tongue
Increase in calculus formation
Alteration in taste perception (dysgeusia)
Oral irritation, desquamation of oral mucosa
Allergic contact dermatitis, severe hypersensitivity/anaphylaxis (rare)

Drug Interactions

Anionic compounds (e.g., sodium lauryl sulfate found in most toothpastes): inactivates chlorhexidine; allow at least 30 minutes between brushing teeth and using oral rinse
Calcium, magnesium, and other polyvalent cations may reduce antimicrobial efficacy

Curated Content: Needs Vetting Before Put to Clinical Use