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hexamidine

R01AX07

Forms & Strengths

Nasal spray solution 0.1% (w/v) hexamidine dihydrochloride
Otic solution 0.1% hexamidine dihydrochloride
Vaginal gel 0.1% hexamidine dihydrochloride
Topical cream/ointment 0.2% hexamidine dihydrochloride

Adult Dosing

Nasal spray: 1-2 sprays per nostril 2-3 times daily
Otic drops: 3-4 drops into each ear 2-3 times daily
Vaginal gel: 5 g intravaginally once daily for 7 days
Topical cream: thin layer to affected area 2-3 times daily

Pediatric Dosing

Children ≥2 years (nasal): 1 spray per nostril 2 times daily
Children 2–12 years (otic): 2-3 drops per ear 2 times daily; avoid if tympanic membrane perforated
Infants <2 years: use only under specialist supervision; generally avoid otic and nasal forms

Indications

Acute and chronic rhinosinusitis adjunctive therapy
Otitis externa (ear canal antisepsis)
Vulvovaginal candidiasis prophylaxis and bacterial vaginosis adjunct
Skin antisepsis for minor wounds and burns

Mechanism of Action

Membrane-active antiseptic: binds to phospholipids, disrupts bacterial and fungal cell membranes
Broad-spectrum microbicidal activity against Gram‑positive, Gram‑negative bacteria and yeasts
Inhibits protein synthesis by altering membrane permeability

Contraindications

Known hypersensitivity to hexamidine or related compounds
Perforated tympanic membrane (otocontact forms)
Severe nasal mucosal ulceration

Adverse Reactions

Local irritation, burning or stinging at application site
Pruritus or erythema; rare allergic contact dermatitis
Transient taste alteration with nasal spray

Drug Interactions

Potential additive ototoxicity when combined with aminoglycoside ear drops
No significant systemic interactions; minimal systemic absorption
Concurrent use with other topical antiseptics may increase irritation risk

Curated Content: Needs Vetting Before Put to Clinical Use