Class: Antibacterial Cleansing Agent
Dosage Forms. Liquid Oral Rinse: 0.12%; Solution: 20%; Topical Solution: 4%
Common FDA Label Indication, Dosing, and Titration.
1. Gingivitis: 15 mL oral rinse (undiluted, 0.12%), swish 30 s and spit bid (morning and evening) after tooth brushing
2. Skin or wound cleansing: Rinse area to be cleansed, apply minimum amount of 4% solution necessary to cover skin or wound area, and wash gently; then rinse
1. Burn, prevention of nosocomial infectious disease: Rinse area to be cleansed, apply minimum amount of 4% solution necessary to cover skin or wound area, and wash gently; then rinse
MOA. Chlorhexidine, a polybiguanide, is an antiseptic and antimicrobial drug with bactericidal activity. The bactericidal effect of chlorhexidine is a result of the binding of this cationic molecule to negatively charged bacterial cell walls and extramicrobial complexes.
Drug Characteristics: Chlorhexidine
Medication Safety Issues: Chlorhexidine
Drug Interactions: Chlorhexidine. None
Adverse Reactions: Chlorhexidine
Efficacy Monitoring Parameters. Oral rinse: resolution of gingivitis. Topical: no signs of bacterial infection (redness, pruritis, burning, swelling).
Toxicity Monitoring Parameters. Tooth discoloration, skin irritation.
Key Patient Counseling Points. For oral rinse, measure out 1/2 fluid ounce (15 mL) as marked in the cap which comes with the bottle, swish the solution in mouth for at least 30 s; do not swallow. Wait several hours after use of chlorhexidine to eat or drink. Likely to cause tooth discoloration, which can be removed by dental cleaning. For topical product, use only on unbroken skin, do not swallow, or get in the eyes, ears, mouth, nose, genital area, or anal area. Contains large amounts of alcohol (70%) and are flammable. Apply the medicine in a well-ventilated place. Do not cover the treated area until the medicine is completely dry. This is usually 3 min or longer for hairless skin. If you must apply the medicine to a hairy area of the body, wipe the area with a towel to remove extra medicine.
Clinical Pearls. Not for use in children.