Chlorhexidine information from DrugsUpdate
P - Contraindicated in pregnancy
LI - Lab *
Chlorhexidine is a chemical antiseptic. It kills (is bactericidal to) both gram-positive and gram-negative microbes, although it is less effective with some gram-negative microbes. It is also bacteriostatic.
The mechanism of action is membrane disruption, and not ATPase inactivation as previously thought. It also shows activity with enveloped viruses, though this has not been extensively investigated.Products containing chlorhexidine in high concentrations must be kept away from eyes and the ears, due to the risk of damage to those organs. However, chlorhexidine is safely used in very low concentrations in some contact lens solutions.
Pharmacodynamics
Pharmacokinetics
Chlorhexidine, is a very potent, cationic chemoprophylactic agent. It has a broad-spectrum action, and is more effective against gm+ve than gm-ve bacteria. It acts by binding to negatively charged bacterial cell wall thereby disrupting membrane integrity and affecting its functions. In high concentrations, chlorhexidine is bactericidal. Absorption: Poor (oral, topical).
Chlorhexidine Indications / Chlorhexidine Uses
Information Not Available
Chlorhexidine Adverse Reactions / Chlorhexidine Side Effects
Skin sensitivity; irritation of conjunctiva, mucosal irritation; reversible brown staining of the teeth; tongue discoloration; parotid gland swelling.
Precautions
General
1. For patients having coexisting gingivitis and periodontitis, the presence or absence of gingival inflammation following treatment with Chlorhexidine gluconate should not be used as a major indicator of underlying periodontitis.
2. Chlorhexidine gluconate oral rinse can cause staining of oral surfaces, such as tooth surfaces, restorations, and the dorsum of the tongue. Not all patients will experience a visually significant increase in toothstaining. In clinical testing, 56% of Chlorhexidine gluconate oral rinse users exhibited a measurable increase in facial anterior stain, compared to 35% of control users after six months; 15% of Chlorhexidine gluconate users developed what was judged to be heavy stain, compared to 1% of control users after six months. Stain will be more pronounced in patients who have heavier accumulations of unremoved plaque.
Stain resulting from use of Chlorhexidine gluconate oral rinse does not adversely affect health of the gingivae or other oral tissues. Stain can be removed from most tooth surfaces by conventional professional prophylactic techniques. Additional time may be required to complete the prophylaxis.
Discretion should be used when prescribing to patients with anterior facial restorations with rough surfaces or margins. If natural stain cannot be removed from these surfaces by a dental prophylaxis, patients should be excluded from Chlorhexidine gluconate treatment if permanent discoloration is unacceptable. Stain in these areas may be difficult to remove by dental prophylaxis and on rare occasions may necessitate replacement of these restorations.
3. Some patients may experience an alteration in taste perception while undergoing treatment with Chlorhexidine gluconate oral rinse. Rare instances of permanent taste alteration following use of Chlorhexidine gluconate oral rinse have been reported via postmarketing surveillance.
Special Precautions
Avoid contact with eyes except when dilute solutions are used.
Other Drug Interactions
Information Not Available
Other Interactions
Information Not Available
Dosage
Mouth/Throat Oral hygiene, Gingivitis Adult: Rinse mouth with 10 ml of a 0.2% soln for 1 minute bid-tid.
Food(before/after)
Information Not Available
List of Contraindications
Chlorhexidine and Pregnancy
Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).
Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.
Chlorhexidine and Lactation
It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Chlorhexidine gluconate is administered to a nursing woman.
In parturition and lactation studies with rats, no evidence of impaired parturition or of toxic effects to suckling pups was observed when Chlorhexidine gluconate was administered to dams at doses up to 100 mg/kg/day.
Chlorhexidine and Children
Clinical effectiveness and safety of Chlorhexidine gluconate have not been established for pediatric patients under the age of 18.
Chlorhexidine and Geriatic
Information Not Available
Chlorhexidine and Other Contraindications
Brain, meninges, middle ear or sensitive tissues
Storage
Information Not Available
Lab interference
Information Not Available
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