Chlorhexidine is an antiseptic that is intended for external local use. Effectively removes pathogenic microorganisms from the surface of the skin, slowing down their reproduction and activity. In high concentrations it leads to the total death of microorganisms in the area of application. Used to treat medical instruments and the skin of operating doctors. Can be used to disinfect skin wounds and abrasions. The effect of using the drug lasts for several hours. Does not cause the development of resistance in microorganisms. Absolutely harmless with frequent use.
Release form
The drug Chlorhexidine is sold in pharmacy chains in the form of gel, cream and patches of various shapes. Also, the drug Chlorhexidine is produced in the form of a concentrate for the preparation of a solution for external local use (water- and alcohol-based solutions are prepared).
- Solution for local and external use (bigluconate) 0.05%, 0.2%, 1%, 5% in bottles of 25, 50, 70, 100, 200, 500 or 1000 ml.
- Spray for external use 0.5% (alcohol). 70 and 100 ml in vials (bottles) with a nozzle and a PE cap or sealed with a cap with a spray device.
- Vaginal suppositories 8 mg and 16 mg - 10 pcs.
Chlorhexidine bigluconate
The last update of the manufacturer's description was 07/31/1996
20% aqueous solution of chlorhexidine bigluconate; in bottles of 500 ml.
Treatment of the surgical field and the surgeon’s hands; sterilization of surgical instruments, treatment of wounds and burns, lavage of the bladder for cystitis.
Disinfection of the surgical field - 0.5% solution in 70% ethanol for 5 minutes; hand disinfection - 0.5% solution in 70% ethanol or 1% aqueous solution; antiseptics of wounds and burns - 0.5% aqueous solution; disinfection measures in gynecology and obstetrics - from 0.05 to 0.2% aqueous solution; cystoscopy, bladder lavage - 0.02% sterile aqueous solution; disinfection of the urethra during catheterization - 0.05% sterile solution in glycerin; disinfection of medical instruments - 0.5% solution in 70% ethanol for 5 minutes; sterilization of medical instruments - 0.5% aqueous solution at a temperature of 70 °C for 3 hours.
Keep out of the reach of children.
Do not use after the expiration date stated on the package.
Chlorhexidine digluconate Instructions for medical use - RU No. P N015600/01
Last modified date: 16.04.2004
Dosage form
Concentrate for the preparation of solutions for local and external use.
Compound
Active substance:
Chlorhexidine bigluconate 20 g.
Excipients:
Water up to 100 ml.
Description of the dosage form
Colorless or light yellow transparent liquid.
Pharmacological group
Antiseptic.
Pharmacodynamics
Antiseptic. Depending on the concentration used, it exhibits both bacteriostatic and bactericidal effects. The bacteriological effect of both aqueous and alcoholic working solutions) manifests itself in a concentration of 0.01% or less; bactericidal - in a concentration of more than 0.01% at a temperature of 22 ° C and exposure for 1 minute.
Fungicidal effect - at a concentration of 0.05%, at a temperature of 22 ° C and exposure for 10 minutes. Virucidal effect - manifests itself at a concentration of 0.01-1%. Effective against pathogens of sexually transmitted infections - gardnerellosis, genital herpes; gram-positive and gram-negative bacteria - Treponema spp., Neisseria gonorrhoeae, Trichomonas spp.
, Chlamydia spp., Ureaplasma spp.
Does not affect acid-resistant forms of bacteria, microbial spores, fungi. It is stable, after treatment of the skin (hands, surgical field) it remains on it in a certain amount sufficient to exhibit a bactericidal effect. Retains activity (albeit somewhat reduced) in the presence of blood, pus, various secretions and organic substances.
It extremely rarely causes allergic reactions, irritation of skin and tissues, and does not have a damaging effect on objects made of glass, plastic and metals.
Pharmacokinetics
Practically not absorbed from the gastrointestinal tract. After accidental ingestion of 300 mg, Cmax is reached after 30 minutes and is 0.206 μg/l.
It is excreted mainly in feces (90%), less than 1% is excreted by the kidneys.
Indications
As a preventive and therapeutic agent for various infections, for antiseptic treatment and disinfection.
0.05%, 0.1%, 0.2% aqueous solutions:
- Postoperative care for patients in ENT and dentistry departments.
0.05% and 0.2% solutions:
- Purulent wounds, infected burns, bacterial and fungal diseases of the skin and mucous membranes in dentistry (rinsing and irrigation - gingivitis, stomatitis, aphthae, periodontitis, alveolitis);
- Prevention of infections in surgery, urology, obstetrics and gynecology;
- Prevention of sexually transmitted infections (chlamydia, ureaplasmosis, trichomoniasis, gonorrhea, syphilis, genital herpes - use no later than 2 hours after sexual intercourse);
- · Disinfection of skin (abrasions, cracks).
0.2% solution:
- Treatment and sanitation of the genital tract in gynecology during therapeutic and diagnostic procedures;
- Disinfection of removable dentures.
0.5% solution:
- Treatment of wounds and burn surfaces; treatment of infected abrasions and cracks of the skin, open mucous membranes.
- Sterilization of medical instruments at a temperature of 70°C.
1% solution:
- Disinfection of thermometers, working surfaces of medical equipment and devices, the heat treatment of which is undesirable;
- Treatment of the surgical field and the surgeon's hands before surgery, disinfection of the skin, treatment of postoperative and burn wounds.
5% concentrate:
- Preparation of aqueous, glycerin and alcohol solutions with concentrations from 0.01 to 1%.
Contraindications
Hypersensitivity to the components of the drug, dermatitis.
Carefully:
Children's age (up to 18 years)
Directions for use and doses
Chlorhexidine is used as a prophylactic and therapeutic agent externally and locally, as well as for disinfection.
0.05%, 0.02% and 0.5% aqueous solutions are used in the form of irrigation, rinsing and applications (5-10 ml are applied to the affected surface of the skin or mucous membranes):
- To treat the surgical field, dilute a 20% solution with 70% ethyl with an exposure of 1-3 minutes, 2-3 times a day (on a tampon or by irrigation).
- Alcohol in a ratio of 1:40. The resulting 0.5% aqueous-alcohol solution of chlorhexidine is treated with the surgical field 2 times with an interval of 2 minutes.
- For postoperative care of patients in the ENT and dentistry departments, a solution (0.05% and 0.1%) for rinsing is usually prescribed 2-3 times a day.
- Complex treatment of urethritis and urethroprostatitis is carried out by injecting 2-3 ml of a 0.05% solution of chlorhexidine digluconate into the urethra 1-2 times a day, the course of treatment is 10 days, procedures are prescribed every other day.
- To wash the bladder during cystoscopy, use a 0.02% sterile aqueous solution.
- For the prevention of sexually transmitted diseases, chlorhexidine bigluconate is effective if it is used no later than 2 hours after sexual intercourse. A diluted 0.05% solution is injected into the urethra for men (2-3 ml), women (1-2 ml) and into the vagina (5-10 ml) for 2-3 minutes. It is also necessary to treat the skin of the inner thighs, pubis, and genitals. After the procedure, do not urinate for 2 hours.
For disinfection:
Treatment of medical instruments and working surfaces is carried out with a clean sponge moistened with an antiseptic solution, or by soaking. To quickly sterilize instruments, use the same 0.5% solution for 5 minutes.
A 0.1% aqueous solution of chlorhexidine can be used to disinfect premises, sanitary equipment, etc.
Recommended dilution of solutions
Procedure | Dilution of the drug and type of solvent | Concentration of solution containing chlorhexidine bigluconate | Special Requirements |
Disinfection of hands and surgical field | 1:40 in 70% ethyl alcohol | 0,5 % | Treatment with the solution for at least 5 minutes. |
Antiseptic treatment of wounds and burns | 1:40 in the water | 0,5 % | Use sterilized water. Sterilize the solution at a temperature of 115-116 °C for 30 minutes in an autoclave. |
Antiseptics in gynecology and obstetrics | 1:400 | 0,05 % | Use sterilized water. The solution is sterilized at a temperature of 115-116 °C for 30 minutes in an autoclave. |
Cystoscopy, bladder lavage | 1:1000 in water or saline sodium chloride solution. | 0,02 % | Sterile solution. |
Washing of the peritoneum, pleura (operational procedures) | 1:1000 in water | 0,02 % | Sterile solution |
Antiseptics for urethral catheterization | 1:400 | 0,05 % | Combine aseptically with sterile glycerin. |
Side effects
In rare cases - allergic reactions (skin rash), dry skin, itching, dermatitis, stickiness of the skin of the hands (within 3-5 minutes), photosensitivity. Changes in tooth color, tartar deposits and taste disturbances with long-term use for oral antiseptics.
Overdose
In case of accidental ingestion, it is practically not absorbed (gastric lavage should be done using milk, raw egg, gelatin or mild soap). If necessary, symptomatic therapy is carried out.
Interaction
Used in a neutral environment; at pH 5-8 the difference in activity is small; at pH more than 8, a precipitate forms. The use of hard water somewhat reduces the bactericidal properties.
Chlorhexidine bigluconate is a cationic substance and does not combine with soap and other anionic compounds such as colloids, gum arabic, carboxymethylcellulose.
At a concentration of 1:2000, it is incompatible with borates, carbonates, chlorides, citrates, phosphates, sulfates, creating poorly soluble sediments after 24 hours.
Compatible with drugs containing a cationic group (benzalkonium chloride, cetrimonium bromide).
Increases the sensitivity of bacteria to chloramphenicol, kanamycin, neomycin, cephalosporins.
Ethanol enhances the effectiveness of the drug.
special instructions
Avoid getting the drug inside the wound in patients with open traumatic brain injury, spinal cord injuries, or perforation of the eardrum.
In case of contact with the mucous membranes of the eyes, they should be quickly and thoroughly rinsed with water.
Concomitant use with iodine is not recommended.
Do not mix chlorhexidine with other disinfectants and detergents.
Contact with hypochlorine bleaches on fabrics that have previously been in contact with chlorhexidine-containing products may cause brown stains.
Do not expose clothing that has been in contact with chlorhexidine to hypochlorites and other compounds that release active chlorine.
Do not dilute with hard water. Aqueous solutions can be sterilized in an autoclave at 116 °C for 30 minutes. Do not sterilize using ionizing radiation.
Release form
Concentrate for the preparation of solutions for local and external use 20%, 500 ml in colored polypropylene bottles with a cap.
For pharmacies - 1 bottle with instructions in a cardboard box.
For hospitals - 16 bottles per box with instructions.
Storage conditions
At temperatures from 1 °C to 25 °C. Protect from light.
Keep out of the reach of children.
Best before date
3 years.
Diluted solutions should be stored for no more than a week.
Do not use after expiration date.
Conditions for dispensing from pharmacies
Chlorhexidine digluconate - instructions for medical use - RU No. P N015600/01 dated 2004-04-16
Source: https://rlsnet.ru/tn_index_id_5422.htm
Pharmacological properties
The instructions for Chlorhexidine state that this drug, being an antiseptic, is capable of having a bactericidal or bacteriostatic effect on gram-positive and gram-negative bacteria. Depending on the concentration of aqueous and alcoholic solutions prepared on the basis of Chlorhexidine, they can produce different effects:
- the bacteriostatic effect of solutions is manifested in concentrations of up to 0.01%;
- the bactericidal effect is manifested at a concentration level above 0.01% (at a solution temperature of 22°C and its effect on the affected area of the skin for 1 minute or more);
- the fungicidal effect is manifested at a solution concentration of 0.05% (at a temperature of 22°C and exposure of the solution to the affected area of the skin for 10 minutes);
- the virucidal effect (suppressing lipophilic viruses) is manifested at a concentration level in the range of 0.01-1% (suppression of bacterial spores is possible only when using a warm solution).
The drug Chlorhexidine is active against certain gram-positive and gram-negative microorganisms: Neisseria gonorrhoeae, Treponema spp., Trichomonas spp., Ureaplasma spp., Chlamydia spp. Positive reviews of Chlorhexidine from healthcare workers and patients confirm the antiseptic effectiveness of the drug.
After treating medical instruments, hands and the surgical field with a solution of Chlorhexidine, this solution exhibits stability, that is, it remains on the skin or surfaces in a small amount, continuing to have a bactericidal effect. The activity of the drug decreases somewhat upon contact with pus, blood, various secretions and organic substances.
Beneficial properties of chlorhexidine
Chlorhexidine is a clear, colorless and odorless solution. In pharmacies it can be found in concentrations of 0.01%, 0.02%, 0.05%, 0.5%, 5% and 20%.
- Chlorhexidine suppresses not only gram-positive and gram-negative bacteria, but even viruses (at a concentration of 0.05%) and fungi.
- The drug acts both on the surface of the skin and in the subcutaneous layers, stopping the development of inflammatory processes.
- At the same time, it does not enter the blood and does not have a systemic effect on the body.
- Its action lasts for several hours.
- When the abscess comes out, chlorhexidine kills bacteria in and around the wound.
- When in contact with biological fluids - blood and pus - chlorhexidine bigluconate retains its therapeutic effect.
- The drug does not irritate the skin and mucous membranes, does not affect metabolic processes in the epidermis.
In addition to cosmetology, chlorhexidine is actively used:
- in gynecology - for the prevention and treatment of inflammation caused by infections;
- dermatovenerology - to prevent sexually transmitted diseases;
- surgery - for disinfecting hands, instruments and skin surfaces before surgery;
- traumatology - for the treatment of wounds and burns;
- ENT practice - for gargling;
- dentistry - in the treatment of stomatitis, gingivitis, periodontitis, rinsing the mouth after implantation and tooth extraction, as well as for disinfecting removable dentures.
Drug concentrations up to 1% are safe for the body
Video: dermatovenerologist V.V. Makarchuk on the correct use of chlorhexidine in the treatment of acne and other problems
Indications
For local use: trichomonas colpitis, cervical erosion, vulvar itching, prevention of sexually transmitted diseases (including gonorrhea, syphilis, trichomoniasis, chlamydia, ureaplasmosis); gingivitis, stomatitis, aphthae, periodontitis, alveolitis, disinfection of removable dentures; angina; postoperative care for patients in ENT and dentistry departments.
Treatment of wounds, burns and surfaces; disinfection of the patient's skin.
Cleaning the hands of the surgeon, medical staff and the surgical field before diagnostic manipulations and surgery.
Disinfection of working surfaces of instruments (including thermometers) and equipment, the heat treatment of which is undesirable.
The use of Chlorhexidine in the form of vaginal suppositories is indicated in pediatric gynecology in girls before the onset of menstruation for the treatment of vulvovaginitis (including nonspecific, mixed, gonorrheal, trichomonas), bacterial vaginosis; for infectious and inflammatory complications in pediatric gynecology (for example, before surgical treatment of gynecological diseases).
Indications for use
The use of chlorhexidine, according to the instructions for use, is determined by its concentration and form of release. The drug is used for therapeutic purposes for a number of ailments:
- for the prevention of infectious diseases in the postoperative period in dentistry, for the treatment of dentures, as well as rinsing gums;
- in gynecology – for thrush, before and after surgery, to avoid infection, during various procedures;
- in the treatment of dermatitis of bacterial or fungal origin;
- for the treatment of purulent wounds, infectious diseases of the mucous membranes.
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How to use Chlorhexidine
It is recommended to use Chlorhexidine as a therapeutic and prophylactic agent:
- Aqueous solutions of Chlorhexidine in concentrations of 0.05, 0.2 and 0.5% should be used for rinsing, irrigation, and applications. These solutions are used as follows: apply 5-10 ml of the solution to the affected area of the skin or mucous membranes 2-3 times a day for 1-3 minutes (you can apply a tampon soaked in the solution).
- To treat working surfaces, they are generously moistened with a solution, which is washed off with warm water after a few minutes, and to disinfect a medical instrument, it is soaked directly in the solution.
- The Chlorhexidine patch is used as follows: remove the protective tape from its surface without touching the surface of the bandage with your fingers, and apply it to the affected area of the skin.
- Chlorhexidine should be used to prevent sexually transmitted diseases as soon as possible after sexual intercourse (no later than two hours). Disinfection treatment is carried out as follows: the tip of the nozzle is inserted into the man’s urethra and 2-3 ml of solution is sprayed out. Women irrigate the vagina with five or ten milliliters of solution (leave in the vaginal cavity for 2-3 minutes). In addition, the solution must be used to treat the skin on the inner thighs, as well as the pubis and genitals. After carrying out such disinfecting treatment, you should not urinate for two hours.
- Chlorhexidine is used as an auxiliary drug in the complex therapy of urethroprostatitis and urethritis. When treating these diseases with Chlorhexidine, 2-3 ml of a 0.05% solution is injected into the urethra once or twice a day for 10 days (procedures are carried out every other day).
- When using the drug intravaginally, 1 suppository is administered 3-4 times a day for 7-20 days.
How to properly prepare a solution for rinsing and mouth baths
Now pharmacies sell solutions that are ready for use - in a concentration of 0.05%. It is recommended to use one tablespoon of the product to treat oral tissues.
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There are also solutions on sale at a concentration of 0.20% - they must be diluted before use. To do this, take 2.5 ml of concentrate (the exact volume can be measured using a regular syringe) and dilute it in a liter of water. The substance should be thoroughly mixed. If a burning sensation occurs while rinsing, you need to add a little more water. It is important to follow the recommended proportions so as not to cause soft tissue burns.
Side effects
When using Chlorhexidine Bigluconate during treatment, the following side effects were observed in some patients:
- dry skin;
- itchy skin;
- the appearance of a rash;
- dermatitis;
- photosensitivity.
With prolonged use of mouth rinsing and irrigation, taste sensations may change, tartar may appear, and teeth will discolor. Restoring the color of the enamel is achieved with the help of whitening toothpastes; your dentist will recommend them.
special instructions
Remains active in the presence of blood and organic substances. Do not allow chlorhexidine to get into the eyes (with the exception of a special dosage form intended for washing the eyes), as well as contact with the meninges and the auditory nerve.
For children
For the treatment of children, the drug is used with caution and only after a doctor’s prescription.
During pregnancy and lactation
Chlorhexidine can be used topically during pregnancy and breastfeeding. The drug can be recommended to a pregnant woman in the treatment of vaginal candidiasis or other diseases. Any disturbances in the microflora of the vagina and uterus can have an extremely negative impact on the development of the fetus, so genital tract infections must be eliminated before birth. During pregnancy, it is recommended to use a dosage form such as suppositories. However, despite the fact that pregnancy is not a contraindication to the use of the drug, prolonged use of the solution is not recommended. Gargling during pregnancy is possible only under the supervision of a doctor.
What is the difference between these drugs?
Surely many people do not even realize that these drugs differ not only in the additional name of the second one, but also in the purposes for their use. What is the difference between them should be known not only to those who often encounter this product. This information may be of great help one day.
- The first medication under consideration contains a large percentage of the active substance itself , unlike the second. For 1 ml. contents account for 0.2 grams of the active component, and per 1 ml. digluconate - 5 mg . The difference is significant.
- Chlorhexidine bigluconate contains the prefix “bi” , which means that it must contain, in addition to the active substance, either glycerol or water. This means that the drug is less concentrated and can be used in its pure form to gargle and treat open wounds.
- The products differ in their scope of application . For the treatment of mucous membranes, minor wounds and in gynecology, a bigluconate solution with a concentration of 0.05% is popular. For operations, such a percentage is not enough, so an analogue is used, where the content of the active substance is significantly higher.
- The usual solution is used mainly as needed , when it is really required. In the form of bigluconate, the medication is often used for prophylactic purposes, since the concentration is not high. For recurrent chronic skin diseases, it is sometimes necessary to carry out procedures in a state of remission.
- Chlorhexidine in the form of bigluconate, unlike the usual one, is not found in the form of an alcohol solution of 0.5%. This product is intended for disinfecting hands and medical instruments.
- In the form of vaginal suppositories, there may be only a second item under consideration, as in other medications sold over the counter.
Having an antiseptic in your home medicine cabinet is extremely important in today's active life. And chlorhexidine, like no other medicine, can cope with a problem of any nature. Thus, the development of infectious diseases can be prevented in time. Then your health will always be under control.