Chlorhexidine for disinfection

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Chlorhexidine: description of the drug and its effectiveness

There are medications that must be in your home medicine cabinet. One of them is Chlorhexidine.

This medication can be used as a disinfectant in almost all cases where protection against pathogenic microflora is necessary.

Table of contents:

It successfully copes with gram-positive, gram-negative microbes, viruses and pathogenic fungi.

Chlorhexidine solution is an excellent treatment for skin prone to inflammation.

Description of the drug

The drug is produced primarily in the form of aqueous solutions with a concentration of the active substance (chlorhexidine bigluconate) of 0.5%. The aqueous solution is poured into plastic or glass bottles.

In addition to the liquid form, the drug can be purchased in the form of a spray (alcohol solution) or vaginal suppositories. The active ingredient can be included in ointments, creams or gels. This is due to the fact that Chlorhexidine is widely used to disinfect the skin and combat inflammation in the dermis.

Operating principle and effectiveness

Chlorhexidine is described in the instructions for the drug as an antiseptic.

Depending on the concentration, a unique medicinal substance can be an excellent bacteriostatic agent, fight a viral infection, or exhibit bactericidal properties, in particular:

  • at a concentration of the active substance of 0.01%, the drug causes bacteria to lose their ability to reproduce;
  • at a higher concentration, as well as at a temperature of the medicinal liquid around twenty-two degrees, chlorhexidine kills bacteria;
  • the drug destroys fungal infection (fugicidal property) in a concentration of the substance equal to 0.05%;
  • in order to fight lipophilic viruses, a heated solution is required in a concentration of 0.01 to 0.1%.

When treating problem skin, experts recommend using an aqueous solution. It penetrates well into the layers of the dermis and has the necessary therapeutic effect without damaging the outer epidermal layer.

The active substance interacts with the membranes of fungi and bacteria and damages the cell walls of microorganisms. Thus, the bacteria die, and the inflammatory process stops its development.

When using Chlorhexidine to treat the skin, the molecules of the active component settle on the proteins of the upper layer of the epidermis and exhibit their therapeutic effect within one to two days.

Chlorhexidine is believed to exhibit excellent antiviral activity. It is used to treat diseases caused by herpes virus, influenza virus and cytomegalovirus.

Advantages of an antiseptic:

  • accessible to everyone, as it is inexpensive medicine;
  • has a wide spectrum of action (eliminates viral, bacterial and fungal infections);
  • stimulates metabolic processes in the dermis;
  • easily penetrates into the deep layers of the skin;
  • promotes tissue healing;
  • quickly stops the inflammatory process;
  • prevents re-infection;
  • safe and easy to use;
  • can be used for a long time;
  • practically does not cause side effects;
  • can be used as a prophylaxis, as it has a long-lasting effect;
  • does not damage the skin;
  • the effectiveness of action does not decrease when mixed with purulent discharge or blood.

Chlorhexidine solution: indications and contraindications for use

The scope of application of Chlorhexidine is extensive. It is used both for the treatment and prevention of ailments, and for the antiseptic treatment of tools and work surfaces. Almost every field of medicine uses Chlorhexidine solution for its own purposes.

  • As a local antiseptic, the drug is used to treat purulent, burn and wound surfaces of the skin;
  • dermatologists prescribe Chlorhexidine solution to treat problem skin;
  • in dermatovenerology it is used as a prophylactic against sexually transmitted diseases (STDs), such as syphilis, gonorrhea, genital herpes, chlamydia;
  • Dentists recommend rinsing the mouth with Horhexidine for patients suffering from periodontal disease, stomatitis, and gingivitis;
  • in otorhinolaryngology, Chlorhexidine solution is prescribed for sore throat, tonsillitis (used for gargling);
  • in gynecology, the drug is used to treat bacterial vaginosis, colpitis, cervical erosion, thrush and other infectious and inflammatory diseases;
  • in surgery, the solution is used to disinfect hands, instruments and operating surfaces.

Contraindications

Chlorhexidine solution has virtually no contraindications. However, despite all the advantages of the drug, the antiseptic still has its drawbacks. It may not be suitable due to individual sensitivity to the active substance or excessive dry skin. In rare cases, an allergic reaction may occur. The drug is approved for use during pregnancy, lactation and for the treatment of children.

Side effects

Cholerhexidine does not cause any unpleasant effects during use. However, with prolonged use of the drug, negative effects may occur: the skin may become dry and irritated, and it may feel itchy, tight or sticky. If the solution is used to treat diseases of the oral cavity, then a person may experience a taste disturbance, tartar deposits, and the tooth enamel acquires a grayish tint.

How to use Chlorhexidine to treat acne

To eliminate pimples and acne, use an aqueous or alcohol solution of Chlorhexidine. The alcohol solution is contained in sprays, which are very convenient to use for the treatment of acne and pimples. You just need to spray it on the affected area two or three times a day. The aqueous solution can be used in several ways.

How to use Chlorhexidine aqueous solution:

  • a small pimple can be targeted by applying a solution to it using a cotton swab;
  • large acne should be lubricated with a cotton swab dipped in the solution;
  • if the pimple is inflamed, it is recommended to apply it using gauze soaked in Chlorhexidine (procedure time 10 minutes).

For a pronounced effect, the medication should be applied to problem areas of the skin twice, three times a day. The duration of treatment usually does not exceed two weeks. For purulent inflammatory phenomena, it is recommended that after treating acne with chlorhexidine, additionally lubricate these areas with salicylic ointment or Levomekol.

When treating problem skin with Chlorhexidine, all features of the drug should be taken into account. To do this, you should carefully read the instructions included with the medication on how to use Chlorhexidine in combination with other treatment methods. When treating with Chlorhexidine, you should not treat with drugs containing chlorides, sulfates, carbonates or phosphates. The drug should not be combined with soap or iodine.

Its effectiveness is also reduced by hard water. To enhance the effect of the solution, slightly warm the medicinal liquid. The solution cannot be heated too much, as it will spoil. The optimal temperature of the liquid at the time of use should be twenty-two degrees. The effect in treatment will become even more obvious if you combine local therapy with Chlorhexidine with treatment with antibacterial drugs, for example, Cephalosporin, Levomycetin, Neomycin. The effect of the antiseptic also increases when combined with alcohol.

How to use Chlorhexidine for pimple popping procedures

Dermatologists and cosmetology specialists do not recommend squeezing pimples. However, not everyone manages to resist such action. To minimize the risks of spread of infection and secondary infection, Chlorhexidine should be used as an antiseptic.

The procedure is performed in stages:

  • wash their hands thoroughly and put on disposable medical gloves;
  • the localization area is also pre-cleaned and the skin is treated with a cotton swab soaked in a Chlorhexidine solution;
  • the purulent head is pierced with a sterile needle from a disposable syringe;
  • gently squeeze out the contents and remove it from the skin using a cotton swab with an antiseptic;
  • Finally, the fresh wound should be treated with Chlorhexidine.

How to use Chlorhexidine in different fields of medicine

Chlorhexidine can be called a universal antiseptic solution. By changing its concentration, the drug can be easily adapted for different purposes - prevention, treatment or disinfection of skin and various objects.

  1. ENT diseases and dental diseases. Aqueous solutions of the drug are often used to rinse the mouth and throat by patients suffering from stomatitis, gingivitis, tonsillitis, pharyngitis and other infectious diseases. Before using Chlorhexidine to treat these diseases, the mouth and throat should first be rinsed with warm, clean water. Then take fifteen milliliters of a solution containing 0.5% of the active substance into the mouth and thoroughly rinse the mouth or throat for half a minute. After the procedure, you should not drink or eat for an hour.
  2. Gynecology. For the treatment of infectious and inflammatory diseases of the female genital area, the solution is used in the form of douching. The procedure is carried out with the body in a horizontal position. A little solution is poured into the vagina and left there for 10 minutes while lying down. For ease of treatment, you can use vaginal suppositories, which are inserted into the vagina twice a day for one to two weeks.
  3. Inflammatory processes in the urinary tract. Three milliliters of Chlorhexidine solution is injected into the urethra of men and women twice a day for ten days.
  4. Treatment of wounds and burns. The skin is treated by applying applications to damaged tissue. The procedure time is 3 minutes.

How to use Chlorhexidine to prevent STDs

Chlorhexidine will effectively protect against sexually transmitted diseases if used no later than two hours after unprotected sexual intercourse. For men, two milliliters of chlorhexidine are injected into the urethra, and for women, ten milliliters are injected into the vagina. In this case, the external genitalia and skin near the intimate area - pubis, groin, inner thighs - are necessarily worked out.

  • Disinfection of instruments. Tools are pre-washed to remove visible dirt. Then they are placed in a container and filled with solution so that it completely covers them. Instruments can remain in the solution for no more than three days.
  • Hand disinfection. For hygienic treatment of brushes, it is convenient to use Chlorhyxedine spray. Five milliliters of spray are sprayed onto the surface of the skin, and then the liquid is rubbed in for two minutes. Before surgery, surgeons treat their hands in the same way, but at least twice.
  • Disinfection of surfaces. Chlorhexidine solution can be used to treat tables, equipment, chair armrests, etc. Surfaces are wiped with a cloth soaked in the solution. For one square meter of surfaces you will need a bottle of Chlorhexidine (100 ml).

Holrhexidine has a number of analogues, which contain the same active component: Miramistin, Hexicon, Akhdez, Citeal, Catetzhel S, Amident, Manusan, Hibiscrub.

Price for Chlorhexidine drugs:

  • solution 0.5% 100 ml - 16 rubles;
  • spray 0.5% 100 ml - 45 rubles;
  • vaginal suppositories (Hexicon) - 125 rubles.

Reviews

Marina Kuznetsova, Moscow “I have a few pimples on my face, but they appear all the time. I only use chlorhexidine. I carefully lubricate the pimples with cotton swabs so that the liquid does not get on healthy skin. The solution relieves inflammation well, the very next day acne decreases, and redness and swelling subside. If a pimple has to be squeezed out, I also use Chlorhexidine as an antiseptic.”

Irina Lipina, Yegoryevsk “Chlorhexidine, of course, helps to cope with acne, but if there are a lot of them and they are large, then you cannot do without ointments. I first disinfect acne and then apply Levomikol. There is also an effective drug called Baziron. If you use all this together, the acne will go away quickly.”

Remember that self-medication is dangerous to your health! Be sure to consult your doctor! The information on the site is presented solely for popular information purposes and does not claim to be reference or medical accuracy, and is not a guide to action.

Source: http://med88.ru/pryshhi/hlorgeksidin/

Chlorhexidine - release form and composition, indications and rules for rinsing the mouth with a solution

For bacterial infections and gum inflammation, Chlorhexidine is used. This skin antiseptic has a wide range of uses and is available in several formats that differ in indications and composition. When using Chlorhexidine, precautions and protection should be taken into account, because the product has a number of contraindications, and if used incorrectly, can lead to negative reactions.

What is Chlorhexidine

According to the pharmacological classification, Chlorhexidine is an antiseptic drug with disinfecting effects. This means that it can be used to disinfect wounds, surfaces, skin and mucous membranes, if you follow the instructions and the precautions specified therein. The role of the active component of the drug is chlorhexidine bigluconate.

Composition and release form

There are three known formats of Chlorhexidine - aqueous, alcoholic solution and vaginal suppositories, plus on the shelves of pharmacies you can find gels and solutions based on the active substance. The detailed composition is shown in the table:

White torpedo-shaped suppositories with slight marbling and a yellowish tint, a funnel-shaped depression

Concentration of chlorhexidine bigluconate

0.05, 0.5, 1, 5 or 20%

8 or 16 mg per 1 piece.

Water, ethyl alcohol 96%

Plastic or glass bottles of 100 ml, for stationary use - 1 or 5 l

5 or 10 pieces in a blister pack

Properties of the drug

Chlorhexidine is an antiseptic for skin disinfection that is active against gram-negative or gram-positive bacteria and viruses. The product can act on bacterial spores only at elevated temperatures. The drug cleanses and disinfects the skin without damaging the integument. It has a prolonged effect of up to four hours.

When used intravaginally, the medication exhibits antiseptic activity against gram-positive and gram-negative bacteria, viruses, including chlamydia, ureaplasma, gardnerella, and herpes simplex. Acid-resistant forms and spores are not sensitive to the drug with a bactericidal effect. When applied topically, the product does not destroy lactobacilli.

Chlorhexidine bigluconate belongs to the cationic biguanides, has amino groups of cellular proteins, penetrates the membranes of bacterial cells, and settles in the cytoplasm. The component prevents the penetration of oxygen, which leads to a decrease in the level of adenosine triphosphate and the death of microorganisms. The medication destroys DNA and its synthesis in bacteria and does not penetrate intact skin.

Indications for use

According to the instructions, the use of Chlorhexidine depends on its concentration and release form. A 0.05% solution can be used without dilution for gargling or antiseptic treatment of mucous membranes. A product with a concentration of 0.5% is used to disinfect medical instruments, in the treatment of wounds, and in the treatment of burns. A 1% solution is used to treat surgeons' hands, instruments, and to prevent infection of burns. 5%, 20% solutions are used to prepare less concentrated liquids based on water, glycerin or alcohol.

Aqueous solution of Chlorhexidine

The aqueous solution of Chlorhexidine has a wide range of active uses. His testimony:

  • cervical erosion;
  • colpitis;
  • itching of the vulva, prevention of gonorrhea, syphilis, trichomoniasis, genital herpes and other vaginal diseases;
  • disinfection of removable dentures, postoperative treatment of wounds and burns;
  • gingivitis, stomatitis, aphthosis, periodontitis, tonsillitis, alveolitis, and other oral diseases.

Chlorhexidine alcohol solution

Unlike an aqueous solution, an alcohol solution of Chlorhexidine cannot be used to treat mucous membranes - this will cause a burning sensation and other unpleasant symptoms. Indications for use of the product include cleaning the hands of medical personnel and the surgical field before an intervention or examination. The working surfaces of devices and equipment are irrigated with an alcohol solution.

Candles

Chlorhexidine-based vaginal suppositories have a wide range of indications for use. This:

  • prevention of sexually transmitted infections (syphilis, gonorrhea, ureaplasmosis);
  • treatment of bacterial vaginosis, trichomonas, mixed and nonspecific colpitis;
  • prevention of infectious and inflammatory complications in gynecology (before operations, childbirth, abortion, installation of an intrauterine device, diathermocoagulation of the cervix, intrauterine examinations).

Directions for use and dosage

Depending on the form of release and concentration, the method of administration and dosage of the medication depends. All types of use require that the product be applied externally or topically, but not internally - it should not be swallowed or drunk, because this can cause unpleasant consequences for the body. The instructions for using the drug are described in the instructions.

Chlorhexidine solution

Aqueous and alcohol solutions are used externally. To treat microtraumas on the skin, scratches, burns, it is recommended to moisten a napkin with liquid and apply it to the damaged area; you can fix it with a bandage or plaster. For the treatment of urethritis, urethroprostatitis, Chlorhexidine is injected into the urethra in an amount of 2-3 ml 2-3 times a day for a course of 10 days every other day. Irrigations, gargling and liquid applications should last 1-3 minutes and be applied 2-3 times/day.

To prevent genital tract infections, the drug is used no later than two hours after sex. Before treatment, you need to go to the toilet, wash your hands and genitals, treat the skin of the pubis, inner thigh, and genitals. Using a nozzle, men inject 2-3 ml of liquid into the urethra, women - 5-10 ml into the vagina for 2-3 minutes (douching). After treatment, you should not go to the toilet for two hours.

How to rinse your mouth with Chlorhexidine after tooth extraction

Chlorhexidine rinsing is actively used in dentistry. After tooth extraction, this will help disinfect the oral cavity and prevent germs from entering the resulting cavity. Recommendations for rinsing the cavity:

  • it is carried out an hour after brushing your teeth, and you should not eat or drink for the same amount of time before and after rinsing your mouth;
  • in case of accidental ingestion, you need to drink several tablets of activated carbon;
  • carry out the procedure 2-3 times/day (morning and evening);
  • do not make movements too intense so as not to wash out the protective blood clot;
  • take the solution into your mouth, hold for 1-2 minutes, slightly tilting your head to the sides.

Rinse for sore gums

Chlorhexidine mouthwash can be used for gum inflammation. Instructions for its use:

  • brush your teeth;
  • rinse your mouth with chamomile decoction or iodine-saline solution (a teaspoon of soda, 2/3 teaspoon of salt, a drop of iodine per glass of water);
  • Take a tablespoon of medicine into your mouth, gargle for a minute, and spit;
  • after the procedure you cannot eat for two hours;
  • if rinsing is not possible (for example, in children), treat the gums with a cotton swab soaked in a 0.05% solution diluted with water twice (adults do not need to dilute).

Suppositories

The suppositories are intended for intravaginal administration. Release the suppository from its protective packaging, lie on your back and insert it into the vagina. To treat infections, one suppository is used twice a day for a course of 7-10 days; if necessary, therapy continues for up to 20 days. To prevent diseases, one suppository is inserted into the vagina no later than two hours from the moment of contact. Suppositories are not used to treat thrush.

Chlorhexidine spray

The aerosol form of the medication is used externally to treat personnel's hands or work surfaces. 5 ml of the product is applied to the skin and rubbed in for two minutes. Before treating the surgeon’s hands, you must first wash your hands with warm water and soap for two minutes, dry with a sterile gauze cloth, apply the product twice in 5 ml portions, rubbing into the skin, maintaining a wet state for three minutes.

To treat the surgical site or the donor's elbow, the skin is wiped with cotton swabs soaked in the product for two minutes. The day before, the patient should take a shower and change his underwear. The holding time of the liquid on the surgical field is one minute. To disinfect large surfaces, the solution rate will be 100 ml per square meter. To process complex instruments, disassembled instruments are completely placed in liquid so that all channels are filled.

special instructions

In the instructions for use, it is useful to study the special instructions section, which contains important points on the use of the drug:

  • the medication remains active in the presence of organic substances;
  • if eye rinsing with a special form is not prescribed, avoid getting the product into the eyes, contact with the meninges, and the auditory nerve;
  • in case of contact with the mucous membrane of the eyes, rinse them with water, drip Albucid; in case of contact with the stomach, rinse it, take activated charcoal;
  • Alcohol-based product is highly flammable;
  • alcohol increases the effect of the medication for skin diseases.

During pregnancy

According to doctors, the product can be used during pregnancy and breastfeeding without dose adjustment. When used topically, the medication does not penetrate the systemic bloodstream and does not affect the development of the fetus and newborn during lactation (does not penetrate into breast milk). Suppositories can be used before and after childbirth to sanitize the birth canal. The course of application lasts 5-10 days, one suppository is used 1-2 times a day as monotherapy or complex treatment.

In childhood

The use of Chlorhexidine in children is limited to the age of 12 years, but applications in the oral cavity can be carried out in younger children. This should be done with caution, after consulting a doctor and in the presence of parents. To avoid swallowing the solution, you should not carry out standard rinses - the solution has a slightly bitter taste, so the baby may accidentally swallow it.

Drug interactions

During treatment with Chlorhexidine, negative reactions may occur when combined with other drugs:

  • not compatible with soap, detergents with anionic group (saponins, lauryl sulfate and sodium carboxymethylcellulose);
  • can be combined with drugs based on a cationic group (cetrimonium bromide);
  • You cannot combine suppositories with iodine preparations.

Side effects

According to reviews, the drug is well tolerated. Very rarely, side effects may occur in the form of allergic reactions, skin itching, redness and short-term swelling. These effects disappear after discontinuation of the drugs. To date, not a single case of drug overdose has been recorded, because it is used externally and does not penetrate internal organs and tissues.

Contraindications

The main prohibiting contraindication for the use of the medication is individual intolerance or allergic reactions to the active substance of the composition and other components. The product can be used with caution in childhood, when combined with surfactants and a number of other drugs. Before use, medical consultation is recommended.

Terms of sale and storage

You can buy the medicine without a prescription. It is stored at temperatures up to 25 degrees for two years for candles and three years for solutions.

Analogs

There are direct analogues of the product, containing the same active substance, and indirect analogues, which have a similar antiseptic effect on the skin and mucous membranes. The following drugs are analogues of the drug:

Chlorhexidine price

You can purchase the product through pharmacies or online stores at prices depending on the form of release, concentration and volume of packaging. The approximate cost for Moscow and St. Petersburg will be (see table):

Type of local antiseptic

Pharmacy price tag, rub.

Aqueous solution 0.05% 100 ml

Alcohol solution 0.5% spray 100 ml

Solution 0.05% 1 l

Vaginal suppositories 16 mg 10 pcs.

Alcohol solution 0.5% 1 l

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Reviews

I have been using Chlorhexidine for a very long time, the main purpose of use is to treat the skin. I have a problem type, acne and rashes often appear. Every evening I wipe my face with a 0.05% solution and apply cream. I like that the product quickly dries out pimples and prevents them from spreading further. All my girlfriends use it too and are happy with it.

Vladimir, 32 years old

I work as a surgeon, so I have to disinfect my hands several times a day. In our hospital we use Chlorhexidine - wash your hands thoroughly before surgery, rub the solution into the skin and leave for a couple of minutes. After this, we disinfect the patient’s skin in the same way. I like that the product does not dry out the skin and is effective in killing germs.

Alexander, 48 years old

Last week I had a tooth removed. Until the crown was installed, they were told to leave it until it healed and to carefully rinse your mouth with Chlorhexidine once a day to kill possible microflora and not cause another infection. The drug has a slightly bitter taste, but does not cause unpleasant feelings or discomfort when used. I've been rinsing it for three days now, and it seems to be healing.

Anastasia, 26 years old

Before giving birth, I was told that there might be complications due to the incorrect position of the fetus and they offered to immediately treat the birth canal with a good antiseptic to save time. I was prescribed Chlorhexidine suppositories. I inserted them for two days, and then went to the delivery room. There was no surgery, but the suppositories helped avoid infection.

The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and make recommendations for treatment based on the individual characteristics of a particular patient.

Source: http://sovets.net/15376-hlorgeksidin.html

Chlorhexidine

whether to treat with chlorhexidine and

Is this effective?

My question is this: in the contraindications for suppositories it is written that the effect on the child during feeding is not known, are there suppositories alternative to Hexicon, where use is possible during breastfeeding. Thanks in advance, Olga.

Different doctors give different prescriptions.

— 20% formalin (I can’t find it in Moscow pharmacies)

– 7% acetic acid

The information provided is intended for medical and pharmaceutical professionals, should not be used for treatment and cannot be considered as official. The most accurate information about the drug is contained in the instructions supplied with the packaging by the manufacturer. No information posted on this or any other page of our website can serve as a substitute for personal contact with a specialist.

Please pay attention to the specified dates for entering information; information may become outdated.

Source: http://www.webapteka.ru/drugbase/name14640.html

Chlorhexidine - instructions, use, reviews

Chlorhexidine (lat. Chlorhexidinum) is an antiseptic for topical use. In Russia it is produced mainly in the form of bigluconate.

Available in the form of solutions, aerosols, vaginal suppositories, external gels and creams. The drug is effective against a wide range of gram-negative and gram-positive bacteria, fungi, and some viruses. Has a bactericidal effect on pathogens of sexually transmitted diseases.

Indicated for the purpose of preventing STDs, for purulent-inflammatory processes of the skin or mucous membranes, for treating surgeon's hands, and sterilizing medical instruments. After application to the body, chlorhexidine continues to remain active for several hours.

Story

Chlorhexidine was synthesized in 1947. The formula for the drug was randomly developed by English scientists during the search for new antimalarial drugs. It turned out that the substance with experimental number “10 040” has a high affinity for the cell walls of bacteria and quickly causes their destruction. The new compound was patented as an antiseptic.

In 1954, the English pharmaceutical company Imperial Chemical Industries released the first medicinal solution of chlorhexidine bigluconate under the trade name Gibitan. Initially, the product was intended for disinfection of skin and wound surfaces, but after 3 years the range of its indications was significantly expanded. "Gibitan" began to be actively used in gynecology, urology, otolaryngology and ophthalmology.

In 1959, chlorhexidine was proposed for use in the treatment of the oral cavity, which led to its spread in dental practice.

Over time, the antiseptic began to find more and more widespread use. In the 80s it was allowed to be added to cosmetic products and lubricants. In 1993, chlorhexidine wipes were introduced to the US market for both household and medical use. In 2012, the FDA approved the release of chlorhexidine-impregnated catheters and implants.

Properties

International nonproprietary name: chlorhexidine.

Chemical name according to IUPAC nomenclature: N,N"-bis(4-chlorophenyl)-3,12-diimino-2,4,11,13-tetraazatetradecanediimidamide

Molecular weight: 505.5

Chlorhexidine is a white crystalline powder, highly soluble in water. Aqueous solutions have an alkaline reaction. Melting point -ºС. According to the chemical structure, the compound belongs to biguanide derivatives.

Clinical data

The therapeutic activity and safety of chlorhexidine have been studied in dozens of international clinical studies. The drug has confirmed its high effectiveness against a wide range of bacteria, fungi and protozoan microorganisms.

A large trial in 1988 (Garibaldi, R. A) compared the antibacterial properties of chlorhexidine and povidone iodine. 700 patients who were scheduled for surgery took part in the experiment. Immediately before the operation, the volunteers took a shower with one of the antiseptics. Laboratory test data showed that chlorhexidine reduced the number of microbial colonies on the skin by 9-9.5 times, while povidone-iodine only reduced the number of microbial colonies on the skin by 1.5-2 times.

In the US, the National Institute of Children's Health assessed the effect of treating newborns with chlorhexidine a few hours after birth on infant mortality rates. The study was conducted in Nepal, where the percentage of births at home is high. Outreach was carried out among 413 local communities, whose members were advised to treat infants with a 4% chlorhexidine solution. Over 4 years of observation, the frequency of child deaths in the studied populations decreased by 30%.

In 1999, the University of Oslo studied the ability of an antiseptic to reduce the transmission of pathogenic streptococci from mother to child during childbirth. A 0.2% solution of the drug was administered intravaginally to infected women during contractions. The results showed that the incidence of illness in infants was reduced by an average of 20%. No adverse reactions associated with exposure to chlorhexidine were observed in children.

A blinded, placebo-controlled study on the effect of the drug on stomatitis was conducted at the University of Kentucky in 1988. In patients who agreed to use chlorhexidine rinses, the authors noted a decrease in ulceration of the oral mucosa, a decrease in colonies of streptococci and yeast fungi.

In all trials, doctors paid attention to the good safety profile of the drug. In rare cases, irritation to the eyes and skin was noted. It was possible to eliminate side effects after reducing the concentration of antiseptic solutions.

Toxicity Information

The toxicity of chlorhexidine was studied in laboratory experiments on white mice. A 0.5% solution was administered to animals subcutaneously, intravenously and intraperitoneally. The drug has been proven to lack mutagenic, teratogenic and embryotoxic effects. A weak inhibitory effect on the functions of the reproductive organs was noted.

Composition, release forms, packaging

The following forms of chlorhexidine are available on the Russian pharmaceutical market:

  • Aqueous solutions with a concentration of the active substance of 0.05; 0.1; 0.15; 0.2; 0.5; 1; 4, 5 and 20%. The drug is packaged in plastic vials, bottles or aerosol cans.
  • Alcohol solutions with an active substance concentration of 0.5 or 0.8%. This form is sold in ml bottles.
  • Vaginal suppositories containing 16 and 8 mg of active ingredient. They are packaged in plastic blisters and then in cardboard packs of 5 or 10 pieces.
  • 0.5% gel for external use. Produced in linear tubes.
  • 1% cream for external use. Available in 50 g tubes.
  • 1% emulsion (in glycerin) for external use. Packaged in 200 ml bottles.

Mechanism of action

In a physiological environment, chlorhexidine dissociates to form active cations that interact with negatively charged bacterial cell walls. Conditions for binding are most favorable at pH values ​​from 5 to 8.

At low concentrations, the drug blocks the transport of ions through the membranes of pathogenic cells, which leads to the development of a bacteriostatic effect. At concentrations greater than 0.01%, cell walls rupture, resulting in rapid death of microbes.

In the presence of blood and pus, the effectiveness of the drug decreases slightly.

Spectrum of antimicrobial activity

Chlorhexidine is active against:

  • gram-positive bacteria (streptococci, staphylococci, clostridia),
  • gram-negative bacteria (neisseria, chlamydia, ureaplasma, bacteroides, enterobacteria),
  • yeast and yeast-like fungi,
  • dermatophytes,
  • protozoa (Trichomonas, chlamydia, etc.),
  • some viruses (herpes virus, influenza A virus).

The drug does not affect lactobacilli, acid-fast strains of bacteria and fungal spores.

Fungicidal properties appear at a concentration of chlorhexidine of more than 0.05%, virucidal properties - at a concentration of more than 1%.

Metabolism and excretion

The drug is practically not absorbed in the digestive tract. If 300 mg of chlorhexidine is accidentally ingested, the maximum plasma concentration is reached after 30 minutes. and does not exceed 0.3 µg/l. After 12 hours the drug is not detected in the blood.

The antiseptic binds well to the skin and mucous membranes. Absorption of the drug when applied topically was studied in experiments with rhesus monkeys. With regular use of an 8% solution for 3 months. trace amounts of chlorhexidine (less than 20 µg/kg) were detected in the kidneys, liver and adipose tissue of animals. The drug was not present in blood samples.

There are no data on the metabolism of chlorhexidine. The antiseptic is excreted from the body unchanged.

Indications

Aqueous solutions of chlorhexidine with a concentration of less than 0.2% are prescribed for the purpose of:

  • prevention of sexually transmitted diseases,
  • disinfection of skin (for cracks, abrasions),
  • treatment of purulent wounds, burns,
  • treatment of bacterial and fungal infections of the skin or mucous membranes,
  • treatment of inflammatory diseases of the oral cavity (gingivitis, stomatitis, alveolitis, etc.).

Indications for the use of 0.5% aqueous and alcohol solutions are:

  • disinfection of wounds, burns, cracks in the skin,
  • disinfection of medical instruments, devices and equipment for which thermal sterilization is impossible.

A 1% solution of the drug is indicated:

  • for disinfection of thermometers, instruments and equipment,
  • for treating the surgeon's hands and the surgical field,
  • for disinfection of postoperative wounds and burns.

Solutions with higher concentrations (4, 5 and 20%) are intended for the preparation of 0.01-1% aqueous, alcoholic or glycerin solutions of chlorhexidine.

The reasons for prescribing vaginal suppositories are:

  • prevention of STDs,
  • prevention of infectious complications in obstetric or gynecological practice (before abortion, childbirth, installation of an intrauterine device, etc.),
  • therapy of vaginosis, colpitis.

Gel and cream with chlorhexidine are used:

  • in dermatology - for the treatment of wounds, diaper rash, impetigo, pyoderma,
  • in urology and gynecology - for vulvovaginitis, balanoposthitis, balanitis,
  • in dentistry - in the treatment of gingivitis, periodontitis, stomatitis, aphthae, etc.

Contraindications

The product is not recommended for the following conditions:

  • dermatitis,
  • hypersensitivity to chlorhexidine.

It is forbidden to use an antiseptic to wash eyes and cavities.

Chlorhexidine should be used with caution in childhood.

Use during pregnancy or lactation

When used cutaneously, chlorhexidine preparations are not contraindicated in pregnant and lactating women.

Intravaginal forms during pregnancy and lactation should be used at the discretion of the physician after a careful assessment of their benefits to the woman and the risks to the fetus or child.

Impact on the ability to drive vehicles and other complex mechanisms

Therapy with chlorhexidine does not affect the speed of psychomotor reactions, so the drug can be prescribed to persons engaged in potentially hazardous activities.

Methods of application

Chlorhexidine solutions are applied to the skin, mucous membranes of the genitourinary organs or mouth for 1-3 minutes. by irrigation or on cotton swabs.

To prevent STDs, the solution is injected using a nozzle on the bottle: for men - into the urethra, for women - into the vagina for 2-3 minutes. After the procedure, you should not urinate for 2 hours. At the same time, it is recommended to treat the inner thighs, pubis and genitals.

To treat urethritis and uroprostatitis, the solution is injected into the urethra up to 2 times a day for 10 days. The procedures are repeated every other day.

Treatment of medical instruments and devices is carried out by wiping the surfaces with a sponge soaked in the preparation or by soaking.

The surgical field is treated twice with an interval of 2 minutes.

The surgeon's hands should be washed with soap and dry thoroughly before applying chlorhexidine.

Suppositories are administered intravaginally in the supine position. To prevent STDs, it is recommended to use 1 suppository no later than 2 hours after sexual intercourse. In other cases, 1 suppository is administered 1-2 times a day for 1-3 weeks.

Gel and cream are applied to the affected areas up to 3 times a day. The duration of treatment is determined individually, taking into account the clinical picture of the disease.

Side effects

When using chlorhexidine, the following may occur:

  • allergic reactions,
  • dermatitis,
  • itching and dry skin,
  • feeling of stickiness on the skin (during the first 3-5 minutes after application),
  • discoloration of the skin areas treated with the drug,
  • increased skin sensitivity to UV radiation (photosensitization),
  • staining of teeth, taste disturbances (only in the treatment of gingivitis),
  • itching and burning in the vagina (in case of using suppositories).

special instructions

If you accidentally use chlorhexidine orally, you should rinse your stomach and take the adsorbent. If necessary, the patient should receive symptomatic therapy.

Solutions with a concentration of more than 0.2% should not be applied to wounds and mucous membranes.

If the product gets into your eyes, you should quickly rinse them under running water, then drip a solution of sodium sulfacyl. If inflammation persists, you should consult a doctor.

Chlorhexidine is flammable, so it is recommended to keep its preparations away from heating devices.

The use of suppositories is acceptable during menstruation.

Bleaching fabrics that have previously been exposed to chlorhexidine may result in brown stains.

Interaction with other drugs

Chlorhexidine is not compatible with soaps and detergents containing sodium lauryl sulfate, saponins or sodium carboxymethylcellulose. Before using the drug, any remaining detergent must be thoroughly rinsed off.

The activity of the antiseptic is inhibited in the presence of iodine and enhanced in the presence of ethyl alcohol.

The use of hard water reduces the bactericidal effects of chlorhexidine.

Under the influence of alkalis or when heated, the drug decomposes to form 4-chloroaniline, which has carcinogenic properties.

The antiseptic can be combined with products containing benzalkonium chloride or cetrimonium bromide.

Vacation conditions

All dosage forms are available without a prescription. 20% concentrated solutions are supplied only to medical institutions.

Storage

At a temperature not higher than 25ºС. Keep away from open flame.

Best before date

For solutions - 2-3 years (depending on the manufacturer).

For candles - 2 years.

For gel and cream - 2-3 years.

Application in different countries

Chlorhexidine is approved for medical use in more than 50 countries.

The antiseptic is available in the form of independent dosage forms, and is also included in various combination products:

  • antibacterial ointments, solutions,
  • lozenges for resorption,
  • toothpastes,
  • mouth rinses,
  • shampoos.

In European countries, the acetate salt of the drug is more common, which in its pharmacological properties is completely identical to bigluconate.

In 2013, chlorhexidine was included in the WHO List of Essential Medicines.

Review of manufacturers

In the Russian Federation, chlorhexidine preparations from several dozen manufacturers are sold. The main market share belongs to domestic enterprises. Various companies produce antiseptics under the names “Chlorhexidine”, “Chlorhexidine bigluconate” or under their own patented names. Among dosage forms, solutions with a concentration of 0.05-0.15% predominate.

Some chlorhexidine preparations and their manufacturers:

SPC "Biogen" (Russia)

CJSC Central European Pharmaceutical Company (Russia)

Analogs

The antiseptic Miramistin (lat. Myramistin) is closest in its properties to chlorhexidine. The drug was developed by Soviet scientists in the 1980s. within the framework of the “Space Biotechnologies” program. At the moment, the product is produced by the Russian company CJSC Infamed and the Ukrainian company CJSC Darnitsa. Products are sold in the countries of the former USSR.

Compared to chlorhexidine, Miramistin has a wider spectrum of antimicrobial activity.

The following are sensitive to the drug:

  • gram-positive and gram-negative bacteria (including strains resistant to antibiotics),
  • protozoa (chlamydia, trichomonas, etc.),
  • ascomycetes,
  • yeast and yeast-like fungi,
  • dermatophytes,
  • influenza viruses, measles, herpes, adenoviruses, coronoviruses.

Experiments also demonstrated the ability of Miramistin to reduce the activity of the human immunodeficiency virus (HIV).

Other advantages of the analogue include:

  • lack of local irritation and allergenic effects,
  • the ability to activate local immunity of the skin and mucous membranes,
  • the presence of anti-inflammatory and regenerating properties,
  • absence of negative reactions in the treatment of dental diseases (patients do not experience staining of teeth or changes in taste sensitivity).

The use of Miramistin is considered preferable in the treatment of the oral cavity, in the treatment of urological and gynecological pathologies and for the prevention of sexually transmitted infections.

At the same time, in laboratory studies it has been proven that chlorhexidine has a higher level of antimicrobial activity against Staphylococcus aureus (St. aureus), Escherichia coli (E. Coli), Pseudomonas aeruginosa (P. Aeruginosa) and fungi of the genus Candida (Candida) . This leads to its more active use for aseptic purposes and in the treatment of wound infections.

In the Republic of Belarus, in addition to Miramistin, its generic, Septomirin, produced by RUE Belmedpreparaty, is widely used.

Thank you for the detailed description of the drug and good health to you all.

Source: http://farmamir.ru/2015/08/xlorgeksidin-instrukciya-primenenie-otzyvy/

Recommendations: what is chlorhexidine used for?

The search for a pill to cure all diseases has not yet yielded results. But the World Health Organization has created a list of essential drugs. They also included chlorhexidine. This is a powerful antiseptic to combat microorganisms on the surface of the skin and some mucous membranes.

Everyone is already accustomed to resorting to medications about which little is known. Often such medications are underestimated.

  • Doctors can best answer what chlorhexidine is used for.
  • This antibacterial agent is available in the form of solutions, suppositories, and gels.
  • Without it, it is impossible to imagine undergoing an operation, preventing sexually transmitted diseases, or disinfecting.
  • Any skin damage can be disinfected with this product - an abrasion, a wound (if it is not an open head injury or an eye disease), a scratch, a bite.

To do this, you can use a chlorhexidine solution or gel.

The product has also proven itself in the treatment of acne.

  1. For treating the mucous surface of the oral cavity.
  2. Stomatitis and gingivitis caused by pathogenic microorganisms will go away much faster.
  3. Treatment of damaged skin areas after cosmetic procedures such as ear piercing, navel piercing (healing of the umbilical wound of newborns), as well as tattooing.

For disinfecting common objects, washing hands in nature, before surgery. Disinfection – in the operating room, patient’s room.

Important! An interesting feature of the product is its “indifference” to soap procedures. Soap does not completely wash away the substance, so it continues to protect the “user” from dangerous microorganisms for some time. The only undesirable combination is the use of this antiseptic with iodine. Their “enmity” can result in dermatitis and burns for a person.

  • Despite the wide range of its (almost limitless) influence, the antiseptic has contraindications and has not been sufficiently studied for use by pregnant women and children.
  • But the manufacturers claim that it is not contraindicated at any period of interest.
  • The decision is made by the doctor.

It is better to check with the specialist who prescribed it how to use chlorhexidine.

To combat possible sexually transmitted diseases (no later than 2 hours after intimacy), a 0.05% solution (5 to 10 ml) is injected into the vagina for 3 minutes.

  • For men, a dose of 1–2 ml is recommended. The surface of the thighs and genitals is also treated with the product. For diseases of the genitourinary system, do the same, only twice a day for 10 days.
  • The dentist and ENT specialist may also recommend treating the mouth with chlorhexidine or gargling with a weak solution.
  • But it is better to give preference to soda-salt rinses.

This is due to the possible staining of teeth in a dark color.

Despite the vital function of this antiseptic, it has a number of side effects (darkening of the enamel, the ability to cause burns of the mucous membranes) and contraindications (sensitivity, allergies). Any treatment is like a team game, where you cannot do without a doctor and certainly cannot win.

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