Indications
Chlorhexidine is an antiseptic that kills a wide range of germs on the skin and in the mouth. Depending on the product, it is used for umbilical cord care in newborns (a 7.1% chlorhexidine digluconate gel or solution, equal to 4% chlorhexidine, to help prevent cord infection), as a mouthwash or gel for gum inflammation, mouth ulcers and oral hygiene, as a skin cleanser or hand wash before surgery and injections, and in creams for minor cuts, burns and skin infections.
How It Works
Chlorhexidine carries a positive charge and sticks to the negatively charged outer surface of bacteria and fungi. It damages their cell membranes so their contents leak out and they die. It also binds to skin and teeth, so its germ-killing effect lasts for several hours after use.
Dosage and Administration
- Cord care gel: apply to the cord stump and the skin around it as directed by the health worker or on the label, usually soon after birth; do not cover the cord, and keep it clean and dry.
- Mouthwash (0.2%): rinse with 10 ml for about 1 minute twice a day, then spit out; do not swallow. Use at least 30 minutes after brushing with toothpaste.
- Skin cleansers, hand washes and creams: use as directed on the label.
Interactions
Toothpaste ingredients (such as sodium lauryl sulfate) can reduce the effect of chlorhexidine mouthwash, so leave a gap after brushing. Soaps and some other skin products can inactivate it; rinse soap off before applying. No important interactions with medicines taken by mouth are known.
Contraindications
- Known allergy to Chlorhexidine.
- Do not use in the eyes, inside the ear when the eardrum may be damaged, or on the brain or spinal tissues.
- Avoid alcohol-based skin solutions on premature babies and broken skin.
Side Effects
Mouthwash may stain the teeth, fillings and tongue brown, change taste for a while and cause mild mouth irritation; stains can usually be removed by a dentist. On the skin it may cause dryness, itching or redness. Rarely, chlorhexidine causes serious allergic reactions.
Get urgent medical help if you develop swelling of the face, lips or throat, hives all over the body, wheezing, difficulty breathing or faintness after use. For newborn cord care, see a health worker at once if the skin around the cord becomes red, swollen or smelly, or the baby has fever, poor feeding or lethargy.
Pregnancy and Lactation
Chlorhexidine is very poorly absorbed through skin and mouth and is considered safe in pregnancy and breastfeeding. If used on the breasts, wash it off before feeding.
Precautions and Warnings
For external use, mouth rinse or cord care only; do not swallow. Keep away from eyes and ears; if it gets in the eyes, rinse well with water. Alcohol-containing solutions are flammable; let them dry fully before any heat or electrical equipment is used. Stop and seek advice if irritation develops.
Overdose
Swallowing a small amount of mouthwash is unlikely to cause harm beyond stomach upset. Larger amounts, or alcohol-containing solutions swallowed by a child, need medical advice.
Therapeutic Class
Antiseptic and disinfectant (biguanide).
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Keep containers closed.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.