Chlorhexidine: instructions for use, for mouth rinsing, for sore throat, in gynecology. Chlorhexidine is most effective in a neutral environment. International nonproprietary name

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.

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

Structural formula:

Gross formula: C22H30Cl2N10

Molecular weight: 505.5

Chlorhexidine is a white crystalline powder, highly soluble in water. Aqueous solutions have an alkaline reaction. Melting point - 132-136ºС. 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 reduced the number of microbial colonies on the skin by only 1.5-2 times.

In 2002–2006, the US National Institute of Children's Health assessed the effect of exposing newborns to 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 the course of stomatitis was conducted at the University of Kentucky in 1988.

In patients who agreed to use chlorhexidine rinses, the authors noted a decrease in ulcerations 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 bottles of 100-500 ml.
• 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 tubes of 15-30 g.
• 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

• 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 administered 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:

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.

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Chlorhexidine is a well-known long-acting antiseptic that is used exclusively externally. Under the influence of the solution, dermatophytes, yeast-like fungi, and a wide range of bacterial flora die.

Over many years of use, Chlorhexidine solution has proven its effectiveness and has gained recognition among patients and doctors. In our article we will talk about 0.05% Chlorhexidine solution, study the instructions for using the solution for mouth rinsing, learn how to rinse your mouth and throat correctly for various infections, get acquainted with Chlorhexidine analogues and patient reviews.

How does Chlorhexidine work?

Chlorhexidine is a powerful antimicrobial drug that acts at the cellular level (destroys the cytoplasmic membrane of the microbe), thanks to which the solution actively suppresses the spread of pathogenic bacteria.

The viral infection is resistant to Chlorhexidine, so the solution for ARVI will be useful only in cases where the disease is complicated by bacterial flora.

When rinsing with an aqueous solution of Chlorhexidine (0.05%), a protective thin film is formed that remains on the mucous membrane for several hours after the procedure. The film protects the oral mucosa from irritation.

When applied topically, the drug does not enter the systemic circulation and, therefore, cannot cause common side effects.

Chlorhexidine 0.05% has a mild effect, so this dilution is recommended for rinsing the mouth (according to the instructions for use). Rinsing with the solution heals damaged mucous membranes and also reduces swelling, hyperemia and inflammation in the affected area.

Composition, release form, storage conditions

The main active ingredient in an aqueous solution of Chlorhexidine is chlorhexidine bigluconate. It is colorless, transparent and does not require dilution. The medicinal substance is enclosed in 100 ml bottles and is available in glass bottles or vials made of polymer material, which are equipped with a special nozzle.

Note! To rinse the mouth, throat and nose with chlorhexidine (according to the instructions for use), only chlorhexidine bigluconate 0.05% is used. More concentrated formulations - 0.1–0.5% are suitable for treating skin of varying degrees of damage.

Chlorhexidine has a number of advantages:

• used in adults, children, pregnant and lactating women;
• has a pronounced antimicrobial effect;
• after rinsing, a long-lasting antiseptic effect is maintained;
• availability of the product at a price - 10–40 rubles per bottle (100 ml);
• treatment is carried out for up to 10 days.

The disadvantages of using chlorhexidine include:

• unpleasant taste, which creates difficulties in children's practice;
• the drug does not act on viral agents;
• a change in the color of the tooth enamel and tongue occurs if the solution is used for a long time (this phenomenon does not pose a danger and when the substance is discontinued, all problems go away).

Chlorhexidine is prescribed only by a doctor, taking into account the age and sensitivity of the patient’s mucous membranes.

Closed vials of a 0.05% solution in sealed packaging are stored in a dark place for 24 months, subject to temperature conditions ranging from 1 to 25 degrees. When a vial or bottle of solution is opened, the shelf life is reduced to 7 days.

When is 0.05% Chlorhexidine solution used?

The drug is actively used in dental practice for the treatment of gums. Its action is aimed at destroying pathogenic bacteria and relieving the inflammatory process, thereby preventing the emergence of new foci of infection.

• after surgical interventions in the oral cavity (during dental operations) and for diseases of the ENT organs;
• for processing dentures and other structures (orthodontic);
• in the complex treatment of inflammatory lesions of the gums and oral mucosa;
• for disinfection of the tongue with glossitis.

Important! Self-prescription of the remedy may not eliminate the detected problem. Chlorhexidine in some inflammatory processes is effective only with complex therapy. Only a qualified specialist can assess whether monotherapy is suitable or not.

The use of Chlorhexidine for the eruption of wisdom teeth and their removal

Many of us have experienced the unpleasant symptoms of the eruption of late wisdom teeth. Sometimes their eruption continues for a long time, even more than a year, periodically reminding of itself with discomfort. Wisdom teeth are very capricious, they are often “born” with complications, have a crooked shape and are pressed into the cheek.

If the tooth does not come out completely, then an inflammatory process occurs in the gum tissue. Redness, swelling and pain may appear. All this indicates the rapid proliferation of pathogenic microflora. As a result of inflammation, pus sometimes appears.

To relieve all these phenomena, rinsing with Chlorhexidine is prescribed. The frequency of doses is determined by the dentist.

If you had to remove a tooth, and often such teeth always have “surprises” - uneven roots, brittle bone tissue, then to prevent the development of a bacterial infection, the doctor may suggest baths with Chlorhexidine, but not earlier than 24 hours after surgery.

The patient takes a small amount of solution into his mouth and moves it to the wound area. Hold the solution for several minutes, or make light movements similar to rinsing.

Important! Intensive rinsing is unacceptable due to the risk of dissolving the postoperative clot in the wound.

Also, baths will be prescribed if the tooth was removed due to an inflammatory process and in the presence of carious teeth in the oral cavity, which are a direct source of infection.

The use of Chlorhexidine for inflammatory gum diseases and stomatitis

Inflammatory processes during periodontitis and gingivitis require antiseptic rinses, which are necessarily “reinforced” by therapeutic applications using ointments and special gels. Chlorhexidine is perfect as an antimicrobial agent for these purposes.

Before starting treatment, the dentist sanitizes the oral cavity: treats carious teeth, removes tartar and plaque from the enamel. Such sanitation will eliminate the bacterial flora and prepare the gums for therapeutic rinses with Chlorhexidine and applications (for which Cholisal-gel can be used).

To achieve maximum effect during the treatment course, it is recommended to use Dentosmin P, Curasept, President toothpastes, which contain Chlorhexidine.

The use of Chlorhexidine for stomatitis

Chlorhexidine disinfects the affected mucous membrane of the gums and cheeks, on which wounds, ulcers and erosions have formed. Before the procedure, the patient rinses his mouth with plain water, preferably boiled, and then rinses the oral cavity with an aqueous solution of Chlorhexidine. Rinsing is done three times a day. Then medicinal gels are applied to the affected tissue.

If stomatitis of a herpetic nature is detected– it is better to use Miramistin, or alternate these two remedies. The dentist draws up a detailed treatment plan.

Is it possible to drip Chlorhexidine into the nose?

The nose is quite sensitive to Chlorhexidine, so it is rarely used at home, but more often saline solutions or a weak solution of furatsilin are used.

In a hospital setting, a therapeutic “cuckoo” is performed - a special method of rinsing the nose. The antiseptic Chlorhexidine is very often used with it.

Instructions for use of Chlorhexidine as a mouth rinse for sore throat

Angina– an infectious disease usually caused by streptococci or staphylococci. Catarrhal, lacunar or follicular tonsillitis requires mandatory rinsing with antiseptic solutions. Chlorhexidine 0.05% is a frequently prescribed antiseptic for all forms of sore throat.

Before using Chlorhexidine, rinse the throat with water or saline in order to remove food debris and mucus from the tonsils. If Chlorhexidine does not have the desired effect, the solution is replaced with another antiseptic.

Rinse 3 times a day. The patient takes a small amount of solution into his mouth, throws his head back slightly, and gargles for a minute. The used solution is spat out. Then he again puts a new portion of Chlorhexidine into his mouth and performs the same procedure. 2-3 servings of solution are enough (one serving is approximately 10-15 ml).

For children, Chlorhexidine solution can be diluted in a 1:1 ratio with water, but only on the recommendation of an otolaryngologist.

For 1-2 hours after rinsing, try to refrain from eating.

Are there any contraindications to the use of chlorhexidine digluconate?

The only contraindication to the prescription is individual immunity to the drug.

Side effects

Negative consequences of using the product include:

• unpleasant taste in the mouth;
;
• Lido Plus spray;
• pharmacoseptic;
• orasept;
• lysoamidase;
• iodovidone;
• Gevalex;
• other.

Pharmacotherapeutic group

Pharmacological properties

Indications for use of Lignocaine hydrochloride

Contraindications

Cautions for use

Interactions with drugs

Side effects

Overdose

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:

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:

• Amident;
• Hexicon;
• hydrogen peroxide;
• Baktosin;
• Mucosanin;
• Citeal;
• Miramistin;
• Pantoderm;
• Chlorophyllipt;
• Furacilin.

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):

Video

Chlorhexidine Bigluconate 0.05 is an antiseptic; depending on the concentration, it exhibits a bacteriostatic or bactericidal effect against gram-positive and gram-negative bacteria.

Active against vegetative forms of gram-negative and gram-positive bacteria, as well as yeast, dermatophytes and lipophilic viruses. It affects bacterial spores only at elevated temperatures. Cleanses and disinfects the skin without causing damage.

In the presence of various organic substances, secretions, pus and blood, it retains its activity (slightly reduced).

Different concentrations of alcohol and aqueous solutions affect the bacteriostatic and bactericidal effects of the drug.

At a concentration of 0.01% it has a bacteriostatic effect, and at a concentration of 0.05% Chlorhexidine Bigluconate has a fungicidal effect. The drug also acts on bacterial spores at elevated temperatures.

Indications for use

What does Chlorhexidine Bigluconate 0.05 help with? According to the instructions, the drug is prescribed in the following cases:

• genital herpes, syphilis, gonorrhea, trichomoniasis, ureaplasmosis, chlamydia (for the prevention of sexually transmitted infections; no later than 2 hours after sexual intercourse);
• cracks, abrasions (for disinfecting the skin);
• infected burns, purulent wounds;
• fungal and bacterial diseases of the skin and mucous membranes of the genitourinary organs;
• alveolitis, periodontitis, aphthae, stomatitis, gingivitis (for irrigation and rinsing).

Instructions for use of Chlorhexidine Bigluconate 0.05, dosage

The solution is used topically or externally 2 to 5 times a day. To treat minor abrasions, scratches, and cuts, use a cotton-gauze swab soaked in the solution to carefully wipe the affected area with blotting movements.

To treat burns, poorly healing wound surfaces or deep cuts, the solution can be used under an occlusive dressing, changing it as it dries, but at least 3 times a day. If pus is released from the wound surface, then before using the solution, the area should be thoroughly treated several times with a solution of hydrogen peroxide.

For the treatment of gynecological diseases of the vagina and cervix, Chlorhexidine Bigluconate solution is used for douching and tampons. The duration of the course of drug treatment is determined by the doctor individually, depending on the diagnosis.

For the prevention of sexually transmitted diseases, the drug is effective if it is used no later than 2 hours after sexual intercourse. Using a nozzle, insert the contents of the bottle into the urethra of men (2-3 ml), women (1-2 ml) and into the vagina (5-10 ml) for 2-3 minutes. Treat the skin of the inner thighs, pubis, and genitals. After the procedure, do not urinate for 2 hours.

Complex treatment of urethritis and urethroprostatitis is carried out by injecting 2-3 ml of a 0.05% solution of Chlorhexidine bigluconate into the urethra 1-2 times a day, the course is 10 days, procedures are prescribed every other day.

Chlorhexidine Bigluconate for gargling

In ENT practice it is used for sore throat, pharyngitis, tonsillitis. If you have a sore throat, you should gargle with a solution of 0.2% or 0.5%.

Before using Chlorhexidine as a gargle, it is recommended to rinse your mouth thoroughly with warm water. Next, gargling for a sore throat is carried out as follows: you should take 10–15 ml (about a tablespoon) of the solution, which can be used to gargle for about 30 seconds. You can repeat these steps one more time.

After rinsing, it is advisable not to take food or liquid for 1 hour. Your doctor will tell you how to gargle with Chlorhexidine, as well as how many times a day you need to do this procedure for your throat, taking into account your individual symptoms.

If you feel a burning sensation when rinsing your mouth, then most likely the solution is too concentrated. The highest permissible concentration is no more than 0.5%.

special instructions

Remains active in the presence of blood and organic substances.

Do not allow contact with 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.

Side effects

The instructions warn about the possibility of developing the following side effects when prescribing Chlorhexidine Bigluconate 0.05:

• Allergic reactions - skin rash, dry skin, itching, dermatitis, stickiness of the skin of the hands (within 3-5 minutes), photosensitivity.
• In the treatment of gingivitis – staining of tooth enamel, tartar deposits, taste disturbance.

Contraindications

It is contraindicated to prescribe Chlorhexidine Bigluconate 0.05 in the following cases:

• hypersensitivity to chlorhexidine.

Overdose

In case of accidental ingestion, it is practically not absorbed (gastric lavage should be done using milk, raw egg, gelatin).

If necessary, symptomatic treatment is carried out.

Analogues of Chlorhexidine Bigluconate 0.05, price in pharmacies

If necessary, you can replace Chlorhexidine Bigluconate 0.05 with an analogue of the active substance - these are the following drugs:

1. Hexicon,
2. Amident.

Similar in action:

• Miramistin;
• Iodonate;

When choosing analogues, it is important to understand that the instructions for use of Chlorhexidine Bigluconate 0.05, the price and reviews do not apply to drugs with similar effects. It is important to consult a doctor and not change the drug yourself.

Price in Russian pharmacies: Chlorhexidine bigluconate solution 0.05% 100ml - from 15 to 18 rubles, according to 702 pharmacies.

Store in a place protected from light and moisture, at temperatures up to 25 °C. Keep away from children. Shelf life – 2 years.

Conditions for dispensing from pharmacies - without a prescription.