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Chlorhexidine is a chemical antiseptic.It kills (is bactericidal to) both gram-positive and gram-negative microbes, although it is less effective with some gram-negative microbes.It is also bacteriostatic.

The mechanism of action is membrane disruption, and not ATPase inactivation as previously thought.

It also shows activity with enveloped viruses, though this has not been extensively investigated.

Products containing chlorhexidine in high concentrations must be kept away from eyes and the ears, due to the risk of damage to those organs. However, chlorhexidine is safely used in very low concentrations in some contact lens solutions.

Availability

Chlorhexidine is present in oral rinses and skin cleansers, and in small quantities it is used as a preservative.

It is sometimes marketed under the brand names Peridex, Periochip, Perichlor or Periogard Oral Rinse. In the UKmarker it is mainly marketed under the brand name Corsodyl (or Chlorohex); in Germanymarker as Chlorhexamed; in Australia and New Zealandmarker as Savacol; in Indiamarker as Suthol (G. D. Pharmaceuticals), Clohex or Dejavu-MW (QUADRA); in Venezuelamarker as Perioxidina or Peridont, and in some Central American countries as Clorexil.

As a skin cleanser, it is marketed under brand names such as Hibiclens, Hibiscrub, or Dexidin mainly as a surgical scrub, and is also available as a wound wash. It is also used in some acne skin washes. In some countries, it is available by prescription only.

Dental

It is often used as an active ingredient in mouthwash designed to reduce dental plaque and oral bacteria. Chlorhexidine can thus be used to improve bad breath. It has been shown to have an immediate bactericidal action and a prolonged bacteriostatic action due to adsorption onto the pellicle-coated enamel surface.

Chlorhexidine-based products are usually utilized to combat or prevent gum diseases such as gingivitis. According to Colgate, chlorhexidine gluconate has not been proven to reduce subgingival calculus and in some studies actually increased deposits. When combined with xylitol, a synergistic effect has been observed.

Chlorhexidine's role in preventing tooth decay (dental caries) is controversial. Continued use of products containing chlorhexidine for long periods can cause stains on teeth, especially on silicate and resin restorations; prolonged use can also alter taste sensation - this latter symptom can be reversed by ceasing use of chlorhexidine. A version which stains the teeth less has been developed. Chlorhexidine is neutralized by common toothpaste additives such as sodium lauryl sulfate (SLS) and sodium monofluorophosphate (MFP). Although data is limited, in order to maximize effectiveness it may be best to keep a 30-minute to 2-hour interval between brushing and using the mouthwash.

Topical

Chlorhexidine is also used in non-dental applications, most notably under the brand names Oronine, Avagard, Hibiclens, Hibiscrub, ChloraPrep, ChloraScrub, BIOPATCH, SOLU-I.V. and Exidine. It is also a component of the household antiseptic Savlon. It is used for general skin cleansing, a surgical scrub, and a pre-operative skin preparation. Due to other chemicals listed as inactive ingredients, the cleanser solution is not suitable for use as mouthwash. It is often used as a rubbing agent prior to the use of hypodermic or intravenous needles in place of iodine. Chlorhexidine is contraindicated for use near the meninges, in body cavities, and near the eyes and ears. At the 2% concentration, it can cause serious and permanent injury with prolonged contact with the eye or if instilled through a perforated eardrum. Nevertheless, a topical solution of 0.02% chlorhexidine is recommended by the US Centers for Disease Control and Prevention (CDC) as treatment for keratitis caused by Acanthamoeba. As a scrub, chlorhexidine is not recommended on persons under two months of age.

Use in animals

For use in animals, it is used as a topical disinfectant of wounds. It is more effective in killing bacteria (bactericidal) than both povidone-iodine and saline, and has residual effects up to 6 hours. Some common brand names are ChlorhexiDerm, ResiChlor, Germi-STAT Antimicrobial Skin Cleanser, Nolvasan Skin and Wound Cleaner, and Nolvasan Ointment. It is also more beneficial to wound healing than using saline solutions alone.Note, however, that problems including deafness have been associated with the use of chlorhexidine products in cats. It is commonly used to manage the skin infections suffered by Westie dogs.

Deactivation

Chlorhexidine is deactivated by anionic compounds, including the anionic surfactants commonly used as detergents in toothpastes and mouthwashes. For this reason, chlorhexidine mouth rinses should be used at least 30 minutes after other dental products. For best effectiveness, food, drink, smoking, and mouth rinses should be avoided for at least one hour after use.

Though effective in the presence of blood, soap, and pus, activity is reduced.

References

  1. Drugs.com states that this information comes directly from the FDA
  2. http://www.freshbreath.ca/fbcpubs.html
  3. Effects of chlorhexidine on human taste perception. [Arch Oral Biol. 1995] - PubMed Result
  4. http://www.addl.purdue.edu/newsletters/1996/winter/psrd.shtml
  5. http://www.petplace.com/cats/deafness-in-cats/page2.aspx
  6. Denton W , Chlorhexidine In: Sterilisation and Preservation 5th Edition, Block SS, eds. Lippincott Williams & Williams, Philadelphia, 2001; 321-36.
  7. World Health Organization, Care of the Umbilical Cord/annex, http://www.who.int/reproductive-health/publications/MSM_98_4/MSM_98_4_annex.en.html


External links

  • Drugs.com states that this information comes directly from the FDA.



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