Chlorhexidine

Registered South African indications:

• Mouth infection
• Prophylaxis of dental plaque

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients

Cautions

• Contact with eyes and ears

Forms avail. in SA and covered in this monograph: sol

Minor infections of the mouth
Dental plaque formation

• Oral (sol): 10ml, 12hrly, rinsed in mouth for 1min

10ml is equivalent to 0.1ml chlorhexidine gluconate 20%

Do not swallow

May dilute with small amount of warm water if desired

Forms avail. in SA and covered in this monograph: sol

Minor infections of the mouth
Dental plaque formation

Younger than 12 years

• Not recommended for use

Older than 12 years

• See adult dose

Children <12 years should not use the product unless recommended by a healthcare professional

Pregnancy

• Safe
• There is no evidence of any adverse effects on the foetus arising from the use of chlorhexidine during pregnancy; therefore no special precautions are recommended

Breastfeeding

• Compatible
• There is no evidence of any adverse effects on the infant arising from the use of chlorhexidine during breastfeeding; therefore no special precautions are recommended

Renal Impairment

• Caution; no information available

Hepatic Impairment

• Caution; no information available

Elderly            

• No dose adjustment recommended

Porphyria Information

• Not porphyrinogenic (NP)

Drugs in Sport

• Permitted - No warnings

Gastrointestinal Disorders

• Coated tongue
• Dry mouth
• Parotid gland swelling
• Discolouration of the teeth
• Irritation of the mouth
• Desquamation / swelling of oral mucosa

Immune, Blood and Lymphatic System Disorders

• Hypersensitivity
• Anaphylaxis

Sensory Disorders

• Aguesia/ dysguesia
• Glossodynia
• Oral paraesthesia/ hypoaesthesia

• Anionic agents

None routine

Anionic agents

• Chlorhexidine is incompatible with anionic agents which are usually present in conventional dentifrices
• These should therefore be used before chlorhexidine (rinsing the mouth between applications) or at a different time of day

Incompatibilities

• Hypochlorite bleaches may cause brown stains to develop in fabrics that have previously been in contact with preparations containing chlorhexidine

Discolouration of teeth and the tongue

• The stain is not permanent and can largely be prevented by reducing the consumption of dietary chromagens such as tea, coffee or red wine
• In the cases of dentures, this can be prevented by cleaning with a conventional denture cleaner

Chlorhexidine is a cationic antiseptic effective against a wide range of Gram negative and Gram positive vegetative bacteria, yeasts, dermatophyte fungi and lipophilic viruses. It acts by destroying the cell membrane and precipitating the cell cytoplasm. It has been shown that chlorhexidine binds on to the hydroxyapatite of tooth enamel, onto the pellicle of the tooth surface and onto salivary mucins. It slowly desorbs from these sites to exert a prolonged effect for several hours.

Chlorhexidine is available in several formulations. Please note the list below gives examples of products which are available and is not necessarily comprehensive. The listing of a product does not constitute endorsement of the product by EMGuidance; likewise, failure to list a product does not imply that EMGuidance disapproves of the product. This information is put together on the basis of the National Government's Medicines Price Registry at the time of publication

Oral Rinse 0.2%

• Corsodyl (GSK)
• Corsodyl mint (GSK)
• Resmed Chlorhexidine Gluconate 0.2% (Resmed)

Also available in the following form: Cream.

COMBINATION PREPARATIONS

Chlorhexidine/ Benzocaine

Solution (per 100ml) 1mg/267mg

• Oramed (Mirren)
• Orochlor (Pharmacare)

Benzydamine/ Chlorhexidine

Spray (per 15ml) 22.5mg/18mg

• Andolex C (iNova) originator
• Throflam Co (Pharmacare)

Oral Rinse (per 15ml) 22.5mg/18mg

• Andolex C (iNova) originator 
• Throflam Co (Pharmacare)