Talk:Chlorhexidine

Naturally occurring?

I am pretty sure this is a synthetic chemical but I can't find a reference. All chemical articles should state this!! — Preceding unsigned comment added by 108.7.172.201 (talk) 12:45, 20 October 2012 (UTC)

Not understood. What should they say about whether it occurs naturally, and why? Please elaborate. JonRichfield (talk) 15:19, 21 March 2013 (UTC)

Colgate statement question

I can't find any ref. to the statement "According to Colgate [1], chlorhexidine gluconate has not been proven to reduce subgingivial calculus and in some studies actually increased deposits." at ref 1. 216.221.33.26 (talk) 14:32, 6 April 2008 (UTC)

I think whoever used this source is referring to this graph in the paper:

"Warnings: The effect of PerioGard Oral Rinse on periodontitis has not been determined. An increase in supragingival calculus was noted in clinical testing with users of chlorhexidine gluconate oral rinse compared with control users. It is not known if chlorhexidine gluconate use results in an increase in subgingival calculus. Calculus deposits should be removed by a dental prophylaxis at intervals not greater than six months. Hypersensitivity and generalized allergic reactions have occurred."

However, I agree that Colgate is probably a questionable source, in this context... Wax (talk) 00:25, 5 May 2013 (UTC)

Agreed. I am sceptical about the statement anyway, certainly in its unqualified form, though I have no formal citation to present. JonRichfield (talk) 06:50, 5 May 2013 (UTC)

I just added a citation for this claim from the Journal of Applied Oral Science. Is this credible enough to pass muster? The "Discussion" section of the paper contains the following: "The increase of calculus formation due to CHX mouthrinse is a usual finding in early long-term investigations^19,23." The paragraph that starts with that sentence supports the claim and may be the actual study that Colgate is even referring to, possibly? Dossy Shiobara (talk) 15:26, 20 February 2015 (UTC)

According to the article, Chlorhexidine helps reduce the build-up of plaque but also may have the side effect of tartar build-up. How can that be? Is this some kind of tartar that doesn't originate in plaque?--2.204.229.54 (talk) 09:25, 21 March 2021 (UTC)

Precise action of chlorhexadine (and effectiveness at conc%/conditions/time??)?

i wud like to know about exact mechanism of action of chlorhexidine —Preceding unsigned comment added by 117.197.6.97 (talk) 14:09, 5 November 2008 (UTC)

• This article is very thin on beef, with all the talk and energy wasted on silly debates by people with biased PoV's and agendas. Intarnet warriors sleep alone ^.^

 It needs some techinfo on concentration effects, and effects of enviroment on efficacy.

benryanau 12:53, 6 August 2013 (UTC)

personal comment

Personal Testimony, that's why I'm listing here and not in the article page, but I wouldn't listen to Colgate honestly. I had a TERRIBLE gum disease infection, to the point where my entire mouth felt like it was on fire. When I used the chlorhexidine gluconate my periodontist gave me, the relief was INSTANT. Following his directions, using the stuff and taking care of my mouth better, the infection did pass. regular mouthwash and toothpaste had not been helping at all.... —Preceding unsigned comment added by 65.113.188.194 (talk) 01:38, 5 March 2009 (UTC)

The Colgate quote refers to calculus, AKA tartar. It says nothing about infections. wfaulk (talk) 15:53, 30 November 2010 (UTC)

Agree with both. Anyway, Colgate is probably just covering their asses… ElectroWolf (talk) 17:40, 24 May 2019 (UTC)

Chlorhexidine in dog treats

This article doesn't mention anything about how Chlorhexidine is used in dog treats (see for example C.E.T. HEXtra Premium Oral Hygiene Chews (with Chlorhexidine) for Medium Dogs http://www.amazon.com/C-E-T-HEXtra-Premium-Hygiene-Chlorhexidine/dp/B001P3NU44/ref=sr_1_1?ie=UTF8&s=home-garden&qid=1257303957&sr=8-1). Does anyone have any information on the action in this application? I am also interested in the safety of these type of products (i.e., is it safe to *ingest* Chlorhexidine?). Thanks!

Biguanide

According to this source, Chlorhexidine is "hexamethyl bischlorophenyl biguanide". Should it be categorised as a biguanide? Colin°^Talk 20:06, 21 December 2009 (UTC)

Fair Use =

Um, how can we have one picture (the mouthwash) with a logo that is "fair use" and further down have a picture of another product (the skin cleanser) that also has a logo that is under the CC license? Aren't they both examples of the same basic idea? Should we remove one or the other? —Preceding unsigned comment added by 204.153.84.10 (talk) 20:03, 23 March 2010 (UTC)

Opening paragraph

I reordered the opening paragraph's into one since it was a few one sentence lines. Also, reworded the paragraphs to make it flow better and to make some information clearer. No info was added or removed, just moved around. Quickone (talk) 01:13, 9 August 2010 (UTC)

In the opening paragraph, the Ray et al (1991) reference (PMID 2060761) doesn't seem to be related to the preceding sentence. Can someone verfiy this and, if necessary, delete it? I'm going to insert two references which do support the statement regarding chlorhexidine MOA ie. Kuyyakanond and Quesnel (1992; PMID 1335944) and Barrett-Bee et al (1994; PMID 39666). 202.28.35.245 (talk) 05:23, 24 September 2013 (UTC) (Forgot to sign in before writing that. Apologies) Active agent (talk) 05:28, 24 September 2013 (UTC)

It's been ten days now, and nobody's responded. Figure that's fair warning. Going to delete the Ray et al (1991) reference (PMID 2060761). You can revert my edit later if you disagree. Active agent (talk) 07:23, 4 October 2013 (UTC)

Misidentification

I believe there is a great deal of potential confusion about this topic. Chlorhexidine is a well-defined entity, and the present article does accurately depict it in the structure panel. However, clinical and veterinary substances are all salts, I believe, such as chlorhexidine (bi) gluconate and chlorhexidine acetate. Therefore, it seems that most of the current content should be listed under a topic such as "chlorhexidine compounds" or something like that, with chlorhexidine, acetate, gluconate, etc. linking to it. This use of "chlorhexidine" to refer to such antiseptic, antibiotic, antimicrobial, and preservative substances is common, but misleading. Even sites such as http://www.drugbank.ca/drugs/DB00878 perpetuate the misuse. By comparison, many (but not all) references at the United States FDA website and others such as http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=2636 employ more accurate terminology.

Mweir2 (talk) 17:55, 11 August 2010 (UTC)

I did a quick literature search to see if I could find more information about your concern. I find most articles talk about chlorhexidine, either pure or a combination and not stating it. Some talk about chlorhexidine:chloride, acetate, gluconate, digluconate and ethanol. The salts appear to be a form of longer acting, sustained release antiseptics. With digluconate used orally and acetate used on the skin more often. Someone with more knowledge on the topic should add these details or I'd have to research it more before I would feel conformable changing the page beyond mentioning that there are the different versions.

Quickone (talk) 18:14, 12 August 2010 (UTC)

I cannot give you any refs that would meet citation requirements, but for your personal information, all the salts do is to control such things as taste and solubility. Chlorhexidine is very rapidly precipitated out of solution by a wide range of ions and it tastes nasty. Depending on the needs of the solution in question it is prepared in the form of an salt, typically a weak organic acid such as acetic or gluconic acid (both of which, btw, are simple, normal food components) though I seem to remember having seen the chloride sold somewhere too. The acids in question are irrelevant to the mechanism of action; they are purely formulants, just as when a spoonful of sugar makes the medicine go down, you don't much care whether it is grape sugar or fruit sugar; it isn't there to help or hurt, just to improve the mode of administration. Oh, and btw, I don't sell or prepare the stuff, and don't know anyone who does. JonRichfield (talk) 15:33, 21 March 2013 (UTC)

MRSA chlorhexidine resistance

this is a new topic in latest research out of London. If someone wants to add about it, it would be great. 76.94.56.100 (talk) 16:57, 7 November 2010 (UTC)

Removing advert tag

Removing advertisement warning. The article includes quite a few warnings and contraindications that may not have been there when the warning was placed or last restored -- I haven't checked the history for all the changes, but this doesn't look to me like any kind of an ad!

I have read the following text (with approval, though no approval was asked! I have no conflicts of interest, but I am a long-time chlorhexidine user) and wished to comment on a few points in case anyone wanted to raise concerns about points that did not merit concern out of context. At this point I am not suggesting any particular article edits, just adding talk-page remarks in case they lend contextual support to anyone with outstanding questions. I have inserted signed comments in situ, as here for example JonRichfield (talk) 12:35, 22 March 2013 (UTC)

• intro:
  • Products containing chlorhexidine in high concentrations must be kept away from eyes and the ears, due to the risk of damage to those organs.

I have heard similar remarks without questioning them, but what is a high concentration? 20%? 2%? 0.02%? I normally use it as a 0.2% mouthwash, which AFAIK is about standard. As an example of a general remark on a pharmaceutical substance, that could apply to hundreds of compounds as applied to a wide range of organs. Unqualified like this, is it supposed to mean anything? JonRichfield (talk) 12:35, 22 March 2013 (UTC)

• Dental:
  • According to Colgate,[6] chlorhexidine gluconate has not been proven to reduce subgingival calculus and in some studies actually increased deposits.

Not having read the original, I find this a curious juxtaposition of statements: "...not been proven to reduce..." (understandable!) and "...and in some studies actually increased deposits..." meaning that in those studies it was "proven"? Reeally??? Do I sniff a whiff of POV? JonRichfield (talk) 12:35, 22 March 2013 (UTC)

• • Chlorhexidine's role in preventing tooth decay (dental caries) is controversial: [long quoted paragraph]

All OK, but do the quotes remark on whether anyone thinks that caries control is the only intended function, controversial or not? JonRichfield (talk) 12:35, 22 March 2013 (UTC)

• • Continued use of products containing chlorhexidine for long periods can cause stains on teeth [...] prolonged use can also alter taste sensation

"...can cause..." "...can alter..." could mean anything or nothing, ranging from blackened stumps and no tongue, to less effect than smoking (which, for what OR it is worth, is my personal experience, just for example). If this is some source's idea of an encyclopaedic statement... JonRichfield (talk) 12:35, 22 March 2013 (UTC)

• Topical:
  • Due to other chemicals listed as inactive ingredients, the cleanser solution is not suitable for use as mouthwash. [...] 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 [insert "not"?!]] instilled carefully and going through the nose through a perforated eardrum.

Do tell! This is encyclopaedic??? I could see it as a list of damfool things not to do of course, but how does it belong in a list or discussion of appropriate use of an active ingredient? Any active ingredient? JonRichfield (talk) 12:35, 22 March 2013 (UTC)

• Use in animals:
  • Note, however, that problems[13] including deafness[14] have been associated with the use of chlorhexidine products in cats.

-- Thnidu (talk) 23:24, 12 February 2011 (UTC)

Note in passing that, as specialist carnivores, probably the most specialist group of carnivores, cats are disastrously sensitive to many chemicals, including natural organics, that in other animals, in particular omnivores such as rats, humans, and pigs, and in herbivores such as goats and horses, are harmless or valuable pharmaceuticals. Salicylate and caffeine are notorious examples. The concerns might be relevant and valid, but not out of context, nor particular to chlorhexidine. JonRichfield (talk) 12:35, 22 March 2013 (UTC)

The reason I added the advert tag was because every section of this article (which is about a chemical compound, and not some product) was sprinkled with brand names. All of the following is right now in the article:

[..] marketed under the brand names Peridex, Periochip, Perichlor or Periogard Oral Rinse. In the UK it is mainly marketed under the brand name Corsodyl (or Chlorohex); in Italy as Curasept (Curaden Healthcare srl); in Germany as Chlorhexamed; in Australia and New Zealand as Savacol; in India as Suthol (G. D. Pharmaceuticals), Sterimax (Bioshields), Clohex or Dejavu-MW (QUADRA); in Venezuela as Perioxidina or Peridont, in Japan as Oronine and in some Central American countries as Clorexil.

As a skin cleanser, it is marketed under brand names such as Hibiclens, Savinox plus (Bioshields), Surgiprep-CHX (Bioshields), Hibiscrub, or Dexidin mainly as a surgical scrub, Hexigard 4 as surgical hand wash,Hexigard HR as hand rub (Mil Laboratories Pvt Ltd)and is also available as a wound wash.

Chlorhexidine is also used in nondental applications, most notably under the brand names Oronine, Avagard, Hibiclens, Savinox plus (Bioshields), Hibiscrub, ChloraPrep, ChloraScrub, BIOPATCH, SOLU-I.V. and Exidine. It is also a component of the household antiseptic Savinox plus (Bioshields), Termilon(Mil Laboratories Pvt Ltd) and Savlon.

Some common brand names are ChlorhexiDerm, ResiChlor, Savinox plus (Bioshields), Germi-STAT Antimicrobial Skin Cleanser, Nolvasan Skin and Wound Cleaner, and Nolvasan Ointment.

– Acdx (talk) 03:25, 13 February 2011 (UTC)

But isn't this legitimate information? Anyone wanting to use chlorhexidine will probably want to know how to find it commercially. Is there a wiki policy on brand names? either Don't mention them at all (I'd be very surprised), or perhaps Put them in a separate section? If you want to remove them, please cite a reason.

I went to Wikipedia:WikiProject Pharmacology and looked at some of the "Good articles" listed there:

• Clindamycin: "Clindamycin is marketed under various trade names including Dalacin. Combination products include Duac, BenzaClin, Clindoxyl and Acanya (in combination with benzoyl peroxide), and Ziana (with tretinoin). Clindamycin is also available as a generic drug. ... Several combination acne treatments containing clindamycin are also marketed, such as single-product formulations of clindamycin with benzoyl peroxide—sold as BenzaClin (Sanofi-Aventis), Duac (a gel form made by Stiefel), and Acanya, among other trade names—and, in the United States, a combination of clindamycin and tretinoin, sold as Ziana.[28] In India, vaginal suppositories containing clindamycin in combination with clotrimazole are manufactured by Olive Health Care and sold as Clinsup-V. In Egypt, vaginal cream containing clindamycin produced by Biopharmgroup sold as "Vagiclind" indicated for vaginosis."
• Warfarin: "Warfarin (also known under the brand names Coumadin, Jantoven, Marevan, Lawarin, and Waran) is an anticoagulant."
• Benzodiazepine describes a whole class of drugs. It features in the box a link to List of benzodiazepines (itself a WikiProject Pharmacology article), which features a table of 30 or so different benzodiazepine drugs, each with its properties and a list of common brand names, plus the footnote "Not all trade names are listed. Click on drug name to see a more comprehensive list."

In the light of these precedents within the project, I cannot see listing brand names as a reason to tag the article as an advertisement.

-- Thnidu (talk) 23:16, 14 February 2011 (UTC)

All I'm saying is that nearly every section in this particular article seems to spend most of its time listing various brand names, detracting from actual content/substance. – Acdx (talk) 01:00, 16 February 2011 (UTC)

It's kind of like if the article on nitrogen was mostly about various liquid nitrogen vendors and chemical companies. – Acdx (talk) 01:05, 16 February 2011 (UTC)

I have asked the WikiProject Pharmacology to look at the article and provide some knowledgeable input. --Thnidu (talk) 01:05, 18 February 2011 (UTC)

Hi. The question how many trade names (and which) should be mentioned is a long-standing problem on WP:PHARM. For a lengthy discussion see Wikipedia_talk:Manual_of_Style_(medicine-related_articles)/Archive5#Trade_names. The consensus tended against adding lists of "generic" trade names (by manufacturers who didn't invent the drug), but as far as I know, this wasn't ever added to WP:MOSMED. My impression of this article is that it contains way to many trade names scattered across the text; a start would be to organise it according to WP:MOSMED#Drugs and collect the trade names in a single section towards the end. Sorry I can't give you advice on whether all trade names should stay, but as I've said before, there is no official policy or consensus on that point. --ἀνυπόδητος (talk) 14:50, 18 February 2011 (UTC)

Thank you. -- To me, though, it makes sense to organize the trade names by the uses of the chemical, as is done here.

So it seems that an appropriate action might be to edit those lists of trade names: something I'm not about to do, since I'm no expert in the field and haven't the time. But it does also seem that, pace Acdx, inclusion of trade names does not in itself warrant an Advert tag. --Thnidu (talk) 01:24, 21 February 2011 (UTC)

The foregoing discussion on trade names seems to me entirely proper, and the concerns and conclusions thoughtful and constructive. Nice going all. JonRichfield (talk) 12:35, 22 March 2013 (UTC)

File:Hibiclens-low-res-219x288.jpg Nominated for Deletion

An image used in this article, File:Hibiclens-low-res-219x288.jpg, has been nominated for deletion at Wikimedia Commons in the following category: Deletion requests September 2011 What should I do? Don't panic; a discussion will now take place over on Commons about whether to remove the file. This gives you an opportunity to contest the deletion, although please review Commons guidelines before doing so. If the image is non-free then you may need to upload it to Wikipedia (Commons does not allow fair use) If the image isn't freely licensed and there is no fair use rationale then it cannot be uploaded or used. This notification is provided by a Bot --CommonsNotificationBot (talk) 03:00, 12 September 2011 (UTC)

Meaningless Phrase

What is "...if instilled carefully and going through the nose through a perforated eardrum" meant to mean?194.72.120.131 (talk) 15:22, 9 August 2012 (UTC)

side effects:

Where is a complete list? I saw somewhere that long term oral use can cause hearing loss...true? ( your article says not to use in eyes, human ears and nasal passages, but what is the effect of ingestion with dental use)

---

chris ranch

Hi, I am not a Wikipedia user (I don't speak English). However, I was using this Wikipedia page to remember some basics (names, chemical structure,...), and I found in the discussion that people is asking some information. So,... Concerning side effects, there is a good list (documented with multiple scientific references) in " Disinfectants and Preservatives", pages 1635-1638, from "drugfuture.com". It is a Chinese web page, which makes it hard to find for the google machine (Nonetheless, with the keywords I mentioned it is possible). I really know this product. I am a molecular biologist that has been using it for almost 20 years. However, the research that brought me to this page was a comparison with other similar products like CTAB. The toxicity of CTAB is well described in its wikipedia page, and it is easy to find using the google searching machine. It is not the same for chlorhexidine, despite it having more side effects at lower concentrations (I am not saying chlorhexidine is not generally safe, adverse side effects occur rarely or at really high concentrations or prolonged used)... What I try to say, is due to the history of the patent, Chlorhexidine has had a consistent and long term positive image building (that's why it is so hard to find adverse effects via google). For example, it is well know and documented that it changes the properties of hydroxyapatite and makes teeth prone to staining. Yet it is commonly used in mouthwashes... I really do not want to enter this discussion because there is an army of companies that uses and defends chlorhexidine. However, being Wikipedia, editors should check alternative and well supported references.... Finally, I don't know how you do it. I wanted to add more information but I am already tired. Just a small addition because there seems to be contradictory information. Chlorhexidine is a decent biocide. However, it is a terrible ingredient for mouthwash products. It has to due with its chemical behavior (especially solubility) and the facility bacteria can acquire the correspondent resistance: not good mouthwash (FDA confirmed), good biocide to treat periodontitis and to increase implant's success (the xantham gel used as matrix for delivery corrects the solubility/concentration problem)... (Somebody asked somewhere in this page: Yes, it is a bis- biguanide.) (Somebody asked somewhere in this page: Yes, it can cause hearing lost if used to disinfect internally, near the nerves: never use chlorexidine over/near an exposed nerve)... My complete admiration to you all, wikipedists. — Preceding unsigned comment added by 181.112.80.204 (talk) 04:32, 24 February 2017 (UTC)

ps I truly apologize if I'm not using this page correctly, it has been difficult figuring out how and where to ask this question. — Preceding unsigned comment added by 76.126.21.36 (talk) 17:23, 24 September 2012 (UTC)

Hi! An extensive list of side effects is at http://www.drugs.com/sfx/chlorhexidine-topical-side-effects.html, but be aware that you won't necessarily experience all of them if you take chlorhexidine :-) There it says "Nervous system side effects have included cases of sensorineural deafness following direct instillation of chlorhexidine into the middle ear", but I've never heard of that side effect in the context of oral/dental use. Hope this helps. Cheers, ἀνυπόδητος (talk) 19:48, 30 September 2012 (UTC)

Surfactants

Endo-CHX, an Endodontic irrigating solution of 2% chlorhexidine manufactured by Essential Dental Systems, also contains 'surfactants'. These surfactants proportedly have been tested as improving the solution's efficacy in permeating microscopic intricacies of the walls of the interior of the tooth's root canal . Does anyone know how this reconsiles with the claim in the main article that surfactants tend to inactivate chlorhexidine? 50.150.181.230 (talk) 16:48, 24 July 2013 (UTC)

Hibiscrub

Perhaps the article should mention Hibiscrub. They use it a lot here in Thailand. It seems to be a red liquid soap with chlorhexidine. They use it for surgery prep. Correctrix (talk) 15:24, 18 December 2014 (UTC)

Quantify what a long period is

"Continued use of products containing chlorhexidine for long periods can cause [...]" -- Would someone please cite a reference that quantifies what a "long period" is in this context? Days? Weeks? Months? Years? Thanks! Dossy Shiobara (talk) 15:30, 20 February 2015 (UTC)

Production

How is chlorhexadine produced? which countries produce it? is it shelf stable? — Preceding unsigned comment added by 188.176.21.160 (talk) 02:14, 17 December 2016 (UTC)

Reversion of edit

Just a couple hours ago I added the following:

... But numerous studies and and meta-reviews have shown it to be effective against plaque and gingivitis.

Chlorhexidine acts by virtue of being a cation (see below) but the effect can be neutralized by common anionic toothpaste ingredients such as sodium lauryl sulfate and sodium monofluorophosphate.

Chlorhexidine can be used to combat halitosis (bad breath) by applying a 4% solution to the most posterior part of the tongue using a toothbrush or cotton swab. The chlorhexidine binds to the mucosal surface and is slowly released, killing the bacteria that cause bad breath.

References

User:Doc James has reverted all of these immediately, saying that the source is unreliable. James, what exactly do you disagree with? The paper I cited (by renowned peiodontist Jørgen Slots) gives several references for the first statement. The second statement is simply an explanation (given by Jørgen Slots) of a fact that goes along with what is said later about chlorhexidine acting as a cation. Do you disagree with that? The third statement is also referenced to the same paper. Why do you claim that all of these statements are unworthy of Wikipedia? I can understand that maybe you think the third statement needs to be corroborated by a Cochrane review of double blinded studies, but the other two should stand. Be constructive. Eric Kvaalen (talk) 10:38, 18 July 2017 (UTC)

User:Eric Kvaalen it was not me who reverted you, it was User:Alexbrn.[1]

The ref you are citing is from 2000[2]

While a review it is a little old. Will need to look further. Doc James (talk · contribs · email) 10:46, 18 July 2017 (UTC)

Reading the paper itself which says "Halitosis can be markedly reduced by applying 4% chlorhexidine to the most posterior part of the tongue dorsum using a toothbrush or a cotton swab tip (own unpublished data)." Not sufficient to support that IMO. Doc James (talk · contribs · email) 10:47, 18 July 2017 (UTC)

It's not a review, it a presentation of a novel therapy. I think we'd need some kind of reputable secondary coverage before Wikipedia can cover this. Alexbrn (talk) 10:54, 18 July 2017 (UTC)

Sorry @Doc James:, I misread the notification. It said restored to version of Doc James. Alexbrn also reverted my innocent edit of Herpesviridae (see Talk:Herpesviridae). Could you please restore what you think is acceptible from my edit of Chlorhexidine? Eric Kvaalen (talk) 12:10, 18 July 2017 (UTC)

Usage in eyes

Just a header in case of disagreements, ElectroWolf (talk) 17:47, 24 May 2019 (UTC)

I checked and the references in https://www.drugs.com/monograph/chlorhexidine-gluconate-topical.html only mentions skindisinfectants as causing eye problems. ElectroWolf (talk) 10:43, 25 May 2019 (UTC)