Chlorhexidine
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| Pharmacokinetic data | |
| Protein binding | 87% |
| Identifiers | |
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| CompTox Dashboard (EPA) | |
| ECHA InfoCard | 100.000.217 |
| Chemical and physical data | |
| Formula | C22H30Cl2N10 |
| Molar mass | 505.446 g/mol g·mol−1 |
Chlorhexidine is a chemical antiseptic.[1] It kills (is bactericidal to) both gram-positive and gram-negative microbes, although it is less effective with some gram-negative microbes. [2] It is also bacteriostatic.
The mechanism of action is membrane disruption, and not ATPase inactivation as previously thought. [3]
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 (corneal ulcers) and the inner ear (deafness), although it is used in minute 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 or Periogard Oral Rinse. In the UK it is mainly marketed under the brand name Corsodyl (or Chlorohex); in Germany as Chlorhexamed; in Australia as Savacol; in India as Clohex or Dejavu-MW (QUADRA); in Venezuela 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 or Hibiscrub 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 kill dental plaque and other oral bacteria Chlorhexidine can thus be used to improve bad breath.[4]. It has been shown to have an immediate bactericidal action and a prolonged bacteriostatic action due to adsorption onto the pellicle coated enamel surface. [5]
Chlorhexidine based products are usually utilized to combat or prevent gum diseases such as gingivitis. According to Colgate [6], chlorhexidine gluconate has not been proven to reduce subgingivial calculus and in some studies actually increased deposits. When combined with xylitol, a synergistic effect has been observed.[7]
Continued use of products containing chlorhexidine for long periods can cause stains on teeth; prolonged use can also alter taste sensation - this latter symptom can be reversed by ceasing use of chlorhexidine.[8] A version which stains the teeth less has been developed.[9]
Topical
Chlorhexidine is also used in non-dental applications, most notably under the brand names Oronine, Avagard, Hibiclens, Hibiscrub, ChloraPrep, BIOPATCH, 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. As a scrub it 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 Nolvasan Skin and Wound Cleaner, and Nolvasan Ointment. It is also more beneficial to wound healing than using saline solutions alone.[10]
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.[11] 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.[12]
References
- ^ "Chlorhexidine Official FDA information, side effects and uses". Drug information Online. Drugs.com. Revised 11/2006. Retrieved 2007-10-08.
{{cite web}}: Check date values in:|date=(help) Drugs.com states that this information comes directly from the FDA - ^ "THE MOST COMMON TOPICAL ANTIMICROBIALS". Care of the umbilical cord. World Health Organization. 1998. Retrieved 2007-10-08.
- ^ Kuyyakanond T, Quesnel LB. (1992 Dec 15). "The mechanism of action of chlorhexidine". FEMS Microbiol Lett. 79: 211–215. ISSN 0378-1097. PMID 1335944. Retrieved 2008-11-19.
{{cite journal}}: Check date values in:|date=(help) - ^ http://www.freshbreath.ca/fbcpubs.html
- ^ Wiley InterScience :: Session Cookies
- ^ "Colgate PerioGard chlorhexidine gluconate oral rinse 0.12% (Rx)".
- ^ Decker EM, Maier G, Axmann D, Brecx M, von Ohle C (2008). "Effect of xylitol/chlorhexidine versus xylitol or chlorhexidine as single rinses on initial biofilm formation of cariogenic streptococci". Quintessence Int. 39 (1): 17–22. PMID 18551212.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ Effects of chlorhexidine on human taste perception. [Arch Oral Biol. 1995] - PubMed Result
- ^ Bernardi F, Pincelli MR, Carloni S, Gatto MR, Montebugnoli L (2004). "Chlorhexidine with an Anti Discoloration System. A comparative study". Int J Dent Hyg. 2 (3): 122–6. doi:10.1111/j.1601-5037.2004.00083.x. PMID 16451475.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ http://www3.interscience.wiley.com/journal/120152604/abstract?CRETRY=1&SRETRY=0
- ^ Denton W , Chlorhexidine In: Sterilisation and Preservation 5th Edition, Block SS, eds. Lippincott Williams & Williams, Philadelphia, 2001; 321-36.
- ^ 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