Chlorhexidine bigluconate: why, when and how to use the product? Chlorhexidine - instructions for use in dentistry How to use Chlorhexidine in different fields of medicine

Name:

Chlorhexidine bigluconate

Pharmachologic effect:

An aqueous solution of chlorhexidine bigluconate is a local antiseptic with a predominantly bactericidal effect. Chlorhexidine bigluconate is close in chemical structure to bigumal and is a dichlorine-containing biguanide derivative. The mechanism of action is based on its ability to change the properties of the cell membrane of a microorganism. After the dissociation of chlorhexidine salts, the resulting cations react with the bacterial membranes, which have a negative charge. In this case, the lipophilic groups of the drug contribute to the disaggregation of the lipoprotein membrane of bacteria, as a result of which the osmotic balance is disturbed and the loss of potassium and phosphorus from the bacterial cell occurs. Under the influence of the drug, the cytoplasmic membrane of the bacterium is destroyed and its osmotic balance is disrupted, resulting in the death of the bacterium.

The drug is effective against strains of the following microorganisms: Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamidia spp., Bacteroides fragilis, Treponema pallidum, Gardnerella vaginalis. In addition, chlorhexidine bigluconate is active against Ureaplasma spp. and is moderately active against some strains of Proteus spp. and Pseudomonas spp.

Viruses (except the herpes virus), as well as fungal spores, are resistant to the drug.

The drug is not absorbed into the systemic circulation when applied topically and does not have a systemic effect.

After treating the skin (including the skin of the hands), a certain amount of the drug remains on the skin, so chlorhexidine bigluconate has a long-lasting antibacterial effect and can be used to treat the surgical field and the surgeon’s hands.

The antimicrobial activity of the drug remains in the presence of pus, blood and other physiological fluids, however, it is worth noting that in this case its effectiveness is somewhat reduced.

Indications for use:

The drug is used for the treatment and prevention of various diseases caused by microorganisms sensitive to the action of chlorhexidine. Indications for use of the drug depend on its initial concentration.

Chlorhexidine bigluconate solution 0.05%, 0.1% and 0.2%:

Prevention of infectious diseases after surgical interventions, including in dental and ENT practice. In dentistry, the drug is also used to treat removable dentures.

Treatment of the skin before and after surgery to prevent infection in urology, surgery, as well as obstetric and gynecological practice.

Disinfection of the skin and mucous membranes before medical and diagnostic procedures in gynecological practice.

The drug is also used to treat various skin diseases of bacterial and fungal etiology, as well as purulent wounds and lesions of the mucous membranes that are caused by microorganisms sensitive to the action of the drug (including stomatitis, periodontitis, gingivitis and aphthae).

In addition, the drug is used after unprotected sexual intercourse to prevent sexually transmitted diseases, including chlamydia, genital herpes, syphilis, trichomoniasis and gonorrhea. As well as treating damaged skin to prevent infection.

Chlorhexidine bigluconate solution 0.5%:

Used for processing medical instruments at a temperature of 70 °C.

Treatment of infected wounds, burns and other injuries to the skin and mucous membranes.

Chlorhexidine bigluconate solution 1%:

It is used for treating medical instruments, devices and working surfaces of equipment that are not desirable to be disinfected by heat treatment.

Disinfection of the patient's skin and surgeon's hands before surgery. Prevention of infection of burns and postoperative wounds.

Chlorhexidine bigluconate solution 5% and 20%:

Used to prepare solutions of various concentrations on a water, glycerin or alcohol basis.

Method of application:

Chlorhexidine bigluconate is used for the local treatment of infectious diseases.

To prevent sexually transmitted diseases, it is recommended to use a 0.05% solution of chlorhexidine bigluconate no more than 2 hours after unprotected sexual intercourse. Men are advised to administer 2-3 ml of the drug into the urinary canal, women 1-2 ml into the urinary canal and 5-10 ml into the vagina. In addition, it is recommended to treat the skin areas on the pubis, genitals and inner thighs with the solution. Urination is allowed 2 hours after using the drug, otherwise the effectiveness of chlorhexidine bigluconate is reduced.

Patients suffering from inflammation of the urinary tract (including urethritis and urethroprostatitis) are advised to administer 2-3 ml of a 0.05% solution of chlorhexidine bigluconate into the urinary canal 1-2 times a day. It is recommended to use the drug every other day. The duration of treatment is 10 days.

In dental and ENT practice, for the prevention of postoperative infection, a 0.05% or 0.1% solution of chlorhexidine digluconate is usually prescribed 2-3 times a day in the form of rinses or irrigations.

For the treatment of wound and burn surfaces, as well as other damage to the skin, a 0.05%, 0.02% or 0.5% solution of chlorhexidine bigluconate is usually used. The drug is used in the form of irrigation or application 2-3 times a day. Application time is usually from 1 to 3 minutes.

To disinfect the surgical field, use a 20% solution of chlorhexidine digluconate, previously diluted with 70% ethyl alcohol (for 1 part of a 20% solution of chlorhexidine digluconate, take 40 parts of 70% ethyl alcohol). The resulting solution is used to disinfect the surgical field twice; the surgical field is treated a second time 2 minutes after the first disinfection.

In urological practice, before performing diagnostic procedures (for example, cystoscopy), flushing the bladder with a 0.02% solution of chlorhexidine digluconate is recommended.

Preparation of solutions of a given concentration from a 20% solution of chlorhexidine bigluconate:

To prepare 1 liter of a 0.5% alcohol solution of chlorhexidine digluconate, take 25 ml of a 20% solution of chlorhexidine digluconate and add 70% ethyl alcohol to the mark.

To prepare 1 liter of 0.5% solution of chlorhexidine digluconate, take 25 ml of 20% solution of chlorhexidine digluconate and add distilled water or water for injection (sterile water) to the mark.

To prepare 1 liter of 0.05% solution of chlorhexidine digluconate, take 2.5 ml of 20% solution of chlorhexidine digluconate and add distilled water or water for injection (sterile water) to the mark.

To prepare 1 liter of 0.02% solution of chlorhexidine digluconate, take 1 ml of 20% solution of chlorhexidine digluconate and add distilled water or water for injection (sterile water) to the mark.

To prepare 1 liter of 0.1% solution of chlorhexidine digluconate, take 5 ml of 20% solution of chlorhexidine digluconate and add distilled water or water for injection (sterile water) to the mark.

The preparation of solutions must take place under aseptic conditions. Sterilization of prepared aqueous solutions of the drug in an autoclave at a temperature of 116 °C for 30 minutes is allowed.

Solutions prepared on the basis of hard water have a less pronounced bactericidal effect, which is explained by the formation of slightly soluble chlorhexidine salts. It is prohibited to sterilize the drug using ionizing radiation.

Adverse events:

When using the drug, some patients experienced the development of such side effects as dry skin, itching, rash, photosensitivity, and dermatitis.

With long-term use of the drug in the form of rinses and irrigations of the oral cavity, patients noted a change in the color of the teeth, the formation of tartar and a change in taste sensations.

Contraindications:

Increased individual sensitivity to the components of the drug.

The drug is contraindicated for use in patients suffering from dermatitis.

The drug is used with caution in pediatrics.

The drug is not used in ophthalmology.

The drug is not used simultaneously with other antiseptic solutions.

During pregnancy:

When the drug was used topically in women during pregnancy and lactation, there was no effect of chlorhexidine on the health of the child. However, long-term use of the drug during pregnancy and lactation is not recommended.

Interaction with other drugs:

When the pH of the medium is more than 8, sedimentation occurs. Using hard water to prepare chlorhexidine solutions reduces its bactericidal properties.

The drug is not used in combination with anionic compounds, including soap.

The drug is not compatible with carbonates, chlorides, phosphates, borates, sulfates and citrates.

Chlorhexidine bigluconate increases the sensitivity of microorganisms to the action of kanamycin, neomycin, cephalosporin and chloramphenicol.

Ethyl alcohol enhances the bactericidal effect of chlorhexidine.

Overdose:

When using the drug according to the instructions, an overdose is impossible.

In case of accidental ingestion of the drug, gastric lavage using milk, mild soap, gelatin or raw egg is indicated.

There is no specific antidote; in case of side effects, symptomatic therapy is carried out.

Release form of the drug:

Solution 0.05% for external use, 100 ml in bottles made of polymer material with a nozzle, 1 bottle in a cardboard package.

Solution 0.05% for external use, 100 ml in glass bottles, 1 bottle in a cardboard package.

Solution 20%, 100 ml in bottles made of polymer material, 1 bottle in a cardboard package.

Solution 20%, 500 ml in bottles made of polymer material with a cap, 1 bottle in a cardboard package.

Solution 20%, 500 ml in bottles made of polymer material with a cap, 16 bottles per box.

Storage conditions:

The shelf life of the drug in the form of a 0.05% solution is 2 years.

The shelf life of the drug in the form of a 20% solution is 3 years.

The shelf life of the prepared solutions is 1 week.

Compound:

1 ml of the drug in the form of a 0.05% solution of chlorhexidine bigluconate contains:

Chlorhexidine bigluconate – 0.5 mg,

Excipients.

1 ml of the drug in the form of a 20% solution of chlorhexidine bigluconate contains:

Chlorhexidine bigluconate – 0.2g,

Excipients.

Drugs with similar effects:

Hepilor (Happylor) Pantestin (Panthestin) Medasept (Medasept) AHD 2000 (AHD 2000) Etonium (Etonium)

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The drug Chlorhexidine has many medicinal properties and has a wide range of applications. It has proven itself as an effective mouth rinse for stomatitis, inflammation and bleeding gums. There are known cases of the drug being used as an antiseptic and anti-inflammatory agent in the field of gynecology. Women even tried to wash themselves with it.

The healing properties of "Chlorhexidine" in dentistry

The medicine is an effective antiseptic, bactericidal and antimicrobial agent. Thanks to this, the drug is widely used in dentistry. The drug actively fights the development and proliferation of biofilm, which is the main cause of gum inflammation. In addition, it prevents the further development of diseases such as gingivitis and periodontal disease.

The solution is not absorbed into the blood, and that is why rinsing the mouth with antiseptic Chlorhexidine can be done by both adults and children. Chlorhexidine rinse has another important feature - after its use, the effect can last up to 24 hours, which again makes it a leader among similar mouth rinses. Thanks to this property, the antiseptic is often used for stomatitis, where long-term disinfection is of great importance. Most toothpastes contain Chlorhexidine, which is invaluable in dentistry.

Composition and release form of the antiseptic

The active component in Chlorhexidine solution is chlorhexidine digluconate. Water acts as an additional substance. The concentration of the drug and its area of ​​application are determined by the volume fraction of the active component.

In dentistry, only an aqueous solution with a concentration of chlorhexidine bigluconate of 0.05% is used. If you need Chlorhexidine, which can be used to rinse the mouth for medicinal purposes, then it should contain 0.035 mg of the active ingredient and water.

The drug is available in several forms:

• water-based solution;
• alcohol-based solution;
• gel (with lidocaine);
• candles;
• cream;
• ointment;
• spray;
• patch.

How to dilute and use the drug: instructions for use

The use of Chlorhexidine involves rinsing the mouth and nasopharynx. The drug purchased at the pharmacy is already ready for use; no additional dilution is required. To rinse the mouth, throat and nose, a solution containing 0.05% chlorhexidine digluconate is required. Let's look at some diseases and methods of treating them with Chlorhexidine in more detail.

For stomatitis

The disease can be cured in a few days. All you have to do is use Chlorhexidine as a mouth rinse, and the effect will not be long in coming. The main thing is to follow the instructions. To treat stomatitis, your doctor may prescribe different forms of the drug.

1. The use of an aqueous solution with a concentration of the active component of 0.05% will not require additional manipulations for its preparation - there is no need to dilute the drug with water. You need to rinse your mouth with the solution for 3-5 seconds. Try to do this carefully so that the entire oral cavity is well treated with the drug.
2. If the doctor prescribed a drug based on alcohol, then you will have to dilute it with boiled water. A specialist will indicate in what ratio it should be diluted, usually 1:2. You need to rinse your mouth well and try not to swallow the solution. How many procedures per day should there be? At least three.

It is very important to remember that such a composition is strictly contraindicated for a child! Chlorhexidine in the form of a spray has been developed for children. Do not swallow the drug! If the baby is not yet three years old, then spraying the tonsils and the back of the throat is prohibited!

Regardless of what solution the oral cavity is treated with - concentrated or diluted - you cannot eat or drink for 30 minutes after the procedure! If you want to quickly get rid of stomatitis, you must use the drug in accordance with the instructions.

For gum inflammation (periodontal disease, periodontitis and gingivitis)

Periodontal disease, periodontitis and gingivitis are diseases accompanied by inflammation of the gums. To eliminate them, dentists recommend rinsing the gums with a concentrated solution of Chlorhexidine 0.05%, which has an antiseptic effect. The procedure should be performed 2-3 times a day, one tablespoon for at least a minute for 10 days. Do not swallow the drug under any circumstances.

The medicine will give a positive result only after the tartar has been removed. In addition, before starting treatment, it is necessary to strengthen the gum tissue. To do this, the periodontist must prescribe a special course of treatment.

After tooth extraction

As an antiseptic after tooth extraction, dentists often recommend baths with 0.05% of the drug (we recommend reading: what else can you rinse your mouth with after tooth extraction?). Rinse your mouth with this solution carefully so as not to wash away the protective blood clot.

Proper rinsing looks like this:

• put a small amount of medicine into your mouth;
• hold it for about 30-60 seconds without intense movements;
• you spit, trying not to swallow a drop.

The procedure must be performed no more than three times a day. You can take baths in the morning and evening immediately after eating and performing oral hygiene procedures. Despite the fact that a blood clot is created in the wound after tooth extraction, the procedure will help not only destroy all the microbes present in it, but will also ensure rapid tissue healing.

For rinsing the nasopharynx and throat

The solution is an effective analgesic and antimicrobial drug during the treatment of sore throat and tonsillitis. It will become an indispensable assistant for you in the fight against these diseases. All you need to do is purchase Chlorhexidine and, according to the instructions, rinse your mouth with it. By enveloping the tonsils, the drug helps them get rid of purulent accumulations and harmful bacteria, and also relieves inflammation.

In order for the treatment to be correct and bring positive results, you need to follow a few simple rules:

1. rinse your mouth with boiled water;
2. measure 10-15 ml of solution (one tablespoon);
3. take the measured liquid into your mouth;
4. throw back your head;
5. exhale, pronouncing the sound “A”;
6. rinse your throat for 30 seconds;
7. spit without swallowing;
8. repeat the previous steps 2 more times.

The procedure must be carried out morning and evening for no more than 1 week. After rinsing with concentrated or diluted Chlorhexidine, you should not eat or drink for 2 hours.

At home, Chlorhexidine is rarely used for nasal procedures, since the nasal passages are too sensitive to the drug. In a hospital setting, the antiseptic still found a purpose. This is the so-called “cuckoo” - a special method for rinsing the nose. As you can see, Chlorhexidine is a drug that is suitable for rinsing the mouth, throat and nose, but it can also cause an allergic reaction.

Contraindications and side effects

The drug is endowed with many medicinal properties, but like any other drug, it also has contraindications, which should not be neglected. The medicine is contraindicated:

• for dermatitis;
• when taking drugs containing iodine in parallel;
• if the oral cavity is infected with a virus;
• if the mucous membrane is too sensitive;
• if an allergy to Chlorhexidine is detected;
• in children under 7 years of age.

The drug also has a number of side effects. This:

• unpleasant aftertaste in the mouth;
• tooth enamel takes on a yellowish-brown tint (the color can be restored using special toothpastes);
• burning and dryness in the mouth;
• allergic reaction;
• formation of tartar;
• change in taste sensations.

Advantages and disadvantages of using the solution

The drug gained its popularity due to a considerable list of advantages. Consumers prefer Chlorhexidine, given its following advantages:

• low cost;
• high efficiency in the fight against microbes;
• long lasting effect after one minute of rinsing.

In addition to the advantages, it is worth highlighting its disadvantages, which the manufacturer does not indicate in the instructions for the drug:

• bitter in taste;
• does not affect viruses;
• stains the surface of the tongue and teeth brown;
• there is a possibility of swallowing the drug, which is dangerous not only for children, but also for adults;
• Because of the bitter taste, it is difficult, and sometimes even impossible, to use for children.

Analogues of "Chlorhexidine"

Today there are a huge number of different antiseptic drugs. Most of them contain chlorhexidine and therefore are characterized by the same properties as the medicine discussed in this article. Miramistin, Sanomed, Hydrogen Peroxide, Furacilin and many others are analogues of Chlorhexidine. Let's look at some of them in more detail.

Hydrogen peroxide

Quite often, hydrogen peroxide is used to treat stomatitis and fight fungi, bacteria and viruses. It, like Chlorhexidine, is an effective antiseptic. Only it doesn’t leave “red” marks on the teeth at all. In addition, the solution helps relieve pain and eliminate inflammation. Hydrogen peroxide is quite cheap. Is it possible to rinse your mouth with hydrogen peroxide? Yes, you can, but only at a dentist’s appointment and only as part of complex therapy. Peroxide effectively flushes out purulent accumulations. Just under no circumstances use it for such purposes yourself - it is very dangerous.

Furacilin solution

It is an antiseptic for wide use both at home and in medical institutions. Its cost, like that of Chlorhexidine, is acceptably low. Available in several forms: alcohol solution, tablets and ointment.

The drug has found its use in the field of dentistry and for the treatment of ENT diseases. Dentists use it to treat the mouth for stomatitis, gingivitis and osteomyelitis. ENT doctors prescribe it as an effective remedy for sore throat, which should be used to gargle. This procedure prevents streptococci and staphylococci, which cause the disease, from multiplying.

Usually a tablet preparation is used. Before using it, you need to prepare an aqueous solution: 2 tablets are crushed into powder and dissolved in a glass of warm boiled water. The drug is ready for use. The maximum shelf life of such a medicine is no more than a day.

Miramistin

It is one of the best analogues of the drug Chlorhexidine. They can also gargle and gargle the mouth. It not only effectively fights germs, but also destroys viral herpes. In addition, Miramistin quickly relieves the inflammatory process in herpetic stomatitis.

In comparison with Chlorhexidine, Miramistin:

• has a wider range of indications;
• tasteless;
• does not leave marks on teeth;
• does not cause irritation.

The medicine can be used by pregnant women, but very carefully. It is contraindicated for children under three years of age. The drug costs several times more than Chlorhexidine.

20% aqueous solution of chlorhexidine bigluconate; in bottles of 500 ml.

pharmachologic effect

pharmachologic effect- antiseptic.

Indications for the drug Chlorhexidine bigluconate

Treatment of the surgical field and the surgeon’s hands; sterilization of surgical instruments, treatment of wounds and burns, lavage of the bladder for cystitis.

Contraindications

Hypersensitivity.

Directions for use and doses

Disinfection of the surgical field - 0.5% solution in 70% ethanol for 5 minutes; hand disinfection - 0.5% solution in 70% ethanol or 1% aqueous solution; antiseptics of wounds and burns - 0.5% aqueous solution; disinfection measures in gynecology and obstetrics - from 0.05 to 0.2% aqueous solution; cystoscopy, bladder lavage - 0.02% sterile aqueous solution; disinfection of the urethra during catheterization - 0.05% sterile solution in glycerin; disinfection of medical instruments - 0.5% solution in 70% ethanol for 5 minutes; sterilization of medical instruments - 0.5% aqueous solution at a temperature of 70 °C for 3 hours.

Storage conditions for the drug Chlorhexidine bigluconate

In a place protected from light, at a temperature of 1-25 °C.

Keep out of the reach of children.

Shelf life of the drug Chlorhexidine bigluconate

3 years.

Do not use after the expiration date stated on the package.

Instructions for medical use

Chlorhexidine bigluconate
Instructions for medical use - RU No. P N015600/01

Last modified date: 16.04.2004

Dosage form

Concentrate for the preparation of solutions for local and external use.

Compound

Active substance:

Chlorhexidine bigluconate 20 g.

Excipients:

Water up to 100 ml.

Description of the dosage form

Colorless or light yellow transparent liquid.

Pharmacological group

Antiseptic.

Pharmacodynamics

Antiseptic. Depending on the concentration used, it exhibits both bacteriostatic and bactericidal effects. The bacteriological effect of both aqueous and alcoholic working solutions) manifests itself in a concentration of 0.01% or less; bactericidal - in a concentration of more than 0.01% at a temperature of 22 ° C and exposure for 1 minute. Fungicidal effect - at a concentration of 0.05%, at a temperature of 22 ° C and exposure for 10 minutes. Virucidal effect - manifests itself at a concentration of 0.01-1%. Effective against pathogens of sexually transmitted infections - gardnerellosis, genital herpes; gram-positive and gram-negative bacteria - Treponema spp., Neisseria gonorrhoeae, Trichomonas spp., Chlamidia spp., Ureaplasma spp.

Does not affect acid-resistant forms of bacteria, microbial spores, fungi. It is stable, after treatment of the skin (hands, surgical field) it remains on it in a certain amount sufficient to exhibit a bactericidal effect. Retains activity (albeit somewhat reduced) in the presence of blood, pus, various secretions and organic substances.

It extremely rarely causes allergic reactions, irritation of skin and tissues, and does not have a damaging effect on objects made of glass, plastic and metals.

Pharmacokinetics

Practically not absorbed from the gastrointestinal tract. After accidental ingestion of 300 mg, Cmax is reached after 30 minutes and is 0.206 μg/l.

It is excreted mainly in feces (90%), less than 1% is excreted by the kidneys.

Indications

As a preventive and therapeutic agent for various infections, for antiseptic treatment and disinfection.

0.05%, 0.1%, 0.2% aqueous solutions:

• Postoperative care for patients in ENT and dentistry departments.

0.05% and 0.2% solutions:

• Purulent wounds, infected burns, bacterial and fungal diseases of the skin and mucous membranes in dentistry (rinsing and irrigation - gingivitis, stomatitis, aphthae, periodontitis, alveolitis);
• Prevention of infections in surgery, urology, obstetrics and gynecology;
• Prevention of sexually transmitted infections (chlamydia, ureaplasmosis, trichomoniasis, gonorrhea, syphilis, genital herpes - use no later than 2 hours after sexual intercourse);
• · Disinfection of skin (abrasions, cracks).

0.2% solution:

• Treatment and sanitation of the genital tract in gynecology during therapeutic and diagnostic procedures;
• Disinfection of removable dentures.

0.5% solution:

• Treatment of wounds and burn surfaces; treatment of infected abrasions and cracks of the skin, open mucous membranes.
• Sterilization of medical instruments at a temperature of 70°C.

1% solution:

• Disinfection of thermometers, working surfaces of medical equipment and devices, the heat treatment of which is undesirable;
• Treatment of the surgical field and the surgeon's hands before surgery, disinfection of the skin, treatment of postoperative and burn wounds.

5% concentrate:

• Preparation of aqueous, glycerin and alcohol solutions with concentrations from 0.01 to 1%.

Contraindications

Hypersensitivity to the components of the drug, dermatitis.

Carefully:

Children's age (up to 18 years)

Directions for use and doses

Chlorhexidine is used as a prophylactic and therapeutic agent externally and locally, as well as for disinfection.

0.05%, 0.02% and 0.5% aqueous solutions are used in the form of irrigation, rinsing and applications (5-10 ml are applied to the affected surface of the skin or mucous membranes):

• To treat the surgical field, dilute a 20% solution with 70% ethyl with an exposure of 1-3 minutes, 2-3 times a day (on a tampon or by irrigation).
• Alcohol in a ratio of 1:40. The resulting 0.5% aqueous-alcohol solution of chlorhexidine is treated with the surgical field 2 times with an interval of 2 minutes.
• For postoperative care of patients in the ENT and dentistry departments, a solution (0.05% and 0.1%) for rinsing is usually prescribed 2-3 times a day.
• 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 of treatment is 10 days, procedures are prescribed every other day.
• To wash the bladder during cystoscopy, use a 0.02% sterile aqueous solution.
• For the prevention of sexually transmitted diseases, chlorhexidine bigluconate is effective if it is used no later than 2 hours after sexual intercourse. A diluted 0.05% solution is injected into the urethra for men (2-3 ml), women (1-2 ml) and into the vagina (5-10 ml) for 2-3 minutes. It is also necessary to treat the skin of the inner thighs, pubis, and genitals. After the procedure, do not urinate for 2 hours.

For disinfection:

Treatment of medical instruments and working surfaces is carried out with a clean sponge moistened with an antiseptic solution, or by soaking. To quickly sterilize instruments, use the same 0.5% solution for 5 minutes.

A 0.1% aqueous solution of chlorhexidine can be used to disinfect premises, sanitary equipment, etc.

Procedure	Dilution of the drug and type of solvent	Concentration of solution containing chlorhexidine bigluconate	Special Requirements
Disinfection of hands and surgical field	1:40 in 70% ethyl alcohol	0,5 %	Treatment with the solution for at least 5 minutes.
Antiseptic treatment of wounds and burns	1:40 in the water	0,5 %	Use sterilized water. Sterilize the solution at a temperature of 115-116 °C for 30 minutes in an autoclave.
Antiseptics in gynecology and obstetrics	1:400	0,05 %	Use sterilized water. The solution is sterilized at a temperature of 115-116 °C for 30 minutes in an autoclave.
Cystoscopy, bladder lavage	1:1000 in water or saline sodium chloride solution.	0,02 %	Sterile solution.
Washing of the peritoneum, pleura (operational procedures)	1:1000 in water	0,02 %	Sterile solution
Antiseptics for urethral catheterization	1:400	0,05 %	Combine aseptically with sterile glycerin.

Side effects

In rare cases - allergic reactions (skin rash), dry skin, itching, dermatitis, stickiness of the skin of the hands (within 3-5 minutes), photosensitivity. Changes in tooth color, tartar deposits and taste disturbances with long-term use for oral antiseptics.

Overdose

In case of accidental ingestion, it is practically not absorbed (gastric lavage should be done using milk, raw egg, gelatin or mild soap). If necessary, symptomatic therapy is carried out.

Interaction

Used in a neutral environment; at pH 5-8 the difference in activity is small; at pH more than 8, a precipitate forms. The use of hard water somewhat reduces the bactericidal properties.

Chlorhexidine bigluconate is a cationic substance and does not combine with soap and other anionic compounds such as colloids, gum arabic, carboxymethylcellulose.

At a concentration of 1:2000, it is incompatible with borates, carbonates, chlorides, citrates, phosphates, sulfates, creating poorly soluble sediments after 24 hours.

Compatible with drugs containing a cationic group (benzalkonium chloride, cetrimonium bromide).

Increases the sensitivity of bacteria to chloramphenicol, kanamycin, neomycin, cephalosporins.

Ethanol enhances the effectiveness of the drug.

special instructions

Avoid getting the drug inside the wound in patients with open traumatic brain injury, spinal cord injuries, or perforation of the eardrum.

In case of contact with the mucous membranes of the eyes, they should be quickly and thoroughly rinsed with water.

Do not mix chlorhexidine with other disinfectants and detergents. Contact with hypochlorine bleaches on fabrics that have previously been in contact with chlorhexidine-containing products may cause brown stains. Do not expose clothing that has been in contact with chlorhexidine to hypochlorites and other compounds that release active chlorine.

Do not dilute with hard water. Aqueous solutions can be sterilized in an autoclave at 116 °C for 30 minutes. Do not sterilize using ionizing radiation.

Release form

Concentrate for the preparation of solutions for local and external use 20%, 500 ml in colored polypropylene bottles with a cap.

For pharmacies - 1 bottle with instructions in a cardboard box.

For hospitals - 16 bottles per box with instructions.

Storage conditions

At temperatures from 1 °C to 25 °C. Protect from light.

Keep out of the reach of children.

Best before date

Diluted solutions should be stored for no more than a week.

Do not use after expiration date.

Conditions for dispensing from pharmacies

Over the counter.

Chlorhexidine bigluconate - instructions for medical use - RU No. P N015600/01 dated 2004-04-16

Synonyms of nosological groups

ICD-10 rubric	Synonyms of diseases according to ICD-10
N30 Cystitis	Exacerbation of chronic cystitis
	Acute bacterial cystitis
	Recurrent cystitis
	Urethrocystitis
	Fibrous cystitis
	Cystopyelitis
T14.1 Open wound of unspecified body area	Secondary healing processes
	Limp granulating wounds
	Slow healing wounds
	Slow-healing wounds
	Deep wounds
	Purulent wound
	Granulating wounds
	Long-term non-healing wound
	Long-term non-healing wound and ulcer
	Long-term non-healing soft tissue wound
	Wound healing
	Wound healing
	Capillary bleeding from superficial wounds
	Bleeding wound
	Radiation wounds
	Slowly epithelializing wounds
	Minor cuts
	Festering wounds
	Impaired wound healing processes
	Violation of skin integrity
	Violations of the integrity of the skin
	Violations of the integrity of the skin
	Small cuts
	Uninfected wounds
	Uncomplicated wounds
	Surgical wound
	Primary treatment of superficial contaminated wounds
	Primary treatment of wounds
	Primary delayed treatment of wounds
	Poorly scarring wound
	Poor wound healing
	Poorly healing wound
	Superficial wound
	Superficial wound with slight exudation
	Wound
	Large wound
	Bite wound
	Wound process
	Wounds
	Slow-healing wounds
	Stump wounds
	Gunshot wounds
	Wounds with deep cavities
	Difficult-to-heal wounds
	Hard-to-heal wounds
	Chronic wounds

Manufacturer: YuzhPharm LLC Russia

ATS code: D08AC02

Farm group:

Release form: Liquid dosage forms. Solution for external use.

General characteristics. Compound:

Active ingredient: 0.05% chlorhexidine bigluconate.

Excipient: purified water.

Pharmacological properties:

Pharmacodynamics. The product is bactericidal against gram-positive and gram-negative bacteria (including pathogens), tuberculocidal, virucidal (acute respiratory viral infections, herpes, hepatitis of all types, including hepatitis A, B and C, adenovirus, etc.) and fungicidal (in action against fungi of the genera Candida and Trichophyton).

According to the parameters of acute toxicity, “Chlorhexidine bigluconate 0.05% - YuzhPharm” belongs to class 4 of low-hazardous substances according to GOST 12.1.007-76 when applied to the skin, introduced into the stomach and inhaled. According to the classification of Sidorov K.K. when administered parenterally, the drug belongs to class 5 of practically non-toxic compounds. Skin-resorptive and sensitizing properties in the recommended modes of use of the product have not been identified.

The product has a moderate irritant effect on the mucous membranes of the eyes. The maximum permissible concentration in the air of the working area of ​​chlorhexidine bigluconate is 1 mg/m3.

The product can be used to treat the skin of children from birth.

Indications for use:

The product "Chlorhexidine bigluconate 0.05% - YuzhPharm" is intended for use in medical institutions:

For hygienic treatment of the hands of medical personnel, including personnel of ambulances;
- for disinfecting the skin of the injection field;
- for sanitary treatment of the skin and the skin of the feet to prevent fungal diseases;
- for disinfection of rubber gloves worn by personnel (made of materials resistant to chemicals) during surgical interventions and manipulations requiring surgical antiseptics, when working with potentially infected material (microbiological and other laboratories); when collecting medical waste of classes B and C.
- for disinfection of small instruments of simple configuration;
- as a prophylactic agent in the form of irrigation, rinsing and application on the surface of the skin, mucous membranes;
- for hygienic treatment of the hands of students of educational institutions, staff of preschool and school institutions, social security institutions (nursing homes, hospices, etc.), employees of perfumery and cosmetics enterprises (including hairdressers, beauty salons, etc.), public catering, municipal facilities, food and chemical-pharmaceutical industries;
- for hygienic treatment of the skin of the hands, injection field, sanitary treatment of the skin and skin of the feet for the purpose of preventing fungal diseases, as a prophylactic for the population in everyday life.

Important! Get to know the treatment

Directions for use and dosage:

Hygienic treatment of hands: 3 ml of the product is applied to the hands and rubbed into the skin until dry for 30 seconds.

Treatment of the injection field, incl. at the site of vaccination: the skin is wiped with a sterile cotton swab or irrigated until completely moisturized, followed by holding for 30 seconds.

Preventive treatment of the feet, sanitary treatment of the skin: with a copiously moistened cotton swab, carefully treat each foot or area of ​​skin with different cotton swabs or irrigate with the product until the skin is completely moistened, holding time for at least 30 seconds.

Processing of gloves worn by personnel: the outer surface of the gloves is thoroughly wiped with a sterile swab, generously moistened with the product. Processing time - at least 1 minute. Exposure - until the surface of the gloves is completely dry.

Small instruments of a simple configuration: (in healthcare facilities, beauty salons, hairdressers, manicure and pedicure rooms, etc.) must be completely immersed in the product immediately after its use. The thickness of the layer of product above the products must be at least 1 cm. After the disinfection period of 5 minutes is completed, the products are removed from the container and washed with running drinking water for at least 1 minute.

As a prophylactic agent in the form of irrigation, rinsing and application - 5-10 ml of solution is applied to the surface of the skin or mucous membranes with an exposure of 1-3 minutes 2-3 times a day (on a tampon or by irrigation).

Features of application:

Use for external use only. Do not use the product after the expiration date. If the product accidentally gets into the stomach, it is recommended to drink several glasses of water with the addition of an adsorbent (for example, 10-15 crushed tablets of activated carbon per glass of water). Do not induce vomiting! If necessary, seek medical help.

Contraindications:

Skin-resorptive and sensitizing properties in the recommended modes of use of the product have not been identified. The product has a moderate irritant effect on the mucous membranes of the eyes.

Storage conditions:

Store in tightly closed manufacturer's packaging at temperatures from 0 ºС to +30 °С; away from sources of heat and fire; Avoid storage in direct sunlight. No smoking! Store separately from medications, out of the reach of children. Transportation by any means of transport is allowed in accordance with the rules for the carriage of goods in force for this type of transport, at temperatures from 0 ° C to +30 ° C. The product's shelf life is 2 years in unopened manufacturer's packaging.

Vacation conditions:

Over the counter

Package:

The product is packaged in 25 ml, 50 ml, 100 ml in orange glass bottles. 25 ml, 50 ml, 100 ml, 200 ml, 500 ml, 1000 ml in high-pressure polyethylene bottles with a polymer nozzle, or with a special nozzle with a screw cap, or equipped with a spray pump and a protective polyethylene cap. 5 l each; 10 l; 20 liters in low-density polyethylene canisters (for hospital use).

From this article you will learn:

• Chlorhexidine - use as a mouth and throat rinse,
• pros and cons of the drug, analogues,
• how much does chlorhexidine cost - price in a pharmacy in 2019.

The article was written by a dentist with more than 19 years of experience.

Chlorhexidine or chlorhexidine digluconate (full name) is a broad-spectrum antiseptic that is effective against most pathogenic oral bacteria. Therefore, the drug is widely used both in dentistry and ENT practice - usually in the form of a 0.5% solution. Available without a prescription.

The drug has no age restrictions - with one “but”. In children under 3 years of age, for use in the oral cavity, it can only be used in the form of a spray, or using gauze swabs moistened with an antiseptic solution. At the same time, up to 3 years of age, it is forbidden to spray the tonsils and throat (so that the drug does not enter the respiratory tract) - when treating tonsillitis and pharyngitis.

Chlorhexidine: photos of packaging from different manufacturers

How to rinse your mouth with chlorhexidine -
Chlorhexidine solution for rinsing the mouth and throat is most often used in a 0.05% concentration. The solution is already ready for use, i.e. There is no need to dilute it with water! The standard regimen for mouth rinsing is 2 times a day (after meals and brushing teeth in the morning and evening), for 10 days.

A number of manufacturers produce mouthwash solutions with a chlorhexidine concentration of 0.1-0.2%, and they are certainly stronger. In addition, there are combination preparations in which chlorhexidine is combined either with a second antiseptic (for example, cetylpyridine) or with extracts of medicinal plants. There are also forms of release of chlorhexidine in the form of gels for gums (see examples below).

Chlorhexidine: application in dentistry and ENT

Chlorhexidine solution has one unique property, which makes it the most effective antiseptic for the oral cavity. When rinsing, a thin film of chlorhexidine bigluconate is formed on the surface of the oral mucosa, which continues to act after rinsing for several more hours (on average about 5-7 hours).

Thus, the wide spectrum of action on most pathogenic bacteria and the high residual concentration of this antiseptic make it possible to effectively use it for the following dental and ENT diseases -

Chlorhexidine: price, composition and release forms

Prices are for 2019. You can buy chlorhexidine for only 20-30 rubles - for a 100 ml bottle with a concentration of 0.05%. Chlorhexidine spray, which is produced by the manufacturer YuzhPharm, is somewhat more expensive, and in this case the bottle will be equipped with a spray dispenser (Fig. 4).

In defense, it is worth noting that blackening occurs only on those surfaces of the teeth on which there is a layer of bacterial plaque or tartar (Fig. 5-6). There are also advantages to this - you will immediately notice that it is time for you to go to the dentist for a dental procedure. In addition, the darkening of the teeth will be temporary and will disappear within a few days after the end of the rinsing course.

Chlorhexidine mouth rinse - detailed analysis of indications for use

We have already said that chlorhexidine has very high effectiveness due to its high antimicrobial activity and high residual concentration on the mucous membrane after rinsing. Chlorhexidine instructions for use for the oral cavity include the following main indications for use of the drug...

• After tooth extraction –
  usually after removal, antiseptic rinses are prescribed 2-3 times a day (rinse for 1 minute). Moreover, you need to rinse your mouth not with active movements, but simply put an antiseptic in your mouth and “cheat a little”, because active rinsing movements will almost certainly lead to the loss of a blood clot from the socket of the extracted tooth, and the development of inflammation in the latter.

  After tooth extraction, you should rinse your mouth with chlorhexidine especially in the following cases: 1) if the removal was difficult, 2) if the tooth was removed due to inflammation, 3) if you have carious teeth or dental deposits in your mouth, infection in which can lead to suppuration blood clot in the socket.

• With alveolitis of the socket of an extracted tooth –
  chlorhexidine for mouth rinsing for alveolitis (this is the name for inflammation of the socket of an extracted tooth) is an excellent remedy for its treatment. Normally, the socket after removal is closed by a blood clot (Fig. 8), but if the clot falls out or its necrotic disintegration as a result of inflammation, the socket may look like in Fig. 9.

• After opening the flux –
  If you have an opening on your gum (in common parlance - gumboil) and a drainage has been placed in the incision, then antiseptic rinses are extremely necessary. This is due to the fact that pus will be released from the incision, spreading throughout the entire oral cavity. Antiseptics will help protect the oral mucosa and tonsils from purulent infection. Important: do not rinse too vigorously, because... otherwise the drain may fall out of the incision.

• For inflammation/bleeding gums –
  The main symptoms of gum inflammation are redness, swelling and bleeding. The causes of inflammation are exclusively soft microbial plaque and hard dental deposits (Fig. 12-13). For inflammation of the gums, Chlorhexidine digluconate can and should be used, and more effective treatment results can be achieved by combining such antiseptic rinses with anti-inflammatory applications
  

• For stomatitis(Fig. 14) –
  as we said above: chlorhexidine for stomatitis caused by the herpes virus is completely ineffective, because its antiviral activity practically approaches zero. But for aphthous stomatitis, rinsing with chlorhexidine is used, but again not as the main treatment, but only as part of complex therapy. For the herpetic form of stomatitis, another antiseptic is used that has antiviral activity, called (Fig. 15).

Well, it’s very important -

• Duration of the course of antiseptic rinses –
  A course of mouth rinsing with 0.05% chlorhexidine should not exceed 10-12 days, otherwise you will be guaranteed oral dysbacteriosis. The use of solutions of 0.1-0.2% concentration is no longer than 8-10 days. Long-term use can lead to suppression of even good microflora and, over time, lead to a decrease in the local immunity of the oral mucosa, which will make the mucosa less resistant to the development of stomatitis and fungal infections.

  If you would like to continue the course of antiseptic rinses, then after the end of the 10-day period of using Chlorhexidine, it is better to switch to ones containing fluorides and extracts of medicinal plants. Such rinses will not harm you even with prolonged use.

• Remember that for gum inflammation, Chlorhexidine is effective only as part of complex therapy, and only after removing dental plaque. Don’t make the mistakes of many thousands of people who suppress the symptoms of inflammation with antiseptics and antibiotics, while the inflammation progresses unnoticed. When such people already go to the dentist, there is nothing that can be done to help them except to refer them for removal of loose teeth.

Chlorhexidine during pregnancy, in children -

Chlorhexidine can be used without restrictions during pregnancy and breastfeeding, but preferably in courses of no more than 10 days. The drug is not absorbed into the blood and has only surface activity. Studies have not revealed a negative effect of the drug in these groups of patients. Chlorhexidine in children can also be used in short courses of up to 10 days (there is no age limit).

Important: children under 3 years old do not know how to rinse their mouths and therefore may choke. Therefore, their oral cavity can be treated either with gauze swabs soaked in an antiseptic solution, or using Chlorhexidine spray. However, keep in mind that in children under 3 years of age, the spray can be used to irrigate the mucous membrane of the entire oral cavity, with one exception - you cannot spray the spray into the throat or tonsils. The latter can only be done in children after 3 years of age.

Storage conditions -

• store in a place protected from light at a temperature not exceeding 25°C.
• shelf life: 2 years,
• store in places inaccessible to children,
• do not use after expiration date.
  We hope that our article on the topic: Chlorhexidine bigluconate instructions for use was useful to you!

Sources:

1. Add. professional,
2. Personal experience as a dental surgeon, periodontist,
3. National Library of Medicine (USA),
4. American Academy of Periodontology (USA),
5. Ingredients of the products are taken from the official websites of the manufacturers.